|
CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD; SUBSEQUENT
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 30906
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$142.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.64
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$129.67
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE
|
Facility
|
OP
|
$1,539.60
|
|
|
Service Code
|
CPT 42960
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$159.46 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.41
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$159.46
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); WITH SECONDARY SURGICAL INTERVENTION
|
Facility
|
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 42962
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.77 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,547.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.05
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$512.77
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY, WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
|
Facility
|
OP
|
$13,752.00
|
|
|
Service Code
|
CPT 27132
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,642.45 |
| Max. Negotiated Rate |
$13,752.00 |
| Rate for Payer: BCBS Trust/PPO |
$10,860.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,806.70
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Exchange |
$1,642.45
|
|
|
COPANLISIB 60 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23,588.67
|
|
|
Service Code
|
HCPCS J9057
|
| Hospital Charge Code |
184552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$21,229.80 |
| Rate for Payer: Aetna American Axle |
$15,332.64
|
| Rate for Payer: Aetna Commercial |
$20,050.37
|
| Rate for Payer: Aetna Medicare |
$91.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,332.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.45
|
| Rate for Payer: BCBS Complete |
$50.30
|
| Rate for Payer: BCBS MAPPO |
$87.56
|
| Rate for Payer: BCBS Trust/PPO |
$268.23
|
| Rate for Payer: BCN Medicare Advantage |
$87.56
|
| Rate for Payer: Cash Price |
$18,870.94
|
| Rate for Payer: Cash Price |
$18,870.94
|
| Rate for Payer: Cofinity Commercial |
$16,512.07
|
| Rate for Payer: Cofinity Commercial |
$20,286.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,870.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.56
|
| Rate for Payer: Healthscope Commercial |
$21,229.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,512.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,691.50
|
| Rate for Payer: Mclaren Medicaid |
$47.90
|
| Rate for Payer: Mclaren Medicare |
$87.56
|
| Rate for Payer: Meridian Medicaid |
$50.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,050.37
|
| Rate for Payer: PACE Medicare |
$83.18
|
| Rate for Payer: PACE SWMI |
$87.56
|
| Rate for Payer: PHP Commercial |
$20,050.37
|
| Rate for Payer: PHP Medicare Advantage |
$87.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,512.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.73
|
| Rate for Payer: Priority Health Medicare |
$87.56
|
| Rate for Payer: Priority Health Narrow Network |
$201.38
|
| Rate for Payer: Priority Health SBD |
$14,860.86
|
| Rate for Payer: Railroad Medicare Medicare |
$87.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.56
|
| Rate for Payer: UHC Medicare Advantage |
$90.19
|
| Rate for Payer: UMR Bronson Commercial |
$8,727.81
|
| Rate for Payer: VA VA |
$87.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,691.50
|
|
|
COPANLISIB 60 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23,588.67
|
|
|
Service Code
|
HCPCS J9057
|
| Hospital Charge Code |
184552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10,379.01 |
| Max. Negotiated Rate |
$21,229.80 |
| Rate for Payer: Aetna American Axle |
$15,332.64
|
| Rate for Payer: Aetna Commercial |
$20,050.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,332.64
|
| Rate for Payer: Cash Price |
$18,870.94
|
| Rate for Payer: Cofinity Commercial |
$16,512.07
|
| Rate for Payer: Cofinity Commercial |
$20,286.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,870.94
|
| Rate for Payer: Healthscope Commercial |
$21,229.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,512.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,691.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,050.37
|
| Rate for Payer: PHP Commercial |
$20,050.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,512.07
|
| Rate for Payer: Priority Health SBD |
$14,860.86
|
| Rate for Payer: UMR Bronson Commercial |
$10,379.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,691.50
|
|
|
COPPER 380 SQUARE MM INTRAUTERINE DEVICE
|
Facility
|
IP
|
$2,689.90
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
167586
