|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: Aetna Medicare |
$795.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.50
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Advantage |
$1,113.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,272.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: Priority Health SBD |
$1,001.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.50
|
| Rate for Payer: UHC Core |
$828.39
|
| Rate for Payer: UHC Exchange |
$624.87
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna Medicare |
$116.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.16
|
| Rate for Payer: BCBS Complete |
$93.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Advantage |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health SBD |
$146.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.16
|
| Rate for Payer: UHC Core |
$121.16
|
| Rate for Payer: UHC Exchange |
$91.40
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.51 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.16
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Advantage |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health SBD |
$146.51
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna Medicare |
$192.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.61
|
| Rate for Payer: BCBS Complete |
$154.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Advantage |
$269.89
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health SBD |
$242.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.61
|
| Rate for Payer: UHC Core |
$200.88
|
| Rate for Payer: UHC Exchange |
$151.53
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.90 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.61
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Advantage |
$269.89
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health SBD |
$242.90
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
IP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,199.33 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.15
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Advantage |
$2,443.70
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: Priority Health SBD |
$2,199.33
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
OP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: Aetna Medicare |
$1,745.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.15
|
| Rate for Payer: BCBS Complete |
$1,396.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Advantage |
$2,443.70
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,792.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: Priority Health SBD |
$2,199.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,269.15
|
| Rate for Payer: UHC Core |
$1,818.81
|
| Rate for Payer: UHC Exchange |
$1,371.96
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.29 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.06
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Advantage |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health SBD |
$339.29
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna Medicare |
$269.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.06
|
| Rate for Payer: BCBS Complete |
$215.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Advantage |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$430.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health SBD |
$339.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.06
|
| Rate for Payer: UHC Core |
$280.59
|
| Rate for Payer: UHC Exchange |
$211.65
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna Medicare |
$459.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.43
|
| Rate for Payer: BCBS Complete |
$367.65
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Advantage |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$735.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health SBD |
$579.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.43
|
| Rate for Payer: UHC Core |
$478.87
|
| Rate for Payer: UHC Exchange |
$361.22
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$579.05 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.43
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Advantage |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health SBD |
$579.05
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,752.07 |
| Max. Negotiated Rate |
$3,931.52 |
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,839.43
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Advantage |
$3,057.85
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| Rate for Payer: Priority Health SBD |
$2,752.07
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$678.23 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,839.43
|
| 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 |
$678.23
|
| Rate for Payer: BCN Commercial |
$678.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Advantage |
$3,057.85
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| 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 |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| 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 |
$2,752.07
|
| 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) |
$2,839.43
|
| Rate for Payer: UHC Core |
$2,275.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,716.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$175.41
|
| Rate for Payer: BCN Commercial |
$175.41
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Advantage |
$371.42
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Mclaren Medicaid |
$104.55
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$334.28
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.89
|
| Rate for Payer: UHC Core |
$276.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$208.53
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.28 |
| Max. Negotiated Rate |
$477.54 |
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.89
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Advantage |
$371.42
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: Priority Health SBD |
$334.28
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,345.91 |
| Max. Negotiated Rate |
$1,922.73 |
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.64
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Advantage |
$1,495.46
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: Priority Health SBD |
$1,345.91
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$854.55 |
| Max. Negotiated Rate |
$1,922.73 |
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: Aetna Medicare |
$1,068.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.64
|
| Rate for Payer: BCBS Complete |
$854.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.88
|
| Rate for Payer: BCN Commercial |
$1,840.88
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Advantage |
$1,495.46
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,709.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: Priority Health SBD |
$1,345.91
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,350.95
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,741.10 |
| Max. Negotiated Rate |
$3,915.86 |
| Rate for Payer: Aetna Commercial |
$3,698.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,828.12
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cofinity Advantage |
$3,045.66
|
| Rate for Payer: Cofinity Commercial |
$3,741.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.76
|
| Rate for Payer: Healthscope Commercial |
$3,915.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,698.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,263.21
|
| Rate for Payer: PHP Commercial |
$3,698.31
|
| Rate for Payer: Priority Health SBD |
$2,741.10
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,350.95
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,698.31
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,828.12
|
| 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 |
$1,277.87
|
| Rate for Payer: BCN Commercial |
$1,277.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cofinity Advantage |
$3,045.66
|
| Rate for Payer: Cofinity Commercial |
$3,741.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,915.86
|
| 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 |
$3,698.31
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,263.21
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,698.31
|
| 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 |
$2,741.10
|
| 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 DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,216.67
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,026.50 |
| Max. Negotiated Rate |
$2,895.00 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,090.84
|
| Rate for Payer: Cash Price |
$2,573.34
|
| Rate for Payer: Cofinity Advantage |
$2,251.67
|
| Rate for Payer: Cofinity Commercial |
$2,766.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,573.34
|
| Rate for Payer: Healthscope Commercial |
$2,895.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,734.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,412.50
|
| Rate for Payer: PHP Commercial |
$2,734.17
|
| Rate for Payer: Priority Health SBD |
$2,026.50
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,216.67
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$696.41 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,090.84
|
| 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 |
$2,573.34
|
| Rate for Payer: Cash Price |
$2,573.34
|
| Rate for Payer: Cash Price |
$2,573.34
|
| Rate for Payer: Cofinity Advantage |
$2,251.67
|
| Rate for Payer: Cofinity Commercial |
$2,766.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,573.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,895.00
|
| 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 |
$2,734.17
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,412.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,734.17
|
| 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 |
$2,026.50
|
| 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 DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$596.92 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| 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 |
$596.92
|
| Rate for Payer: BCN Commercial |
$596.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| 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 |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| 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 |
$1,376.50
|
| 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) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,238.15
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,040.03 |
| Max. Negotiated Rate |
$2,914.34 |
| Rate for Payer: Aetna Commercial |
$2,752.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,104.80
|
| Rate for Payer: Cash Price |
$2,590.52
|
| Rate for Payer: Cofinity Advantage |
$2,266.70
|
| Rate for Payer: Cofinity Commercial |
$2,784.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.52
|
| Rate for Payer: Healthscope Commercial |
$2,914.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,752.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.61
|
| Rate for Payer: PHP Commercial |
$2,752.43
|
| Rate for Payer: Priority Health SBD |
$2,040.03
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,238.15
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,914.34 |
| Rate for Payer: Aetna Commercial |
$2,752.43
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,104.80
|
| 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 |
$667.78
|
| Rate for Payer: BCN Commercial |
$667.78
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$2,590.52
|
| Rate for Payer: Cash Price |
$2,590.52
|
| Rate for Payer: Cash Price |
$2,590.52
|
| Rate for Payer: Cofinity Advantage |
$2,266.70
|
| Rate for Payer: Cofinity Commercial |
$2,784.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$2,914.34
|
| 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 |
$2,752.43
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.61
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$2,752.43
|
| 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 |
$2,040.03
|
| 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
|
|
