|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
OP
|
$89.78
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$35.91 |
| Max. Negotiated Rate |
$80.80 |
| Rate for Payer: Aetna Commercial |
$76.31
|
| Rate for Payer: Aetna Medicare |
$44.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.36
|
| Rate for Payer: BCBS Complete |
$35.91
|
| Rate for Payer: Cash Price |
$71.82
|
| Rate for Payer: Cofinity Commercial |
$62.85
|
| Rate for Payer: Cofinity Commercial |
$77.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.82
|
| Rate for Payer: Healthscope Commercial |
$80.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.31
|
| Rate for Payer: PHP Commercial |
$76.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.36
|
| Rate for Payer: Priority Health SBD |
$56.56
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
IP
|
$89.78
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$56.56 |
| Max. Negotiated Rate |
$80.80 |
| Rate for Payer: Aetna Commercial |
$76.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.36
|
| Rate for Payer: Cash Price |
$71.82
|
| Rate for Payer: Cofinity Commercial |
$62.85
|
| Rate for Payer: Cofinity Commercial |
$77.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.82
|
| Rate for Payer: Healthscope Commercial |
$80.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.31
|
| Rate for Payer: PHP Commercial |
$76.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.36
|
| Rate for Payer: Priority Health SBD |
$56.56
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$57.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: BCBS Complete |
$45.78
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Cofinity Commercial |
$80.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.39
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: UHC Core |
$84.69
|
| Rate for Payer: UHC Exchange |
$84.69
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.10 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.39
|
| Rate for Payer: Priority Health SBD |
$72.10
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
OP
|
$2,803.88
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,766.44 |
| Max. Negotiated Rate |
$22,720.18 |
| Rate for Payer: Aetna Commercial |
$2,383.30
|
| Rate for Payer: Aetna Medicare |
$8,394.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,822.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,089.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,089.25
|
| Rate for Payer: BCBS Complete |
$4,542.58
|
| Rate for Payer: BCBS MAPPO |
$8,071.40
|
| Rate for Payer: BCN Medicare Advantage |
$8,071.40
|
| Rate for Payer: Cash Price |
$2,243.10
|
| Rate for Payer: Cash Price |
$2,243.10
|
| Rate for Payer: Cofinity Commercial |
$2,411.34
|
| Rate for Payer: Cofinity Commercial |
$1,962.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,962.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,243.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,071.40
|
| Rate for Payer: Healthscope Commercial |
$2,523.49
|
| Rate for Payer: Mclaren Medicaid |
$4,326.27
|
| Rate for Payer: Mclaren Medicare |
$8,071.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,474.97
|
| Rate for Payer: Meridian Medicaid |
$4,542.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,282.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,383.30
|
| Rate for Payer: PACE Medicare |
$7,667.83
|
| Rate for Payer: PACE SWMI |
$8,071.40
|
| Rate for Payer: PHP Commercial |
$2,383.30
|
| Rate for Payer: PHP Medicare Advantage |
$8,071.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,326.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,822.52
|
| Rate for Payer: Priority Health Medicare |
$8,071.40
|
| Rate for Payer: Priority Health SBD |
$1,766.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8,071.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,720.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,071.40
|
| Rate for Payer: UHC Medicare Advantage |
$8,071.40
|
| Rate for Payer: UHCCP Medicaid |
$4,544.20
|
| Rate for Payer: VA VA |
$8,071.40
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
IP
|
$2,803.88
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,766.44 |
| Max. Negotiated Rate |
$2,523.49 |
| Rate for Payer: Aetna Commercial |
$2,383.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,822.52
|
| Rate for Payer: Cash Price |
$2,243.10
|
| Rate for Payer: Cofinity Commercial |
$1,962.72
|
| Rate for Payer: Cofinity Commercial |
$2,411.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,962.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,243.10
|
| Rate for Payer: Healthscope Commercial |
$2,523.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,383.30
|
| Rate for Payer: PHP Commercial |
$2,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,822.52
|
| Rate for Payer: Priority Health SBD |
$1,766.44
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
OP
|
$688.29
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$275.32 |
| Max. Negotiated Rate |
$619.46 |
| Rate for Payer: Aetna Commercial |
$585.05
|
| Rate for Payer: Aetna Medicare |
$344.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.39
|
| Rate for Payer: BCBS Complete |
$275.32
|
| Rate for Payer: Cash Price |
$550.63
|
| Rate for Payer: Cofinity Commercial |
$481.80
|
| Rate for Payer: Cofinity Commercial |
