|
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY, WITHOUT FREE GRAFT, EACH TENDON
|
Facility
|
OP
|
$8,925.64
|
|
|
Service Code
|
CPT 26356
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$794.05 |
| Max. Negotiated Rate |
$8,925.64 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,366.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,925.64
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,140.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.46
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$794.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL
|
Facility
|
OP
|
$19,834.21
|
|
|
Service Code
|
CPT 27695
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$484.29 |
| Max. Negotiated Rate |
$19,834.21 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,103.42
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,834.21
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,867.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$532.72
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$484.29
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;
|
Facility
|
OP
|
$19,834.21
|
|
|
Service Code
|
CPT 27650
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$652.92 |
| Max. Negotiated Rate |
$19,834.21 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,556.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,834.21
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,867.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.21
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$652.92
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED
|
Facility
|
OP
|
$8,414.74
|
|
|
Service Code
|
CPT 49521
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$707.93 |
| Max. Negotiated Rate |
$8,414.74 |
| Rate for Payer: Aetna Medicare |
$7,001.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,414.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,414.74
|
| Rate for Payer: BCBS Complete |
$3,866.74
|
| Rate for Payer: BCBS MAPPO |
$6,731.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,472.51
|
| Rate for Payer: BCN Medicare Advantage |
$6,731.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,731.79
|
| Rate for Payer: Mclaren Medicaid |
$3,682.29
|
| Rate for Payer: Mclaren Medicare |
$6,731.79
|
| Rate for Payer: Meridian Medicaid |
$3,866.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,068.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,741.56
|
| Rate for Payer: PACE Medicare |
$6,395.20
|
| Rate for Payer: PACE SWMI |
$6,731.79
|
| Rate for Payer: PHP Medicare Advantage |
$6,731.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,682.29
|
| Rate for Payer: Priority Health Medicare |
$6,731.79
|
| Rate for Payer: Railroad Medicare Medicare |
$6,731.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.72
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,731.79
|
| Rate for Payer: UHC Exchange |
$707.93
|
| Rate for Payer: UHC Medicare Advantage |
$6,933.74
|
| Rate for Payer: VA VA |
$6,731.79
|
|
|
REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE
|
Facility
|
OP
|
$5,427.00
|
|
|
Service Code
|
CPT 49520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$626.72 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Medicare |
$3,201.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,847.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,847.99
|
| Rate for Payer: BCBS Complete |
$1,768.23
|
| Rate for Payer: BCBS MAPPO |
$3,078.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,105.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,078.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,078.39
|
| Rate for Payer: Mclaren Medicaid |
$1,683.88
|
| Rate for Payer: Mclaren Medicare |
$3,078.39
|
| Rate for Payer: Meridian Medicaid |
$1,768.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,232.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,540.15
|
| Rate for Payer: PACE Medicare |
$2,924.47
|
| Rate for Payer: PACE SWMI |
$3,078.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,078.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.88
|
| Rate for Payer: Priority Health Medicare |
$3,078.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,078.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.39
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,078.39
|
| Rate for Payer: UHC Exchange |
$626.72
|
| Rate for Payer: UHC Medicare Advantage |
$3,170.74
|
| Rate for Payer: VA VA |
$3,078.39
|
|
|
REPAIR, SECONDARY, ACHILLES TENDON, WITH OR WITHOUT GRAFT
|
Facility
|
OP
|
$19,834.21
|
|
|
Service Code
|
CPT 27654
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$710.22 |
| Max. Negotiated Rate |
$19,834.21 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,299.99
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,834.21
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,867.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$781.24
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$710.22
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
REPAIR, SECONDARY, DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-JONES PROCEDURE)
|
Facility
|
OP
|
$19,834.21
|
|
|
Service Code
|
CPT 27698
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$632.29 |
| Max. Negotiated Rate |
$19,834.21 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,127.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,834.21
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,867.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.52
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$632.29
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
REPAIR, TENDON, FLEXOR, FOOT; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT, EACH TENDON
|
Facility
|
OP
|
$4,155.00
|
|
|
Service Code
|
CPT 28200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$324.50 |
| Max. Negotiated Rate |
$4,155.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.95
