|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
IP
|
$649.43
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$454.60 |
| Max. Negotiated Rate |
$649.43 |
| Rate for Payer: Aetna Commercial |
$584.49
|
| Rate for Payer: ASR ASR |
$629.95
|
| Rate for Payer: BCBS Trust/PPO |
$503.50
|
| Rate for Payer: BCN Commercial |
$503.50
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$610.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Healthscope Commercial |
$649.43
|
| Rate for Payer: Healthscope Whirlpool |
$629.95
|
| Rate for Payer: Mclaren Commercial |
$584.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.50
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
OP
|
$649.43
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$649.43 |
| Rate for Payer: Aetna Commercial |
$584.49
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$629.95
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$503.50
|
| Rate for Payer: BCN Commercial |
$503.50
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$610.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$649.43
|
| Rate for Payer: Healthscope Whirlpool |
$629.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$584.49
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.02
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.98
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$461.10
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.50
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
IP
|
$235.62
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.93 |
| Max. Negotiated Rate |
$235.62 |
| Rate for Payer: Aetna Commercial |
$212.06
|
| Rate for Payer: ASR ASR |
$228.55
|
| Rate for Payer: BCBS Trust/PPO |
$182.68
|
| Rate for Payer: BCN Commercial |
$182.68
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$221.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Healthscope Commercial |
$235.62
|
| Rate for Payer: Healthscope Whirlpool |
$228.55
|
| Rate for Payer: Mclaren Commercial |
$212.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.35
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
OP
|
$235.62
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$329.09 |
| Rate for Payer: Aetna Commercial |
$212.06
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$228.55
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$182.68
|
| Rate for Payer: BCN Commercial |
$182.68
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$221.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$235.62
|
| Rate for Payer: Healthscope Whirlpool |
$228.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$212.06
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.28
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.39
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$156.31
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.35
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
IP
|
$439.63
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$307.74 |
| Max. Negotiated Rate |
$439.63 |
| Rate for Payer: Aetna Commercial |
$395.67
|
| Rate for Payer: ASR ASR |
$426.44
|
| Rate for Payer: BCBS Trust/PPO |
$340.85
|
| Rate for Payer: BCN Commercial |
$340.85
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cofinity Commercial |
$413.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.70
|
| Rate for Payer: Healthscope Commercial |
$439.63
|
| Rate for Payer: Healthscope Whirlpool |
$426.44
|
| Rate for Payer: Mclaren Commercial |
$395.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$373.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.87
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
OP
|
$439.63
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$439.63 |
| Rate for Payer: Aetna Commercial |
$395.67
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$426.44
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$340.85
|
| Rate for Payer: BCN Commercial |
$340.85
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cofinity Commercial |
$413.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$439.63
|
| Rate for Payer: Healthscope Whirlpool |
$426.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$395.67
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$373.69
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.36
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$173.09
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.87
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
OP
|
$682.78
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$303.02 |
| Max. Negotiated Rate |
$768.38 |
| Rate for Payer: Aetna Commercial |
$614.50
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$662.30
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$529.36
|
| Rate for Payer: BCN Commercial |
$529.36
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$641.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$682.78
|
| Rate for Payer: Healthscope Whirlpool |
