|
HC BIOPSY PENIS DEEP STRUCTURES
|
Facility
|
OP
|
$7,452.33
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
76100348
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$6,334.48
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,844.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cofinity Advantage |
$5,216.63
|
| Rate for Payer: Cofinity Commercial |
$6,409.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,961.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$6,707.10
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,334.48
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,589.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$6,334.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$4,694.97
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,844.01
|
| Rate for Payer: UHC Core |
$3,882.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$2,928.77
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BIOPSY PENIS DEEP STRUCTURES
|
Facility
|
IP
|
$7,452.33
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
76100348
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$4,694.97 |
| Max. Negotiated Rate |
$6,707.10 |
| Rate for Payer: Aetna Commercial |
$6,334.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,844.01
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cofinity Advantage |
$5,216.63
|
| Rate for Payer: Cofinity Commercial |
$6,409.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,961.86
|
| Rate for Payer: Healthscope Commercial |
$6,707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,334.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,589.25
|
| Rate for Payer: PHP Commercial |
$6,334.48
|
| Rate for Payer: Priority Health SBD |
$4,694.97
|
|
|
HC BIOPSY PENIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$4,369.68
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
76100388
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$696.41 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,714.23
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,840.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$696.41
|
| Rate for Payer: BCN Commercial |
$696.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cofinity Advantage |
$3,058.78
|
| Rate for Payer: Cofinity Commercial |
$3,757.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,495.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,932.71
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,714.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,277.26
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,714.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,752.90
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,840.29
|
| Rate for Payer: UHC Core |
$2,276.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,717.28
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY PENIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$4,369.68
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
76100388
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,752.90 |
| Max. Negotiated Rate |
$3,932.71 |
| Rate for Payer: Aetna Commercial |
$3,714.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,840.29
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cofinity Advantage |
$3,058.78
|
| Rate for Payer: Cofinity Commercial |
$3,757.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,495.74
|
| Rate for Payer: Healthscope Commercial |
$3,932.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,714.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,277.26
|
| Rate for Payer: PHP Commercial |
$3,714.23
|
| Rate for Payer: Priority Health SBD |
$2,752.90
|
|
|
HC BIOPSY PLEURA
|
Facility
|
IP
|
$944.37
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
36100048
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.95 |
| Max. Negotiated Rate |
$849.93 |
| Rate for Payer: Aetna Commercial |
$802.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.84
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cofinity Advantage |
$661.06
|
| Rate for Payer: Cofinity Commercial |
$812.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.50
|
| Rate for Payer: Healthscope Commercial |
$849.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.28
|
| Rate for Payer: PHP Commercial |
$802.71
|
| Rate for Payer: Priority Health SBD |
$594.95
|
|
|
HC BIOPSY PLEURA
|
Facility
|
OP
|
$944.37
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
36100048
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.95 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$802.71
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$696.41
|
| Rate for Payer: BCN Commercial |
$696.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cofinity Advantage |
$661.06
|
| Rate for Payer: Cofinity Commercial |
$812.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$849.93
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.71
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.28
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$802.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$594.95
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY PROSTATE
|
Facility
|
IP
|
$2,056.30
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
36100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,295.47 |
| Max. Negotiated Rate |
$1,850.67 |
| Rate for Payer: Aetna Commercial |
$1,747.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.60
|
| Rate for Payer: Cash Price |
$1,645.04
|
| Rate for Payer: Cofinity Advantage |
$1,439.41
|
| Rate for Payer: Cofinity Commercial |
$1,768.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,645.04
|
| Rate for Payer: Healthscope Commercial |
$1,850.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.22
|
| Rate for Payer: PHP Commercial |
$1,747.86
|
| Rate for Payer: Priority Health SBD |
$1,295.47
|
|
|
HC BIOPSY PROSTATE
|
Facility
|
OP
|
$2,056.30
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