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$324.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE
|
Facility
|
OP
|
$8,817.68
|
|
|
Service Code
|
CPT 25260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$635.24 |
| Max. Negotiated Rate |
$8,817.68 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,817.68
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,054.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.76
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$635.24
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECONDARY (EXCLUDES ROTATOR CUFF)
|
Facility
|
OP
|
$7,957.04
|
|
|
Service Code
|
CPT 24341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$749.19 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,299.99
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.11
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$749.19
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT, THROUGH SAME VENOUS ACCESS
|
Facility
|
OP
|
$8,913.25
|
|
|
Service Code
|
CPT 36582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$277.67 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$999.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.44
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$277.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP, THROUGH SAME VENOUS ACCESS
|
Facility
|
OP
|
$8,913.25
|
|
|
Service Code
|
CPT 36581
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$176.16 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,430.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.78
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$176.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 43762
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$228.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.89
|
| Rate for Payer: BCBS Complete |
$126.32
|
| Rate for Payer: BCBS MAPPO |
$219.91
|
| Rate for Payer: BCBS Trust/PPO |
$242.60
|
| Rate for Payer: BCN Medicare Advantage |
$219.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.91
|
| Rate for Payer: Mclaren Medicaid |
$120.29
|
| Rate for Payer: Mclaren Medicare |
$219.91
|
| Rate for Payer: Meridian Medicaid |
$126.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.90
|
| Rate for Payer: PACE Medicare |
$208.91
|
| Rate for Payer: PACE SWMI |
$219.91
|
| Rate for Payer: PHP Medicare Advantage |
$219.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.29
|
| Rate for Payer: Priority Health Medicare |
$219.91
|
| Rate for Payer: Railroad Medicare Medicare |
$219.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.98
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.91
|
| Rate for Payer: UHC Exchange |
$36.35
|
| Rate for Payer: UHC Medicare Advantage |
$226.51
|
| Rate for Payer: VA VA |
$219.91
|
|
|
REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 43762
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$228.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.89
|
| Rate for Payer: BCBS Complete |
$126.32
|
| Rate for Payer: BCBS MAPPO |
$219.91
|
| Rate for Payer: BCBS Trust/PPO |
$242.60
|
| Rate for Payer: BCN Medicare Advantage |
$219.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.91
|
| Rate for Payer: Mclaren Medicaid |
$120.29
|
| Rate for Payer: Mclaren Medicare |
$219.91
|
| Rate for Payer: Meridian Medicaid |
$126.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.90
|
| Rate for Payer: PACE Medicare |
$208.91
|
| Rate for Payer: PACE SWMI |
$219.91
|
| Rate for Payer: PHP Medicare Advantage |
$219.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.29
|
| Rate for Payer: Priority Health Medicare |
$219.91
|
| Rate for Payer: Railroad Medicare Medicare |
$219.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.98
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.91
|
| Rate for Payer: UHC Exchange |
$36.35
|
| Rate for Payer: UHC Medicare Advantage |
$226.51
|
| Rate for Payer: VA VA |
$219.91
|
|
|
REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT IMPLANT
|
Facility
|
OP
|
$19,502.65
|
|
|
Service Code
|
CPT 11970
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$555.01 |
| Max. Negotiated Rate |
$19,502.65 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,452.96
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,502.65
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,602.12
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.51
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$555.01
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
RESECTION, CONDYLE(S), DISTAL END OF PHALANX, EACH TOE
|
Facility
|
OP
|
$4,155.00
|
|
|
Service Code
|
CPT 28153
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$262.28 |
| Max. Negotiated Rate |
$4,155.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$804.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.51
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$262.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
RESECTION OF SCROTUM
|
Facility
|
OP
|
$9,573.02
|
|
|
Service Code
|
CPT 55150
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$485.60 |
| Max. Negotiated Rate |
$9,573.02 |
| Rate for Payer: Aetna Medicare |
$3,226.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,877.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,877.45
|
| Rate for Payer: BCBS Complete |
$1,781.77
|
| Rate for Payer: BCBS MAPPO |
$3,101.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.05
|
| Rate for Payer: BCN Medicare Advantage |
$3,101.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,101.96
|
| Rate for Payer: Mclaren Medicaid |
$1,696.77
|
| Rate for Payer: Mclaren Medicare |
$3,101.96
|
| Rate for Payer: Meridian Medicaid |
$1,781.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,257.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,567.25
|
| Rate for Payer: PACE Medicare |
$2,946.86
|
| Rate for Payer: PACE SWMI |
$3,101.96
|
| Rate for Payer: PHP Medicare Advantage |
$3,101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,573.02
|