$662.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$614.50
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378.77
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$303.02
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$600.85
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
IP
|
$682.78
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$477.95 |
| Max. Negotiated Rate |
$682.78 |
| Rate for Payer: Aetna Commercial |
$614.50
|
| Rate for Payer: ASR ASR |
$662.30
|
| Rate for Payer: BCBS Trust/PPO |
$529.36
|
| Rate for Payer: BCN Commercial |
$529.36
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$641.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Healthscope Commercial |
$682.78
|
| Rate for Payer: Healthscope Whirlpool |
$662.30
|
| Rate for Payer: Mclaren Commercial |
$614.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$600.85
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$135.66 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: ASR ASR |
$187.99
|
| Rate for Payer: BCBS Trust/PPO |
$150.25
|
| Rate for Payer: BCN Commercial |
$150.25
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$182.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$193.80
|
| Rate for Payer: Healthscope Whirlpool |
$187.99
|
| Rate for Payer: Mclaren Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.54
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$23.09 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna Medicare |
$42.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.78
|
| Rate for Payer: ASR ASR |
$187.99
|
| Rate for Payer: BCBS Complete |
$24.25
|
| Rate for Payer: BCBS MAPPO |
$42.22
|
| Rate for Payer: BCBS Trust/PPO |
$150.25
|
| Rate for Payer: BCN Commercial |
$150.25
|
| Rate for Payer: BCN Medicare Advantage |
$42.22
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$182.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.22
|
| Rate for Payer: Healthscope Commercial |
$193.80
|
| Rate for Payer: Healthscope Whirlpool |
$187.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.22
|
| Rate for Payer: Mclaren Commercial |
$174.42
|
| Rate for Payer: Mclaren Medicaid |
$23.09
|
| Rate for Payer: Mclaren Medicare |
$42.22
|
| Rate for Payer: Meridian Medicaid |
$24.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.73
|
| Rate for Payer: PACE Medicare |
$40.11
|
| Rate for Payer: PACE SWMI |
$42.22
|
| Rate for Payer: PHP Commercial |
$46.44
|
| Rate for Payer: PHP Medicaid |
$23.09
|
| Rate for Payer: PHP Medicare Advantage |
$42.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.36
|
| Rate for Payer: Priority Health Medicare |
$42.22
|
| Rate for Payer: Priority Health Narrow Network |
$137.60
|
| Rate for Payer: Railroad Medicare Medicare |
$42.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.54
|
| Rate for Payer: UHC Medicare Advantage |
$43.49
|
| Rate for Payer: VA VA |
$42.22
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
OP
|
$238.30
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$34.25 |
| Max. Negotiated Rate |
$238.30 |
| Rate for Payer: Aetna Commercial |
$214.47
|
| Rate for Payer: Aetna Medicare |
$62.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.28
|
| Rate for Payer: ASR ASR |
$231.15
|
| Rate for Payer: BCBS Complete |
$35.97
|
| Rate for Payer: BCBS MAPPO |
$62.62
|
| Rate for Payer: BCBS Trust/PPO |
$184.75
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$62.62
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cofinity Commercial |
$224.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.62
|
| Rate for Payer: Healthscope Commercial |
$238.30
|
| Rate for Payer: Healthscope Whirlpool |
$231.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.62
|
| Rate for Payer: Mclaren Commercial |
$214.47
|
| Rate for Payer: Mclaren Medicaid |
$34.25
|
| Rate for Payer: Mclaren Medicare |
$62.62
|
| Rate for Payer: Meridian Medicaid |
$35.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.56
|
| Rate for Payer: PACE Medicare |
$59.49
|
| Rate for Payer: PACE SWMI |
$62.62
|
| Rate for Payer: PHP Commercial |
$68.88
|
| Rate for Payer: PHP Medicaid |
$34.25
|
| Rate for Payer: PHP Medicare Advantage |
$62.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.61
|
| Rate for Payer: Priority Health Medicare |
$62.62
|
| Rate for Payer: Priority Health Narrow Network |
$82.09
|
| Rate for Payer: Railroad Medicare Medicare |
$62.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.70
|
| Rate for Payer: UHC Medicare Advantage |
$64.50
|
| Rate for Payer: VA VA |
$62.62
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
IP
|
$238.30
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$166.81 |
| Max. Negotiated Rate |
$238.30 |
| Rate for Payer: Aetna Commercial |
$214.47
|
| Rate for Payer: ASR ASR |
$231.15
|
| Rate for Payer: BCBS Trust/PPO |
$184.75
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cofinity Commercial |
