|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$351.10 |
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: Aetna Medicare |
$118.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.08
|
| Rate for Payer: BCBS Complete |
$65.29
|
| Rate for Payer: BCBS MAPPO |
$113.66
|
| Rate for Payer: BCBS Trust/PPO |
$72.58
|
| Rate for Payer: BCN Medicare Advantage |
$113.66
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$140.12
|
| Rate for Payer: Cofinity Commercial |
$114.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.66
|
| Rate for Payer: Healthscope Commercial |
$146.64
|
| Rate for Payer: Mclaren Medicaid |
$62.17
|
| Rate for Payer: Mclaren Medicare |
$113.66
|
| Rate for Payer: Meridian Medicaid |
$65.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PACE Medicare |
$107.98
|
| Rate for Payer: PACE SWMI |
$113.66
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: PHP Medicare Advantage |
$113.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$351.10
|
| Rate for Payer: Priority Health Medicare |
$113.66
|
| Rate for Payer: Priority Health Narrow Network |
$280.88
|
| Rate for Payer: Priority Health SBD |
$102.65
|
| Rate for Payer: Railroad Medicare Medicare |
$113.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.66
|
| Rate for Payer: UHC Exchange |
$61.23
|
| Rate for Payer: UHC Medicare Advantage |
$117.07
|
| Rate for Payer: VA VA |
$113.66
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$892.88 |
| Max. Negotiated Rate |
$1,275.54 |
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.23
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Cofinity Commercial |
$992.09
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health SBD |
$892.88
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.17 |
| Max. Negotiated Rate |
$5,222.22 |
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: Aetna Medicare |
$1,760.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,116.40
|
| Rate for Payer: BCBS Complete |
$972.53
|
| Rate for Payer: BCBS MAPPO |
$1,693.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.12
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$992.09
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.12
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Mclaren Medicaid |
$926.14
|
| Rate for Payer: Mclaren Medicare |
$1,693.12
|
| Rate for Payer: Meridian Medicaid |
$972.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,777.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,947.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PACE Medicare |
$1,608.46
|
| Rate for Payer: PACE SWMI |
$1,693.12
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,222.22
|
| Rate for Payer: Priority Health Medicare |
$1,693.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,177.77
|
| Rate for Payer: Priority Health SBD |
$892.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.59
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.12
|
| Rate for Payer: UHC Exchange |
$194.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,743.91
|
| Rate for Payer: VA VA |
$1,693.12
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$422.51 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.11
|
| Rate for Payer: BCBS Complete |
$148.99
|
| Rate for Payer: BCBS Trust/PPO |
$422.51
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health SBD |
$234.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.03
|
| Rate for Payer: UHC Exchange |
$49.12
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.66 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.11
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health SBD |
$234.66
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,572.25 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.53 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,862.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$81.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,572.25 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.21 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$374.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.33
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$81.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,829.82 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.19 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,645.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.61
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$304.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,829.82 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.13 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.74
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$326.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.36 |
| Max. Negotiated Rate |
$4,461.38 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$1,482.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,781.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,781.30
|
| Rate for Payer: BCBS Complete |
$818.54
|
| Rate for Payer: BCBS MAPPO |
$1,425.04
|
| Rate for Payer: BCBS Trust/PPO |
$621.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,425.04
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,425.04
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Mclaren Medicaid |
$779.50
|
| Rate for Payer: Mclaren Medicare |
$1,425.04
|
| Rate for Payer: Meridian Medicaid |
$818.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,496.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,638.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PACE Medicare |
$1,353.79
|
| Rate for Payer: PACE SWMI |
$1,425.04
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,425.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,461.38
|
| Rate for Payer: Priority Health Medicare |
$1,425.04
|
| Rate for Payer: Priority Health Narrow Network |
$3,569.10
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,425.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.50
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,425.04
|
| Rate for Payer: UHC Exchange |
$91.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.79
|
| Rate for Payer: VA VA |
$1,425.04
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,062.38 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$4,461.38 |
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: Aetna Medicare |
$1,482.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,781.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,781.30
|
| Rate for Payer: BCBS Complete |
$818.54
|
| Rate for Payer: BCBS MAPPO |
$1,425.04
|
| Rate for Payer: BCBS Trust/PPO |
$374.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,425.04
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,127.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,425.04
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Mclaren Medicaid |
$779.50
|
| Rate for Payer: Mclaren Medicare |
$1,425.04
|
| Rate for Payer: Meridian Medicaid |
$818.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,496.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,638.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PACE Medicare |
$1,353.79
|
| Rate for Payer: PACE SWMI |
$1,425.04
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,425.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,461.38
|
| Rate for Payer: Priority Health Medicare |
$1,425.04
|
| Rate for Payer: Priority Health Narrow Network |
$3,569.10
|
| Rate for Payer: Priority Health SBD |
$1,014.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,425.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.25
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,425.04
|
| Rate for Payer: UHC Exchange |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.79
|
| Rate for Payer: VA VA |
$1,425.04
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,014.33 |
| Max. Negotiated Rate |
$1,449.04 |