$591.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.63
|
| Rate for Payer: Healthscope Commercial |
$619.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.05
|
| Rate for Payer: PHP Commercial |
$585.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.39
|
| Rate for Payer: Priority Health SBD |
$433.62
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
IP
|
$688.29
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$433.62 |
| Max. Negotiated Rate |
$619.46 |
| Rate for Payer: Aetna Commercial |
$585.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.39
|
| Rate for Payer: Cash Price |
$550.63
|
| Rate for Payer: Cofinity Commercial |
$481.80
|
| Rate for Payer: Cofinity Commercial |
$591.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.63
|
| Rate for Payer: Healthscope Commercial |
$619.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.05
|
| Rate for Payer: PHP Commercial |
$585.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.39
|
| Rate for Payer: Priority Health SBD |
$433.62
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health SBD |
$66.86
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.45 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: BCBS Complete |
$42.45
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$78.53
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,892.68
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,822.39 |
| Max. Negotiated Rate |
$2,603.41 |
| Rate for Payer: Aetna Commercial |
$2,458.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,880.24
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cofinity Commercial |
$2,024.88
|
| Rate for Payer: Cofinity Commercial |
$2,487.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,024.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,314.14
|
| Rate for Payer: Healthscope Commercial |
$2,603.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,458.78
|
| Rate for Payer: PHP Commercial |
$2,458.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.24
|
| Rate for Payer: Priority Health SBD |
$1,822.39
|
|
|
HC TENOTOMY
|
Facility
|
OP
|
$2,892.68
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna Commercial |
$2,458.78
|
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,880.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cofinity Commercial |
$2,024.88
|
| Rate for Payer: Cofinity Commercial |
$2,487.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,024.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,314.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$2,603.41
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,458.78
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$2,458.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.24
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health SBD |
$1,822.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$878.76
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,277.92
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,711.17 |
| Max. Negotiated Rate |
$3,850.13 |
| Rate for Payer: Aetna Commercial |
$3,636.23
|
| Rate for Payer: Aetna Medicare |
$2,138.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,780.65
|
| Rate for Payer: BCBS Complete |
$1,711.17
|
| Rate for Payer: Cash Price |
$3,422.34
|
| Rate for Payer: Cofinity Commercial |
$2,994.54
|
| Rate for Payer: Cofinity Commercial |
$3,679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,994.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,422.34
|
| Rate for Payer: Healthscope Commercial |
$3,850.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,636.23
|
| Rate for Payer: PHP Commercial |
$3,636.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.65
|
| Rate for Payer: Priority Health SBD |
$2,695.09
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,277.92
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,695.09 |
| Max. Negotiated Rate |
$3,850.13 |
| Rate for Payer: Aetna Commercial |
$3,636.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,780.65
|
| Rate for Payer: Cash Price |
$3,422.34
|
| Rate for Payer: Cofinity Commercial |
$2,994.54
|
| Rate for Payer: Cofinity Commercial |
$3,679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,994.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,422.34
|
| Rate for Payer: Healthscope Commercial |
$3,850.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,636.23
|
| Rate for Payer: PHP Commercial |
$3,636.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.65
|
| Rate for Payer: Priority Health SBD |
$2,695.09
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,494.21
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,831.35 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,494.21
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,494.21
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,797.68 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna Medicare |
$2,247.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: BCBS Complete |
$1,797.68
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,494.21
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,831.35 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,235.97
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,094.39 |
| Max. Negotiated Rate |
$4,712.37 |
| Rate for Payer: Aetna Commercial |
$4,450.57
|
| Rate for Payer: Aetna Medicare |
$2,617.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,403.38