$224.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.64
|
| Rate for Payer: Healthscope Commercial |
$238.30
|
| Rate for Payer: Healthscope Whirlpool |
$231.15
|
| Rate for Payer: Mclaren Commercial |
$214.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.70
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
IP
|
$885.43
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$619.80 |
| Max. Negotiated Rate |
$885.43 |
| Rate for Payer: Aetna Commercial |
$796.89
|
| Rate for Payer: ASR ASR |
$858.87
|
| Rate for Payer: BCBS Trust/PPO |
$686.47
|
| Rate for Payer: BCN Commercial |
$686.47
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cofinity Commercial |
$832.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.34
|
| Rate for Payer: Healthscope Commercial |
$885.43
|
| Rate for Payer: Healthscope Whirlpool |
$858.87
|
| Rate for Payer: Mclaren Commercial |
$796.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$752.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$779.18
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$885.43
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$164.66 |
| Max. Negotiated Rate |
$885.43 |
| Rate for Payer: Aetna Commercial |
$796.89
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: ASR ASR |
$858.87
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$686.47
|
| Rate for Payer: BCN Commercial |
$686.47
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cofinity Commercial |
$832.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$885.43
|
| Rate for Payer: Healthscope Whirlpool |
$858.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Mclaren Commercial |
$796.89
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$752.62
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.52
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$361.22
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$779.18
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: VA VA |
$301.03
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$561.62 |
| Max. Negotiated Rate |
$802.32 |
| Rate for Payer: Aetna Commercial |
$722.09
|
| Rate for Payer: ASR ASR |
$778.25
|
| Rate for Payer: BCBS Trust/PPO |
$622.04
|
| Rate for Payer: BCN Commercial |
$622.04
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$754.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.86
|
| Rate for Payer: Healthscope Commercial |
$802.32
|
| Rate for Payer: Healthscope Whirlpool |
$778.25
|
| Rate for Payer: Mclaren Commercial |
$722.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.04
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$164.66 |
| Max. Negotiated Rate |
$802.32 |
| Rate for Payer: Aetna Commercial |
$722.09
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: ASR ASR |
$778.25
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$622.04
|
| Rate for Payer: BCN Commercial |
$622.04
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$754.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$802.32
|
| Rate for Payer: Healthscope Whirlpool |
$778.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Mclaren Commercial |
$722.09
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$730.11
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$569.65
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.04
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: VA VA |
$301.03
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$34.25 |
| Max. Negotiated Rate |
$400.22 |
| Rate for Payer: Aetna Commercial |
$360.20
|
| Rate for Payer: Aetna Medicare |
$62.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.28
|
| Rate for Payer: ASR ASR |
$388.21
|
| Rate for Payer: BCBS Complete |
$35.97
|
| Rate for Payer: BCBS MAPPO |
$62.62
|
| Rate for Payer: BCBS Trust/PPO |
$310.29
|
| Rate for Payer: BCN Commercial |
$310.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.62
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$376.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.62
|
| Rate for Payer: Healthscope Commercial |
$400.22
|
| Rate for Payer: Healthscope Whirlpool |
$388.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.62
|
| Rate for Payer: Mclaren Commercial |
$360.20
|
| Rate for Payer: Mclaren Medicaid |
$34.25
|
| Rate for Payer: Mclaren Medicare |
$62.62
|
| Rate for Payer: Meridian Medicaid |
$35.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: PACE Medicare |
$59.49
|
| Rate for Payer: PACE SWMI |
$62.62
|
| Rate for Payer: PHP Commercial |
$68.88
|
| Rate for Payer: PHP Medicaid |
$34.25
|
| Rate for Payer: PHP Medicare Advantage |
$62.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.96
|
| Rate for Payer: Priority Health Medicare |
$62.62
|
| Rate for Payer: Priority Health Narrow Network |
$123.97
|
| Rate for Payer: Railroad Medicare Medicare |
$62.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.19
|
| Rate for Payer: UHC Medicare Advantage |
$64.50
|
| Rate for Payer: VA VA |
$62.62
