|
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 Commercial |
$269.89
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.89
|
| 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: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health SBD |
$242.90
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$215.42 |
| 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: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$376.99
|
| 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: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: Priority Health SBD |
$339.29
|
|
|
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 Commercial |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$376.99
|
| 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: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: Priority Health SBD |
$339.29
|
|
|
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 Commercial |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.39
|
| 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: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: Priority Health SBD |
$579.05
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.65 |
| 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: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.39
|
| 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: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: Priority Health SBD |
$579.05
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,640.30
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,783.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$3,683.13
|
| Rate for Payer: Cofinity Commercial |
$2,997.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,997.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,854.44
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,640.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,698.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,698.11 |
| Max. Negotiated Rate |
$3,854.44 |
| Rate for Payer: Aetna Commercial |
$3,640.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,783.76
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$2,997.90
|
| Rate for Payer: Cofinity Commercial |
$3,683.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,997.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Healthscope Commercial |
$3,854.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: PHP Commercial |
$3,640.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: Priority Health SBD |
$2,698.11
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$327.73
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.73 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health SBD |
$327.73
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,319.52 |
| Max. Negotiated Rate |
$1,885.03 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.41
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,466.14
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,466.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health SBD |
$1,319.52
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$837.79 |
| Max. Negotiated Rate |
$1,885.03 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: Aetna Medicare |
$1,047.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.41
|
| Rate for Payer: BCBS Complete |
$837.79
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,466.14
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,466.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health SBD |
$1,319.52
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,687.35 |
| Max. Negotiated Rate |
$3,839.08 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,772.67
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$2,985.95
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,985.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health SBD |
$2,687.35
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,772.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Cofinity Commercial |
$2,985.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,985.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,687.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,986.77 |
| Max. Negotiated Rate |
$2,838.24 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,049.84
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,207.52
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health SBD |
$1,986.77
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,049.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Cofinity Commercial |
$2,207.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,986.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,349.51 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$2,857.19 |
| Rate for Payer: Aetna Commercial |
$2,698.46
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,222.26
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,222.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$2,857.19
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$2,698.46
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$2,000.04
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,000.04 |
| Max. Negotiated Rate |
$2,857.19 |
| Rate for Payer: Aetna Commercial |
$2,698.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.53
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,222.26
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,222.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Healthscope Commercial |
$2,857.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: PHP Commercial |
$2,698.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: Priority Health SBD |
$2,000.04
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,560.58 |
| Max. Negotiated Rate |
$3,657.98 |
| Rate for Payer: Aetna Commercial |
$3,454.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.87
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$2,845.09
|
| Rate for Payer: Cofinity Commercial |
$3,495.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,845.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Healthscope Commercial |
$3,657.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: PHP Commercial |
$3,454.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: Priority Health SBD |
$2,560.58
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,454.76
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$3,495.40
|
| Rate for Payer: Cofinity Commercial |
$2,845.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,845.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,657.98
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,454.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,560.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,866.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,579.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,579.85 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,866.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: Priority Health SBD |
$2,579.85
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$611.53 |
| Max. Negotiated Rate |
$873.62 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health SBD |
$611.53
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$611.53
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