36100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.13 |
| Max. Negotiated Rate |
$1,850.67 |
| Rate for Payer: Aetna Commercial |
$1,747.86
|
| Rate for Payer: Aetna Medicare |
$1,028.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.60
|
| Rate for Payer: BCBS Complete |
$822.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.51
|
| Rate for Payer: BCN Commercial |
$1,141.51
|
| Rate for Payer: Cash Price |
$1,645.04
|
| Rate for Payer: Cash Price |
$1,645.04
|
| Rate for Payer: Cofinity Advantage |
$1,439.41
|
| Rate for Payer: Cofinity Commercial |
$1,768.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,645.04
|
| Rate for Payer: Healthscope Commercial |
$1,850.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,645.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.22
|
| Rate for Payer: PHP Commercial |
$1,747.86
|
| Rate for Payer: Priority Health SBD |
$1,295.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,336.60
|
| Rate for Payer: UHC Core |
$1,071.33
|
| Rate for Payer: UHC Exchange |
$808.13
|
|
|
HC BIOPSY PROSTATE EA ADDL CT/MR GUIDED TARGETED LESION
|
Facility
|
IP
|
$2,056.00
|
|
|
Service Code
|
CPT 55715
|
| Hospital Charge Code |
76100565
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,295.28 |
| Max. Negotiated Rate |
$1,850.40 |
| Rate for Payer: Aetna Commercial |
$1,747.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.40
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Advantage |
$1,439.20
|
| Rate for Payer: Cofinity Commercial |
$1,768.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.80
|
| Rate for Payer: Healthscope Commercial |
$1,850.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: PHP Commercial |
$1,747.60
|
| Rate for Payer: Priority Health SBD |
$1,295.28
|
|
|
HC BIOPSY PROSTATE EA ADDL CT/MR GUIDED TARGETED LESION
|
Facility
|
OP
|
$2,056.00
|
|
|
Service Code
|
CPT 55715
|
| Hospital Charge Code |
76100565
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.01 |
| Max. Negotiated Rate |
$1,850.40 |
| Rate for Payer: Aetna Commercial |
$1,747.60
|
| Rate for Payer: Aetna Medicare |
$1,028.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.40
|
| Rate for Payer: BCBS Complete |
$822.40
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Advantage |
$1,439.20
|
| Rate for Payer: Cofinity Commercial |
$1,768.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.80
|
| Rate for Payer: Healthscope Commercial |
$1,850.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,644.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: PHP Commercial |
$1,747.60
|
| Rate for Payer: Priority Health SBD |
$1,295.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,336.40
|
| Rate for Payer: UHC Core |
$1,071.18
|
| Rate for Payer: UHC Exchange |
$808.01
|
|
|
HC BIOPSY PROSTATE TRANSRECT MRI-ULS-FUSION GUIDE TARGET LESION ONLY
|
Facility
|
OP
|
$9,003.00
|
|
|
Service Code
|
CPT 55711
|
| Hospital Charge Code |
76100564
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,851.95
|
| Rate for Payer: UHC Core |
$4,690.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$3,538.18
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC BIOPSY PROSTATE TRANSRECT MRI-ULS-FUSION GUIDE TARGET LESION ONLY
|
Facility
|
IP
|
$9,003.00
|
|
|
Service Code
|
CPT 55711
|
| Hospital Charge Code |
76100564
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,671.89 |
| Max. Negotiated Rate |
$8,102.70 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS GUIDE
|
Facility
|
IP
|
$9,003.00
|
|
|
Service Code
|
CPT 55707
|
| Hospital Charge Code |
76100562
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,671.89 |
| Max. Negotiated Rate |
$8,102.70 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS GUIDE
|
Facility
|
OP
|
$9,003.00
|
|
|
Service Code
|
CPT 55707
|
| Hospital Charge Code |
76100562
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,851.95
|
| Rate for Payer: UHC Core |
$4,690.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$3,538.18
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS W MRI FUSION GUIDE FIRST LESION (SEXTANT)
|
Facility
|
OP
|
$9,003.00
|
|
|
Service Code
|
CPT 55708
|
| Hospital Charge Code |
76100563
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,851.95
|
| Rate for Payer: UHC Core |
$4,690.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$3,538.18
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS W MRI FUSION GUIDE FIRST LESION (SEXTANT)
|
Facility
|
IP
|
$9,003.00
|
|
|
Service Code
|
CPT 55708
|
| Hospital Charge Code |
76100563
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,671.89 |
| Max. Negotiated Rate |
$8,102.70 |
| Rate for Payer: Aetna Commercial |
$7,652.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,851.95
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Advantage |
$6,302.10
|
| Rate for Payer: Cofinity Commercial |
$7,742.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Healthscope Commercial |
$8,102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PHP Commercial |
$7,652.55
|
| Rate for Payer: Priority Health SBD |
$5,671.89
|
|
|
HC BIOPSY RENAL
|
Facility
|
OP
|
$1,822.94
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
36100235
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,549.50
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$871.14
|
| Rate for Payer: BCN Commercial |
$871.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,458.35
|
| Rate for Payer: Cash Price |
$1,458.35
|
| Rate for Payer: Cash Price |
$1,458.35
|
| Rate for Payer: Cofinity Advantage |
$1,276.06
|
| Rate for Payer: Cofinity Commercial |
$1,567.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,640.65
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,549.50
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,367.20
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,549.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,148.45
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY RENAL
