|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.35 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$131.35
|
| Rate for Payer: BCN Commercial |
$131.35
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Advantage |
$801.11
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Mclaren Medicaid |
$232.80
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$721.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.89
|
| Rate for Payer: UHC Core |
$596.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$449.76
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: VA VA |
$445.12
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$721.00 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.89
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Advantage |
$801.11
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health SBD |
$721.00
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.49 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$55.49
|
| Rate for Payer: BCN Commercial |
$55.49
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Advantage |
$254.90
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$229.41
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.69
|
| Rate for Payer: UHC Core |
$189.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$143.11
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$229.41 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.69
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Advantage |
$254.90
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health SBD |
$229.41
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
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 REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| 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 |
$1,188.59
|
| Rate for Payer: BCN Commercial |
$1,188.59
|
| 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 REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$4,408.01
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,370.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,539.75
|
| Rate for Payer: BCN Commercial |
$1,539.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Advantage |
$3,630.12
|
| Rate for Payer: Cofinity Commercial |
$4,459.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$4,667.30
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$4,408.01
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$3,267.11
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,370.83
|
| Rate for Payer: UHC Core |
$2,701.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Exchange |
$2,038.05
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,267.11 |
| Max. Negotiated Rate |
$4,667.30 |
| Rate for Payer: Aetna Commercial |
$4,408.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,370.83
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Advantage |
$3,630.12
|
| Rate for Payer: Cofinity Commercial |
$4,459.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Healthscope Commercial |
$4,667.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: PHP Commercial |
$4,408.01
|
| Rate for Payer: Priority Health SBD |
$3,267.11
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,847.60 |
| Max. Negotiated Rate |
$12,041.54 |
| Rate for Payer: Aetna Commercial |
$2,732.86
|
| Rate for Payer: Aetna Medicare |
$3,872.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,089.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,847.60
|
| Rate for Payer: BCN Commercial |
$1,847.60
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Advantage |
$2,250.59
|
| Rate for Payer: Cofinity Commercial |
$2,765.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$2,893.62
|
| Rate for Payer: Mclaren Medicaid |
$1,947.40
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$3,909.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Nomi Health Commercial |
$11,170.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$2,732.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,041.54
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health SBD |
$2,025.53
|
| Rate for Payer: Priority Health Tiered Network |
$9,633.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: VA VA |
$3,723.52
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,025.53 |
| Max. Negotiated Rate |
$2,893.62 |
| Rate for Payer: Aetna Commercial |
$2,732.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,089.83
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Advantage |
$2,250.59
|
| Rate for Payer: Cofinity Commercial |
$2,765.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Healthscope Commercial |
$2,893.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: PHP Commercial |
$2,732.86
|
| Rate for Payer: Priority Health SBD |
$2,025.53
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,228.08 |
| Max. Negotiated Rate |
$26,665.62 |
| Rate for Payer: Aetna Commercial |
$3,006.14
|
| Rate for Payer: Aetna Medicare |
$8,575.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$5,428.91
|
| Rate for Payer: BCN Commercial |
$5,428.91
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Advantage |
$2,475.65
|
| Rate for Payer: Cofinity Commercial |
$3,041.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$3,182.98
|
| Rate for Payer: Mclaren Medicaid |
$4,312.46
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$8,657.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Nomi Health Commercial |
$24,736.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$3,006.14
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,665.62
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health SBD |
$2,228.08
|
| Rate for Payer: Priority Health Tiered Network |
$21,332.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: VA VA |
$8,245.63
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,228.08 |
| Max. Negotiated Rate |
$3,182.98 |
| Rate for Payer: Aetna Commercial |
$3,006.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.82
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Advantage |
$2,475.65
|
| Rate for Payer: Cofinity Commercial |
$3,041.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Healthscope Commercial |
$3,182.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: PHP Commercial |
$3,006.14
|
| Rate for Payer: Priority Health SBD |
$2,228.08
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.76 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$142.76
|
| Rate for Payer: BCN Commercial |
$142.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Mclaren Medicaid |
$1,727.75
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,178.07 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,744.70 |
| Max. Negotiated Rate |
$2,492.42 |
| Rate for Payer: Aetna Commercial |
$2,353.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,800.08
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Advantage |
$1,938.55
|
| Rate for Payer: Cofinity Commercial |
$2,381.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Healthscope Commercial |
$2,492.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: PHP Commercial |
$2,353.96
|
| Rate for Payer: Priority Health SBD |
$1,744.70
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,007.00 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Commercial |
$2,353.96
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,800.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.00
|
| Rate for Payer: BCN Commercial |
$1,007.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Advantage |
$1,938.55
|
| Rate for Payer: Cofinity Commercial |
$2,381.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,492.42
|
| Rate for Payer: Mclaren Medicaid |
$1,089.34
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,353.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$1,744.70
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,800.08
|
| Rate for Payer: UHC Core |
$1,442.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$1,088.36
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
OP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$417.18 |
| Max. Negotiated Rate |
$1,256.73 |
| Rate for Payer: Aetna Commercial |
$1,186.91
|
| Rate for Payer: Aetna Medicare |
$698.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.64
|
| Rate for Payer: BCBS Complete |
$558.55
|
| Rate for Payer: BCBS Trust/PPO |
$417.18
|
| Rate for Payer: BCN Commercial |
$417.18
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Advantage |
$977.46
|
| Rate for Payer: Cofinity Commercial |
$1,200.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,256.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,117.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: PHP Commercial |
$1,186.91
|
| Rate for Payer: Priority Health SBD |
$879.71
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
IP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$879.71 |
| Max. Negotiated Rate |
$1,256.73 |
| Rate for Payer: Aetna Commercial |
$1,186.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.64
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Advantage |
$977.46
|
| Rate for Payer: Cofinity Commercial |
$1,200.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,256.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: PHP Commercial |
$1,186.91
|
| Rate for Payer: Priority Health SBD |
$879.71
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,178.07 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.14 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$239.14
|
| Rate for Payer: BCN Commercial |
$239.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Mclaren Medicaid |
$1,727.75
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.57 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$64.57
|
| Rate for Payer: BCN Commercial |
$64.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Advantage |
$3,641.40
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Mclaren Medicaid |
$1,075.21
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$3,277.26
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.30
|
| Rate for Payer: UHC Core |
$2,710.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$2,044.39
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,277.26 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.30
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Advantage |
$3,641.40
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: Priority Health SBD |
$3,277.26
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$722.93 |
| Max. Negotiated Rate |
$1,032.76 |
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.88
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Advantage |
$803.26
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: Priority Health SBD |
$722.93
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$626.50
|
| Rate for Payer: BCN Commercial |
$626.50
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Advantage |
$803.26
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Mclaren Medicaid |
$326.90
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$722.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.88
|
| Rate for Payer: UHC Core |
$597.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$450.97
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,854.89
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,183.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,807.79
|
| Rate for Payer: BCN Commercial |
$1,807.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Advantage |
$2,351.09
|
| Rate for Payer: Cofinity Commercial |
$2,888.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,022.83
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,854.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,115.98
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