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,183.56 |
| Max. Negotiated Rate |
$2,420.91 |
| Rate for Payer: Aetna American Axle |
$1,748.44
|
| Rate for Payer: Aetna Commercial |
$2,286.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,748.44
|
| Rate for Payer: Cash Price |
$2,151.92
|
| Rate for Payer: Cofinity Commercial |
$1,882.93
|
| Rate for Payer: Cofinity Commercial |
$2,313.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,151.92
|
| Rate for Payer: Healthscope Commercial |
$2,420.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,882.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,017.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,286.42
|
| Rate for Payer: PHP Commercial |
$2,286.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,882.93
|
| Rate for Payer: Priority Health SBD |
$1,694.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,183.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,017.42
|
|
|
COPPER GLYCINATE AMINO ACID CHELATE 2.5 MG TABLET
|
Facility
|
IP
|
$209.15
|
|
|
Service Code
|
NDC 33984-00640
|
| Hospital Charge Code |
163478
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.03 |
| Max. Negotiated Rate |
$188.24 |
| Rate for Payer: Aetna American Axle |
$135.95
|
| Rate for Payer: Aetna Commercial |
$177.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.95
|
| Rate for Payer: Cash Price |
$167.32
|
| Rate for Payer: Cofinity Commercial |
$146.40
|
| Rate for Payer: Cofinity Commercial |
$179.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.32
|
| Rate for Payer: Healthscope Commercial |
$188.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.78
|
| Rate for Payer: PHP Commercial |
$177.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.40
|
| Rate for Payer: Priority Health SBD |
$131.76
|
| Rate for Payer: UMR Bronson Commercial |
$92.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.86
|
|
|
COPPER GLYCINATE AMINO ACID CHELATE 2.5 MG TABLET
|
Facility
|
IP
|
$209.15
|
|
|
Service Code
|
NDC 9900-0003-85
|
| Hospital Charge Code |
163478
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.03 |
| Max. Negotiated Rate |
$188.24 |
| Rate for Payer: Aetna American Axle |
$135.95
|
| Rate for Payer: Aetna Commercial |
$177.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.95
|
| Rate for Payer: Cash Price |
$167.32
|
| Rate for Payer: Cofinity Commercial |
$146.40
|
| Rate for Payer: Cofinity Commercial |
$179.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.32
|
| Rate for Payer: Healthscope Commercial |
$188.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.78
|
| Rate for Payer: PHP Commercial |
$177.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.40
|
| Rate for Payer: Priority Health SBD |
$131.76
|
| Rate for Payer: UMR Bronson Commercial |
$92.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.86
|
|
|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$126,680.31
|
|
|
Service Code
|
MS-DRG 233
|
| Min. Negotiated Rate |
$57,585.52 |
| Max. Negotiated Rate |
$126,680.31 |
| Rate for Payer: Aetna Medicare |
$63,040.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75,770.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75,770.42
|
| Rate for Payer: BCBS MAPPO |
$60,616.34
|
| Rate for Payer: BCBS Trust/PPO |
$126,680.31
|
| Rate for Payer: BCN Medicare Advantage |
$60,616.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60,616.34
|
| Rate for Payer: Mclaren Medicare |
$60,616.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63,647.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69,708.79
|
| Rate for Payer: PACE Medicare |
$57,585.52
|
| Rate for Payer: PACE SWMI |
$60,616.34
|
| Rate for Payer: PHP Medicare Advantage |
$60,616.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111,923.64
|
| Rate for Payer: Priority Health Medicare |
$60,616.34
|
| Rate for Payer: Priority Health Narrow Network |
$89,538.91
|
| Rate for Payer: Railroad Medicare Medicare |
$60,616.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118,975.10
|
| Rate for Payer: UHC Core |
$97,557.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$60,616.34
|
| Rate for Payer: UHC Exchange |
$77,559.22
|
| Rate for Payer: UHC Medicare Advantage |
$62,434.83
|
| Rate for Payer: VA VA |
$60,616.34
|
|
|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$99,432.94
|
|
|
Service Code
|
MS-DRG 234
|
| Min. Negotiated Rate |
$38,539.17 |
| Max. Negotiated Rate |
$99,432.94 |
| Rate for Payer: Aetna Medicare |
$42,190.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50,709.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50,709.44
|
| Rate for Payer: BCBS MAPPO |
$40,567.55
|
| Rate for Payer: BCBS Trust/PPO |
$99,432.94
|
| Rate for Payer: BCN Medicare Advantage |
$40,567.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40,567.55