|
Facility
|
IP
|
$1,822.94
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
36100235
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,148.45 |
| Max. Negotiated Rate |
$1,640.65 |
| Rate for Payer: Aetna Commercial |
$1,549.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.91
|
| Rate for Payer: Cash Price |
$1,458.35
|
| Rate for Payer: Cofinity Advantage |
$1,276.06
|
| Rate for Payer: Cofinity Commercial |
$1,567.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.35
|
| Rate for Payer: Healthscope Commercial |
$1,640.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,549.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,367.20
|
| Rate for Payer: PHP Commercial |
$1,549.50
|
| Rate for Payer: Priority Health SBD |
$1,148.45
|
|
|
HC BIOPSY SALIVARY GLAND
|
Facility
|
OP
|
$961.81
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
36100189
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$817.54
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$769.45
|
| Rate for Payer: Cash Price |
$769.45
|
| Rate for Payer: Cash Price |
$769.45
|
| Rate for Payer: Cofinity Advantage |
$673.27
|
| Rate for Payer: Cofinity Commercial |
$827.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$865.63
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.54
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.36
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$817.54
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$605.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC BIOPSY SALIVARY GLAND
|
Facility
|
IP
|
$961.81
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
36100189
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$605.94 |
| Max. Negotiated Rate |
$865.63 |
| Rate for Payer: Aetna Commercial |
$817.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.18
|
| Rate for Payer: Cash Price |
$769.45
|
| Rate for Payer: Cofinity Advantage |
$673.27
|
| Rate for Payer: Cofinity Commercial |
$827.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.45
|
| Rate for Payer: Healthscope Commercial |
$865.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.36
|
| Rate for Payer: PHP Commercial |
$817.54
|
| Rate for Payer: Priority Health SBD |
$605.94
|
|
|
HC BIOPSY SALIVARY GLAND INCISIONAL
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 42405
|
| Hospital Charge Code |
76100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,621.81 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,705.04
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Advantage |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: Priority Health SBD |
$2,621.81
|
|
|
HC BIOPSY SALIVARY GLAND INCISIONAL
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 42405
|
| Hospital Charge Code |
76100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,705.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,119.42
|
| Rate for Payer: BCN Commercial |
$1,119.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Advantage |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Mclaren Medicaid |
$808.56
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health SBD |
$2,621.81
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,705.04
|
| Rate for Payer: UHC Core |
$2,168.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$1,635.51
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC BIOPSY SOFT TISSUE FLANK DEEP
|
Facility
|
IP
|
$2,573.23
|
|
|
Service Code
|
CPT 21925
|
| Hospital Charge Code |
36100029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,621.13 |
| Max. Negotiated Rate |
$2,315.91 |
| Rate for Payer: Aetna Commercial |
$2,187.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,672.60
|
| Rate for Payer: Cash Price |
$2,058.58
|
| Rate for Payer: Cofinity Advantage |
$1,801.26
|
| Rate for Payer: Cofinity Commercial |
$2,212.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,058.58
|
| Rate for Payer: Healthscope Commercial |
$2,315.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,187.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.92
|
| Rate for Payer: PHP Commercial |
$2,187.25
|
| Rate for Payer: Priority Health SBD |
$1,621.13
|
|
|
HC BIOPSY SOFT TISSUE FLANK DEEP
|
Facility
|
OP
|
$2,573.23
|
|
|
Service Code
|
CPT 21925
|
| Hospital Charge Code |
36100029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$2,187.25
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,672.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.10
|
| Rate for Payer: BCN Commercial |
$1,018.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,058.58
|
| Rate for Payer: Cash Price |
$2,058.58
|
| Rate for Payer: Cash Price |
$2,058.58
|
| Rate for Payer: Cofinity Advantage |
$1,801.26
|
| Rate for Payer: Cofinity Commercial |
$2,212.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,058.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,315.91
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,187.25
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.92
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,187.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,621.13
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY SOFT TISSUE NECK THORAX
|
Facility
|
IP
|
$1,698.82
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
36100028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.26 |
| Max. Negotiated Rate |
$1,528.94 |
| Rate for Payer: Aetna Commercial |
$1,444.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,104.23
|
| Rate for Payer: Cash Price |
$1,359.06
|
| Rate for Payer: Cofinity Advantage |
$1,189.17
|
| Rate for Payer: Cofinity Commercial |
$1,460.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.06
|
| Rate for Payer: Healthscope Commercial |
$1,528.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,444.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,274.12
|
| Rate for Payer: PHP Commercial |
$1,444.00
|
| Rate for Payer: Priority Health SBD |
$1,070.26
|
|
