|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,272.08 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$3,065.51
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cofinity Commercial |
$3,101.57
|
| Rate for Payer: Cofinity Commercial |
$2,524.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,524.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,245.83
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,065.51
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,272.08
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,272.08 |
| Max. Negotiated Rate |
$3,245.83 |
| Rate for Payer: Aetna Commercial |
$3,065.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.21
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cofinity Commercial |
$2,524.54
|
| Rate for Payer: Cofinity Commercial |
$3,101.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,524.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.18
|
| Rate for Payer: Healthscope Commercial |
$3,245.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: PHP Commercial |
$3,065.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: Priority Health SBD |
$2,272.08
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,069.85 |
| Max. Negotiated Rate |
$2,956.93 |
| Rate for Payer: Aetna Commercial |
$2,792.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,135.56
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$2,299.84
|
| Rate for Payer: Cofinity Commercial |
$2,825.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,299.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Healthscope Commercial |
$2,956.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: PHP Commercial |
$2,792.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: Priority Health SBD |
$2,069.85
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna Commercial |
$2,792.66
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,135.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$2,825.51
|
| Rate for Payer: Cofinity Commercial |
$2,299.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,299.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$2,956.93
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$2,792.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$2,069.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,937.74
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$1,857.03
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$1,878.88
|
| Rate for Payer: Cofinity Commercial |
$1,529.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,529.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,966.27
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.03
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,857.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.08
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,376.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$852.97
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,376.39 |
| Max. Negotiated Rate |
$1,966.27 |
| Rate for Payer: Aetna Commercial |
$1,857.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.08
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$1,529.32
|
| Rate for Payer: Cofinity Commercial |
$1,878.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,529.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Healthscope Commercial |
$1,966.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.03
|
| Rate for Payer: PHP Commercial |
$1,857.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.08
|
| Rate for Payer: Priority Health SBD |
$1,376.39
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,787.51 |
| Rate for Payer: Aetna Commercial |
$1,688.20
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,290.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,708.06
|
| Rate for Payer: Cofinity Commercial |
$1,390.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,390.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$1,787.51
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$1,688.20
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$1,251.26
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$339.48
|
| Rate for Payer: VA VA |
$602.98
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
IP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,251.26 |
| Max. Negotiated Rate |
$1,787.51 |
| Rate for Payer: Aetna Commercial |
$1,688.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,290.98
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,390.28
|
| Rate for Payer: Cofinity Commercial |
$1,708.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,390.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Healthscope Commercial |
$1,787.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: PHP Commercial |
$1,688.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: Priority Health SBD |
$1,251.26
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,760.19 |
| Max. Negotiated Rate |
$88,019.16 |
| Rate for Payer: Aetna Commercial |
$72,163.76
|
| Rate for Payer: Aetna Medicare |
$32,519.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55,184.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,086.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,086.28
|
| Rate for Payer: BCBS Complete |
$17,598.20
|
| Rate for Payer: BCBS MAPPO |
$31,269.02
|
| Rate for Payer: BCN Medicare Advantage |
$31,269.02
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$59,428.98
|
| Rate for Payer: Cofinity Commercial |
$73,012.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$59,428.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,269.02
|
| Rate for Payer: Healthscope Commercial |
$76,408.69
|
| Rate for Payer: Mclaren Medicaid |
$16,760.19
|
| Rate for Payer: Mclaren Medicare |
$31,269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,832.47
|
| Rate for Payer: Meridian Medicaid |
$17,598.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,959.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: PACE Medicare |
$29,705.57
|
| Rate for Payer: PACE SWMI |
$31,269.02
|
| Rate for Payer: PHP Commercial |
$72,163.76
|
| Rate for Payer: PHP Medicare Advantage |
$31,269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: Priority Health Medicare |
$31,269.02
|
| Rate for Payer: Priority Health SBD |
$53,486.08
|
| Rate for Payer: Railroad Medicare Medicare |
$31,269.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88,019.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,269.02
|
| Rate for Payer: UHC Medicare Advantage |
$31,269.02
|
| Rate for Payer: UHCCP Medicaid |
$17,604.46
|
| Rate for Payer: VA VA |
$31,269.02
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$53,486.08 |
| Max. Negotiated Rate |
$76,408.69 |
| Rate for Payer: Aetna Commercial |
$72,163.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55,184.05
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$59,428.98
|
| Rate for Payer: Cofinity Commercial |
$73,012.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$59,428.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Healthscope Commercial |
$76,408.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: PHP Commercial |
$72,163.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: Priority Health SBD |
$53,486.08
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.36
|
| Rate for Payer: Cofinity Commercial |
$129.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$166.77
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$157.50
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$116.74
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.74 |