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$280.15 |
| Max. Negotiated Rate |
$400.22 |
| Rate for Payer: Aetna Commercial |
$360.20
|
| Rate for Payer: ASR ASR |
$388.21
|
| Rate for Payer: BCBS Trust/PPO |
$310.29
|
| Rate for Payer: BCN Commercial |
$310.29
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$376.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.18
|
| Rate for Payer: Healthscope Commercial |
$400.22
|
| Rate for Payer: Healthscope Whirlpool |
$388.21
|
| Rate for Payer: Mclaren Commercial |
$360.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.19
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$430.05
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$164.66 |
| Max. Negotiated Rate |
$430.05 |
| Rate for Payer: Aetna Commercial |
$387.04
|
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: ASR ASR |
$417.15
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$333.42
|
| Rate for Payer: BCBS Trust/PPO |
$271.51
|
| Rate for Payer: BCN Commercial |
$271.51
|
| Rate for Payer: BCN Commercial |
$333.42
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$404.25
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$350.20
|
| Rate for Payer: Healthscope Commercial |
$430.05
|
| Rate for Payer: Healthscope Whirlpool |
$339.69
|
| Rate for Payer: Healthscope Whirlpool |
$417.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Mclaren Commercial |
$387.04
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$305.34
|
| Rate for Payer: Priority Health Narrow Network |
$248.64
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: VA VA |
$301.03
|
| Rate for Payer: VA VA |
$301.03
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$430.05
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$301.04 |
| Max. Negotiated Rate |
$430.05 |
| Rate for Payer: Aetna Commercial |
$387.04
|
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: ASR ASR |
$417.15
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$333.42
|
| Rate for Payer: BCBS Trust/PPO |
$271.51
|
| Rate for Payer: BCN Commercial |
$333.42
|
| Rate for Payer: BCN Commercial |
$271.51
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$404.25
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$430.05
|
| Rate for Payer: Healthscope Commercial |
$350.20
|
| Rate for Payer: Healthscope Whirlpool |
$417.15
|
| Rate for Payer: Healthscope Whirlpool |
$339.69
|
| Rate for Payer: Mclaren Commercial |
$387.04
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$164.66 |
| Max. Negotiated Rate |
$376.29 |
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: Aetna Commercial |
$387.04
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Aetna Medicare |
$301.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: ASR ASR |
$417.15
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$333.42
|
| Rate for Payer: BCBS Trust/PPO |
$271.51
|
| Rate for Payer: BCN Commercial |
$333.42
|
| Rate for Payer: BCN Commercial |
$271.51
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$404.25
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$430.05
|
| Rate for Payer: Healthscope Commercial |
$350.20
|
| Rate for Payer: Healthscope Whirlpool |
$417.15
|
| Rate for Payer: Healthscope Whirlpool |
$339.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$301.03
|
| Rate for Payer: Mclaren Commercial |
$387.04
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Commercial |
$331.13
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicaid |
$164.66
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.35
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$248.64
|
| Rate for Payer: Priority Health Narrow Network |
$305.34
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.44
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: VA VA |
$301.03
|
| Rate for Payer: VA VA |
$301.03
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$245.14 |
| Max. Negotiated Rate |
$350.20 |
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: Aetna Commercial |
$387.04
|
| Rate for Payer: ASR ASR |
$417.15
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$333.42
|
| Rate for Payer: BCBS Trust/PPO |
$271.51
|
| Rate for Payer: BCN Commercial |
$333.42
|
| Rate for Payer: BCN Commercial |
$271.51
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$404.25
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$350.20
|
| Rate for Payer: Healthscope Commercial |
$430.05
|
| Rate for Payer: Healthscope Whirlpool |
$417.15
|
| Rate for Payer: Healthscope Whirlpool |
$339.69
|
| Rate for Payer: Mclaren Commercial |
$387.04
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.44
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.00 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.21
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,086.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,071.00 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.21
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