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.53
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,127.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health SBD |
$1,014.33
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.30 |
| Max. Negotiated Rate |
$4,378.42 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$1,482.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,781.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,781.30
|
| Rate for Payer: BCBS Complete |
$818.54
|
| Rate for Payer: BCBS MAPPO |
$1,425.04
|
| Rate for Payer: BCBS Trust/PPO |
$486.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,425.04
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,425.04
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Mclaren Medicaid |
$779.50
|
| Rate for Payer: Mclaren Medicare |
$1,425.04
|
| Rate for Payer: Meridian Medicaid |
$818.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,496.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,638.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Medicare |
$1,353.79
|
| Rate for Payer: PACE SWMI |
$1,425.04
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,425.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,378.42
|
| Rate for Payer: Priority Health Medicare |
$1,425.04
|
| Rate for Payer: Priority Health Narrow Network |
$3,502.74
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,425.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,425.04
|
| Rate for Payer: UHC Exchange |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.79
|
| Rate for Payer: VA VA |
$1,425.04
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$963.90 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.02 |
| Max. Negotiated Rate |
$15,411.76 |
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: Aetna Medicare |
$5,085.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,112.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,112.15
|
| Rate for Payer: BCBS Complete |
$2,808.66
|
| Rate for Payer: BCBS MAPPO |
$4,889.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,534.33
|
| Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$2,475.03
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Mclaren Medicaid |
$2,674.68
|
| Rate for Payer: Mclaren Medicare |
$4,889.72
|
| Rate for Payer: Meridian Medicaid |
$2,808.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,134.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,623.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PACE Medicare |
$4,645.23
|
| Rate for Payer: PACE SWMI |
$4,889.72
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,889.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,674.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,411.76
|
| Rate for Payer: Priority Health Medicare |
$4,889.72
|
| Rate for Payer: Priority Health Narrow Network |
$12,329.41
|
| Rate for Payer: Priority Health SBD |
$2,227.53
|
| Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.12
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
| Rate for Payer: UHC Exchange |
$351.02
|
| Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
| Rate for Payer: VA VA |
$4,889.72
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,227.53 |
| Max. Negotiated Rate |
$3,182.18 |
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.24
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$2,475.03
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health SBD |
$2,227.53
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,029.27 |
| Max. Negotiated Rate |
$2,898.95 |
| Rate for Payer: Aetna Commercial |
$2,737.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,093.69
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$2,254.74
|
| Rate for Payer: Cofinity Commercial |
$2,770.11
|
| Rate for Payer: Healthscope Commercial |
$2,898.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PHP Commercial |
$2,737.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health SBD |
$2,029.27
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.47 |
| Max. Negotiated Rate |
$9,906.28 |
| Rate for Payer: Aetna Commercial |
$2,737.90
|
| Rate for Payer: Aetna Medicare |
$3,201.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,093.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,847.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,847.99
|
| Rate for Payer: BCBS Complete |
$1,768.23
|
| Rate for Payer: BCBS MAPPO |
$3,078.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,078.39
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$2,254.74
|
| Rate for Payer: Cofinity Commercial |
$2,770.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,078.39
|
| Rate for Payer: Healthscope Commercial |
$2,898.95
|
| Rate for Payer: Mclaren Medicaid |
$1,683.88
|
| Rate for Payer: Mclaren Medicare |
$3,078.39
|
| Rate for Payer: Meridian Medicaid |
$1,768.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,232.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,540.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PACE Medicare |
$2,924.47
|
| Rate for Payer: PACE SWMI |
$3,078.39
|
| Rate for Payer: PHP Commercial |
$2,737.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,078.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,906.28
|
| Rate for Payer: Priority Health Medicare |
$3,078.39
|
| Rate for Payer: Priority Health Narrow Network |
$7,925.02
|
| Rate for Payer: Priority Health SBD |
$2,029.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,078.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,078.39
|
| Rate for Payer: UHC Exchange |
$196.47
|
| Rate for Payer: UHC Medicare Advantage |
$3,170.74
|
| Rate for Payer: VA VA |
$3,078.39
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,349.40 |
| Max. Negotiated Rate |
$1,927.71 |
| Rate for Payer: Aetna Commercial |
$1,820.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.24
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$1,499.33
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Healthscope Commercial |
$1,927.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: PHP Commercial |
$1,820.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: Priority Health SBD |
$1,349.40
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.90 |
| Max. Negotiated Rate |
$4,461.38 |
| Rate for Payer: Aetna Commercial |
$1,820.62
|
| Rate for Payer: Aetna Medicare |
$1,482.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,781.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,781.30
|
| Rate for Payer: BCBS Complete |
$818.54
|
| Rate for Payer: BCBS MAPPO |
$1,425.04
|
| Rate for Payer: BCBS Trust/PPO |
$657.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,425.04
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$1,499.33
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,425.04
|
| Rate for Payer: Healthscope Commercial |
$1,927.71
|
| Rate for Payer: Mclaren Medicaid |
$779.50
|
| Rate for Payer: Mclaren Medicare |
$1,425.04
|
| Rate for Payer: Meridian Medicaid |
$818.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,496.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,638.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: PACE Medicare |
$1,353.79
|
| Rate for Payer: PACE SWMI |
$1,425.04
|
| Rate for Payer: PHP Commercial |
$1,820.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,425.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,461.38
|
| Rate for Payer: Priority Health Medicare |
$1,425.04
|
| Rate for Payer: Priority Health Narrow Network |
$3,569.10
|
| Rate for Payer: Priority Health SBD |
$1,349.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,425.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.89
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,425.04
|
| Rate for Payer: UHC Exchange |
$79.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.79
|
| Rate for Payer: VA VA |
$1,425.04
|
|