|
| Rate for Payer: Mclaren Medicare |
$40,567.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42,595.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46,652.68
|
| Rate for Payer: PACE Medicare |
$38,539.17
|
| Rate for Payer: PACE SWMI |
$40,567.55
|
| Rate for Payer: PHP Medicare Advantage |
$40,567.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74,589.45
|
| Rate for Payer: Priority Health Medicare |
$40,567.55
|
| Rate for Payer: Priority Health Narrow Network |
$59,671.56
|
| Rate for Payer: Railroad Medicare Medicare |
$40,567.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79,288.77
|
| Rate for Payer: UHC Core |
$65,015.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$40,567.55
|
| Rate for Payer: UHC Exchange |
$51,687.92
|
| Rate for Payer: UHC Medicare Advantage |
$41,784.58
|
| Rate for Payer: VA VA |
$40,567.55
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$104,596.95
|
|
|
Service Code
|
MS-DRG 235
|
| Min. Negotiated Rate |
$43,537.03 |
| Max. Negotiated Rate |
$104,596.95 |
| Rate for Payer: Aetna Medicare |
$47,661.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57,285.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57,285.56
|
| Rate for Payer: BCBS MAPPO |
$45,828.45
|
| Rate for Payer: BCBS Trust/PPO |
$104,596.95
|
| Rate for Payer: BCN Medicare Advantage |
$45,828.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45,828.45
|
| Rate for Payer: Mclaren Medicare |
$45,828.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48,119.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52,702.72
|
| Rate for Payer: PACE Medicare |
$43,537.03
|
| Rate for Payer: PACE SWMI |
$45,828.45
|
| Rate for Payer: PHP Medicare Advantage |
$45,828.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84,386.14
|
| Rate for Payer: Priority Health Medicare |
$45,828.45
|
| Rate for Payer: Priority Health Narrow Network |
$67,508.91
|
| Rate for Payer: Railroad Medicare Medicare |
$45,828.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89,702.67
|
| Rate for Payer: UHC Core |
$73,554.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$45,828.45
|
| Rate for Payer: UHC Exchange |
$58,476.69
|
| Rate for Payer: UHC Medicare Advantage |
$47,203.30
|
| Rate for Payer: VA VA |
$45,828.45
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$82,724.67
|
|
|
Service Code
|
MS-DRG 236
|
| Min. Negotiated Rate |
$30,071.29 |
| Max. Negotiated Rate |
$82,724.67 |
| Rate for Payer: Aetna Medicare |
$32,920.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,567.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,567.49
|
| Rate for Payer: BCBS MAPPO |
$31,653.99
|
| Rate for Payer: BCBS Trust/PPO |
$82,724.67
|
| Rate for Payer: BCN Medicare Advantage |
$31,653.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,653.99
|
| Rate for Payer: Mclaren Medicare |
$31,653.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33,236.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,402.09
|
| Rate for Payer: PACE Medicare |
$30,071.29
|
| Rate for Payer: PACE SWMI |
$31,653.99
|
| Rate for Payer: PHP Medicare Advantage |
$31,653.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57,990.90
|
| Rate for Payer: Priority Health Medicare |
$31,653.99
|
| Rate for Payer: Priority Health Narrow Network |
$46,392.72
|
| Rate for Payer: Railroad Medicare Medicare |
$31,653.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,644.46
|
| Rate for Payer: UHC Core |
$50,547.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,653.99
|
| Rate for Payer: UHC Exchange |
$40,185.69
|
| Rate for Payer: UHC Medicare Advantage |
$32,603.61
|
| Rate for Payer: VA VA |
$31,653.99
|
|
|
CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$156,216.94
|
|
|
Service Code
|
MS-DRG 231
|
| Min. Negotiated Rate |
$59,895.95 |
| Max. Negotiated Rate |
$156,216.94 |
| Rate for Payer: Aetna Medicare |
$65,570.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78,810.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78,810.46
|
| Rate for Payer: BCBS MAPPO |
$63,048.37
|
| Rate for Payer: BCBS Trust/PPO |
$156,216.94
|
| Rate for Payer: BCN Medicare Advantage |
$63,048.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63,048.37
|
| Rate for Payer: Mclaren Medicare |
$63,048.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66,200.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72,505.63
|
| Rate for Payer: PACE Medicare |
$59,895.95
|
| Rate for Payer: PACE SWMI |
$63,048.37
|
| Rate for Payer: PHP Medicare Advantage |
$63,048.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116,452.47
|
| Rate for Payer: Priority Health Medicare |
$63,048.37
|
| Rate for Payer: Priority Health Narrow Network |
$93,161.98
|
| Rate for Payer: Railroad Medicare Medicare |