| Max. Negotiated Rate |
$166.77 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.44
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$129.71
|
| Rate for Payer: Cofinity Commercial |
$159.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Healthscope Commercial |
$166.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: PHP Commercial |
$157.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: Priority Health SBD |
$116.74
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$3,465.44
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,650.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,506.21
|
| Rate for Payer: Cofinity Commercial |
$2,853.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,853.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,669.29
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,465.44
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,568.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,568.50 |
| Max. Negotiated Rate |
$3,669.29 |
| Rate for Payer: Aetna Commercial |
$3,465.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,650.04
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$2,853.89
|
| Rate for Payer: Cofinity Commercial |
$3,506.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,853.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Healthscope Commercial |
$3,669.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: PHP Commercial |
$3,465.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: Priority Health SBD |
$2,568.50
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,607.92 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$3,518.63
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,690.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,560.02
|
| Rate for Payer: Cofinity Commercial |
$2,897.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,897.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,725.60
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,518.63
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,607.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,607.92 |
| Max. Negotiated Rate |
$3,725.60 |
| Rate for Payer: Aetna Commercial |
$3,518.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,690.71
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$2,897.69
|
| Rate for Payer: Cofinity Commercial |
$3,560.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,897.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Healthscope Commercial |
$3,725.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: PHP Commercial |
$3,518.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: Priority Health SBD |
$2,607.92
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$238.59 |
| Rate for Payer: Aetna Commercial |
$225.34
|
| Rate for Payer: Aetna Medicare |
$132.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.31
|
| Rate for Payer: BCBS Complete |
$106.04
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$185.57
|
| Rate for Payer: Cofinity Commercial |
$227.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$185.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: PHP Commercial |
$225.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.31
|
| Rate for Payer: Priority Health SBD |
$167.01
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$167.01 |
| Max. Negotiated Rate |
$238.59 |
| Rate for Payer: Aetna Commercial |
$225.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.31
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$185.57
|
| Rate for Payer: Cofinity Commercial |
$227.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$185.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: PHP Commercial |
$225.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.31
|
| Rate for Payer: Priority Health SBD |
$167.01
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
IP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$412.93 |
| Max. Negotiated Rate |
$589.90 |
| Rate for Payer: Aetna Commercial |
$557.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.04
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$458.81
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$458.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Healthscope Commercial |
$589.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: PHP Commercial |
$557.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health SBD |
$412.93
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
OP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.58 |
| Max. Negotiated Rate |
$589.90 |
| Rate for Payer: Aetna Commercial |
$557.13
|
| Rate for Payer: Aetna Medicare |
$173.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$458.81
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$458.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$589.90
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$557.13
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health SBD |
$412.93
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$94.09
|
| Rate for Payer: VA VA |
$167.12
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
IP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$470.31 |
| Max. Negotiated Rate |
$671.88 |
| Rate for Payer: Aetna Commercial |
$634.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.24
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$522.57
|
| Rate for Payer: Cofinity Commercial |
$642.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$522.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Healthscope Commercial |
$671.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: PHP Commercial |
$634.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health SBD |
$470.31
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
OP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna Commercial |
$634.55
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$642.02
|
| Rate for Payer: Cofinity Commercial |
$522.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$522.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$671.88
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$634.55
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$470.31
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$366.50
|
| Rate for Payer: VA VA |
$650.97
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
IP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$420.15 |
| Max. Negotiated Rate |
$600.21 |
| Rate for Payer: Aetna Commercial |
$566.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.49
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$466.83
|
| Rate for Payer: Cofinity Commercial |
$573.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Healthscope Commercial |
$600.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.87
|
| Rate for Payer: PHP Commercial |
$566.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| Rate for Payer: Priority Health SBD |
$420.15
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
OP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna Commercial |
$566.87
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$573.53
|
| Rate for Payer: Cofinity Commercial |
$466.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$600.21
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.87
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$566.87
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$420.15
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$133.54
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC INSULIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
|