| Rate for Payer: Priority Health Medicare |
$3,101.96
|
| Rate for Payer: Priority Health Narrow Network |
$7,658.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.16
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,101.96
|
| Rate for Payer: UHC Exchange |
$485.60
|
| Rate for Payer: UHC Medicare Advantage |
$3,195.02
|
| Rate for Payer: VA VA |
$3,101.96
|
|
|
RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, EACH TOE
|
Facility
|
OP
|
$4,155.00
|
|
|
Service Code
|
CPT 28126
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$249.18 |
| Max. Negotiated Rate |
$4,155.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.10
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$249.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
RESOURCE ARGINAID ORAL PACKET CUSTOM
|
Facility
|
IP
|
$3.87
|
|
|
Service Code
|
NDC 4390035988
|
| Hospital Charge Code |
150858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.29
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.44
|
|
|
RESOURCE ARGINAID ORAL PACKET CUSTOM
|
Facility
|
IP
|
$3.87
|
|
|
Service Code
|
NDC 4390035983
|
| Hospital Charge Code |
150858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$2.71
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.29
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.44
|
|
|
RESOURCE ARGINAID ORAL PACKET CUSTOM
|
Facility
|
IP
|
$3.87
|
|
|
Service Code
|
NDC 4390035980
|
| Hospital Charge Code |
150858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.29
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.44
|
|
|
RESOURCE ARGINAID ORAL PACKET CUSTOM
|
Facility
|
IP
|
$3.87
|
|
|
Service Code
|
NDC 4390035984
|
| Hospital Charge Code |
150858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.29
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.44
|
|
|
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC
|
Facility
|
IP
|
$16,658.10
|
|
|
Service Code
|
MS-DRG 178
|
| Min. Negotiated Rate |
$7,218.80 |
| Max. Negotiated Rate |
$16,658.10 |
| Rate for Payer: Aetna Medicare |
$7,902.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,498.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,498.42
|
| Rate for Payer: BCBS MAPPO |
$7,598.74
|
| Rate for Payer: BCBS Trust/PPO |
$16,658.10
|
| Rate for Payer: BCN Medicare Advantage |
$7,598.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,598.74
|
| Rate for Payer: Mclaren Medicare |
$7,598.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,978.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,738.55
|
| Rate for Payer: PACE Medicare |
$7,218.80
|
| Rate for Payer: PACE SWMI |
$7,598.74
|
| Rate for Payer: PHP Medicare Advantage |
$7,598.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,159.07
|
| Rate for Payer: Priority Health Medicare |
$7,598.74
|
| Rate for Payer: Priority Health Narrow Network |
$11,327.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,598.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,051.12
|
| Rate for Payer: UHC Core |
$9,235.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,598.74
|
| Rate for Payer: UHC Exchange |
$9,891.67
|
| Rate for Payer: UHC Medicare Advantage |
$7,826.70
|
| Rate for Payer: VA VA |
$7,598.74
|
|
|
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC
|
Facility
|
IP
|
$25,876.89
|
|
|
Service Code
|
MS-DRG 177
|
| Min. Negotiated Rate |
$12,074.36 |
| Max. Negotiated Rate |
$25,876.89 |
| Rate for Payer: Aetna Medicare |
$13,218.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,887.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,887.31
|
| Rate for Payer: BCBS MAPPO |
$12,709.85
|
| Rate for Payer: BCBS Trust/PPO |
$21,860.18
|
| Rate for Payer: BCN Medicare Advantage |
$12,709.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,709.85
|
| Rate for Payer: Mclaren Medicare |
$12,709.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,345.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,616.33
|
| Rate for Payer: PACE Medicare |
$12,074.36
|
| Rate for Payer: PACE SWMI |
$12,709.85
|
| Rate for Payer: PHP Medicare Advantage |
$12,709.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,343.20
|
| Rate for Payer: Priority Health Medicare |
$12,709.85
|
| Rate for Payer: Priority Health Narrow Network |
$19,474.56
|
| Rate for Payer: Railroad Medicare Medicare |
$12,709.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,876.89
|
| Rate for Payer: UHC Core |
$15,878.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,709.85
|
| Rate for Payer: UHC Exchange |
$17,006.41
|
| Rate for Payer: UHC Medicare Advantage |
$13,091.15
|
| Rate for Payer: VA VA |
$12,709.85
|
|
|
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,986.55
|
|
|
Service Code
|
MS-DRG 179
|
| Min. Negotiated Rate |
$5,690.37 |
| Max. Negotiated Rate |
$12,986.55 |
| Rate for Payer: Aetna Medicare |
$6,229.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,487.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,487.32
|
| Rate for Payer: BCBS MAPPO |
$5,989.86
|
| Rate for Payer: BCBS Trust/PPO |
$12,986.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,989.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,989.86
|
| Rate for Payer: Mclaren Medicare |
$5,989.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,289.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,888.34
|
| Rate for Payer: PACE Medicare |
$5,690.37
|
| Rate for Payer: PACE SWMI |
$5,989.86
|
| Rate for Payer: PHP Medicare Advantage |
$5,989.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,953.29
|
| Rate for Payer: Priority Health Medicare |
$5,989.86
|
| Rate for Payer: Priority Health Narrow Network |
$8,762.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5,989.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,643.38
|
| Rate for Payer: UHC Core |
$7,144.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,989.86
|
| Rate for Payer: UHC Exchange |
$7,652.08
|
| Rate for Payer: UHC Medicare Advantage |
$6,169.56
|
| Rate for Payer: VA VA |
$5,989.86
|
|