$63,048.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123,789.26
|
| Rate for Payer: UHC Core |
$101,504.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63,048.37
|
| Rate for Payer: UHC Exchange |
$80,697.55
|
| Rate for Payer: UHC Medicare Advantage |
$64,939.82
|
| Rate for Payer: VA VA |
$63,048.37
|
|
|
CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$137,779.79
|
|
|
Service Code
|
MS-DRG 232
|
| Min. Negotiated Rate |
$44,034.86 |
| Max. Negotiated Rate |
$137,779.79 |
| Rate for Payer: Aetna Medicare |
$48,206.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57,940.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57,940.60
|
| Rate for Payer: BCBS MAPPO |
$46,352.48
|
| Rate for Payer: BCBS Trust/PPO |
$137,779.79
|
| Rate for Payer: BCN Medicare Advantage |
$46,352.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,352.48
|
| Rate for Payer: Mclaren Medicare |
$46,352.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48,670.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53,305.35
|
| Rate for Payer: PACE Medicare |
$44,034.86
|
| Rate for Payer: PACE SWMI |
$46,352.48
|
| Rate for Payer: PHP Medicare Advantage |
$46,352.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85,361.93
|
| Rate for Payer: Priority Health Medicare |
$46,352.48
|
| Rate for Payer: Priority Health Narrow Network |
$68,289.54
|
| Rate for Payer: Railroad Medicare Medicare |
$46,352.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90,739.94
|
| Rate for Payer: UHC Core |
$74,405.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,352.48
|
| Rate for Payer: UHC Exchange |
$59,152.88
|
| Rate for Payer: UHC Medicare Advantage |
$47,743.05
|
| Rate for Payer: VA VA |
$46,352.48
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$102,880.64
|
|
|
Service Code
|
MS-DRG 323
|
| Min. Negotiated Rate |
$30,794.56 |
| Max. Negotiated Rate |
$102,880.64 |
| Rate for Payer: Aetna Medicare |
$33,711.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,519.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,519.16
|
| Rate for Payer: BCBS MAPPO |
$32,415.33
|
| Rate for Payer: BCBS Trust/PPO |
$102,880.64
|
| Rate for Payer: BCN Medicare Advantage |
$32,415.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,415.33
|
| Rate for Payer: Mclaren Medicare |
$32,415.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34,036.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,277.63
|
| Rate for Payer: PACE Medicare |
$30,794.56
|
| Rate for Payer: PACE SWMI |
$32,415.33
|
| Rate for Payer: PHP Medicare Advantage |
$32,415.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59,408.67
|
| Rate for Payer: Priority Health Medicare |
$32,415.33
|
| Rate for Payer: Priority Health Narrow Network |
$47,526.94
|
| Rate for Payer: Railroad Medicare Medicare |
$32,415.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,151.56
|
| Rate for Payer: UHC Core |
$51,783.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,415.33
|
| Rate for Payer: UHC Exchange |
$41,168.16
|
| Rate for Payer: UHC Medicare Advantage |
$33,387.79
|
| Rate for Payer: VA VA |
$32,415.33
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$69,019.31
|
|
|
Service Code
|
MS-DRG 324
|
| Min. Negotiated Rate |
$22,219.06 |
| Max. Negotiated Rate |
$69,019.31 |
| Rate for Payer: Aetna Medicare |
$24,324.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,235.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,235.60
|
| Rate for Payer: BCBS MAPPO |
$23,388.48
|
| Rate for Payer: BCBS Trust/PPO |
$69,019.31
|
| Rate for Payer: BCN Medicare Advantage |
$23,388.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,388.48
|
| Rate for Payer: Mclaren Medicare |
$23,388.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24,557.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,896.75
|
| Rate for Payer: PACE Medicare |
$22,219.06
|
| Rate for Payer: PACE SWMI |
$23,388.48
|
| Rate for Payer: PHP Medicare Advantage |
$23,388.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,599.17
|
| Rate for Payer: Priority Health Medicare |
$23,388.48
|
| Rate for Payer: Priority Health Narrow Network |
$34,079.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23,388.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,283.02
|
| Rate for Payer: UHC Core |
$37,131.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,388.48
|
| Rate for Payer: UHC Exchange |
$29,519.76
|
| Rate for Payer: UHC Medicare Advantage |
$24,090.13
|
| Rate for Payer: VA VA |
$23,388.48
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$40,892.42
|
|
|
Service Code
|
MS-DRG 325
|
| Min. Negotiated Rate |
$19,844.95 |
| Max. Negotiated Rate |
$40,892.42 |
| Rate for Payer: Aetna Medicare |
$21,725.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,111.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,111.78