|
| Rate for Payer: BCBS Complete |
$2,094.39
|
| Rate for Payer: Cash Price |
$4,188.78
|
| Rate for Payer: Cofinity Commercial |
$3,665.18
|
| Rate for Payer: Cofinity Commercial |
$4,502.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,665.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,188.78
|
| Rate for Payer: Healthscope Commercial |
$4,712.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,450.57
|
| Rate for Payer: PHP Commercial |
$4,450.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,403.38
|
| Rate for Payer: Priority Health SBD |
$3,298.66
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,235.97
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,298.66 |
| Max. Negotiated Rate |
$4,712.37 |
| Rate for Payer: Aetna Commercial |
$4,450.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,403.38
|
| Rate for Payer: Cash Price |
$4,188.78
|
| Rate for Payer: Cofinity Commercial |
$3,665.18
|
| Rate for Payer: Cofinity Commercial |
$4,502.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,665.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,188.78
|
| Rate for Payer: Healthscope Commercial |
$4,712.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,450.57
|
| Rate for Payer: PHP Commercial |
$4,450.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,403.38
|
| Rate for Payer: Priority Health SBD |
$3,298.66
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,737.88
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,354.86 |
| Max. Negotiated Rate |
$3,364.09 |
| Rate for Payer: Aetna Commercial |
$3,177.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,429.62
|
| Rate for Payer: Cash Price |
$2,990.30
|
| Rate for Payer: Cofinity Commercial |
$2,616.52
|
| Rate for Payer: Cofinity Commercial |
$3,214.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,616.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,990.30
|
| Rate for Payer: Healthscope Commercial |
$3,364.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,177.20
|
| Rate for Payer: PHP Commercial |
$3,177.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,429.62
|
| Rate for Payer: Priority Health SBD |
$2,354.86
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,737.88
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,495.15 |
| Max. Negotiated Rate |
$3,364.09 |
| Rate for Payer: Aetna Commercial |
$3,177.20
|
| Rate for Payer: Aetna Medicare |
$1,868.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,429.62
|
| Rate for Payer: BCBS Complete |
$1,495.15
|
| Rate for Payer: Cash Price |
$2,990.30
|
| Rate for Payer: Cofinity Commercial |
$2,616.52
|
| Rate for Payer: Cofinity Commercial |
$3,214.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,616.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,990.30
|
| Rate for Payer: Healthscope Commercial |
$3,364.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,177.20
|
| Rate for Payer: PHP Commercial |
$3,177.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,429.62
|
| Rate for Payer: Priority Health SBD |
$2,354.86
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,570.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,249.12 |
| Max. Negotiated Rate |
$3,213.03 |
| Rate for Payer: Aetna Commercial |
$3,034.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.52
|
| Rate for Payer: Cash Price |
$2,856.02
|
| Rate for Payer: Cofinity Commercial |
$2,499.02
|
| Rate for Payer: Cofinity Commercial |
$3,070.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.02
|
| Rate for Payer: Healthscope Commercial |
$3,213.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.53
|
| Rate for Payer: PHP Commercial |
$3,034.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.52
|
| Rate for Payer: Priority Health SBD |
$2,249.12
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,570.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,428.01 |
| Max. Negotiated Rate |
$3,213.03 |
| Rate for Payer: Aetna Commercial |
$3,034.53
|
| Rate for Payer: Aetna Medicare |
$1,785.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.52
|
| Rate for Payer: BCBS Complete |
$1,428.01
|
| Rate for Payer: Cash Price |
$2,856.02
|
| Rate for Payer: Cofinity Commercial |
$2,499.02
|
| Rate for Payer: Cofinity Commercial |
$3,070.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.02
|
| Rate for Payer: Healthscope Commercial |
$3,213.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.53
|
| Rate for Payer: PHP Commercial |
$3,034.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.52
|
| Rate for Payer: Priority Health SBD |
$2,249.12
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
OP
|
$4,590.00
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna Commercial |
$3,901.50
|
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,983.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$3,947.40
|
| Rate for Payer: Cofinity Commercial |
$3,213.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,213.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,672.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$4,131.00
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.50
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$3,901.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health SBD |
$2,891.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$878.76
|
| Rate for Payer: VA VA |
$1,560.85
|
|