|
| Rate for Payer: BCBS MAPPO |
$20,889.42
|
| Rate for Payer: BCBS Trust/PPO |
$40,892.42
|
| Rate for Payer: BCN Medicare Advantage |
$20,889.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,889.42
|
| Rate for Payer: Mclaren Medicare |
$20,889.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,933.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,022.83
|
| Rate for Payer: PACE Medicare |
$19,844.95
|
| Rate for Payer: PACE SWMI |
$20,889.42
|
| Rate for Payer: PHP Medicare Advantage |
$20,889.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,945.49
|
| Rate for Payer: Priority Health Medicare |
$20,889.42
|
| Rate for Payer: Priority Health Narrow Network |
$30,356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$20,889.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,336.15
|
| Rate for Payer: UHC Core |
$33,074.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,889.42
|
| Rate for Payer: UHC Exchange |
$26,294.92
|
| Rate for Payer: UHC Medicare Advantage |
$21,516.10
|
| Rate for Payer: VA VA |
$20,889.42
|
|
|
CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (EG, BIOPSY NEEDLE, WINTER PROCEDURE, RONGEUR, OR PUNCH) FOR PRIAPISM
|
Facility
|
OP
|
$9,755.07
|
|
|
Service Code
|
CPT 54435
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$9,755.07 |
| Rate for Payer: Aetna Medicare |
$3,222.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,873.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,873.46
|
| Rate for Payer: BCBS Complete |
$1,779.93
|
| Rate for Payer: BCBS MAPPO |
$3,098.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,098.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,098.77
|
| Rate for Payer: Mclaren Medicaid |
$1,695.03
|
| Rate for Payer: Mclaren Medicare |
$3,098.77
|
| Rate for Payer: Meridian Medicaid |
$1,779.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,253.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,563.59
|
| Rate for Payer: PACE Medicare |
$2,943.83
|
| Rate for Payer: PACE SWMI |
$3,098.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,098.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,755.07
|
| Rate for Payer: Priority Health Medicare |
$3,098.77
|
| Rate for Payer: Priority Health Narrow Network |
$7,804.06
|
| Rate for Payer: Railroad Medicare Medicare |
$3,098.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.15
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,098.77
|
| Rate for Payer: UHC Exchange |
$408.32
|
| Rate for Payer: UHC Medicare Advantage |
$3,191.73
|
| Rate for Payer: VA VA |
$3,098.77
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DISTAL METATARSAL OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$508.52 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.37
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$508.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DOUBLE OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 28299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$589.72 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,493.70
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.69
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$589.72
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH FIRST METATARSAL AND MEDIAL CUNEIFORM JOINT ARTHRODESIS, ANY METHOD
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 28297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$595.62 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$6,281.22
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.18
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$595.62
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH PROXIMAL METATARSAL OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28295
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$596.93 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,847.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.62
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$596.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH PROXIMAL PHALANX OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 28298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$503.61 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,028.90
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.97
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$503.61
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH RESECTION OF PROXIMAL PHALANX BASE, WHEN PERFORMED, ANY METHOD
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$481.99 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,505.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.19
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$481.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
