|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$41.65 |
| Max. Negotiated Rate |
$205.48 |
| Rate for Payer: Aetna Commercial |
$124.75
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$134.45
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$114.28
|
| Rate for Payer: BCN Commercial |
$114.28
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Commercial |
$130.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$134.45
|
| Rate for Payer: Healthscope Whirlpool |
$138.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$124.75
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Nomi Health Commercial |
$113.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.06
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$41.65
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,908.38 |
| Max. Negotiated Rate |
$5,211.17 |
| Rate for Payer: Aetna Commercial |
$4,690.05
|
| Rate for Payer: ASR ASR |
$5,054.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,279.41
|
| Rate for Payer: BCN Commercial |
$4,279.41
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Commercial |
$4,898.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Healthscope Commercial |
$5,054.83
|
| Rate for Payer: Healthscope Whirlpool |
$5,211.17
|
| Rate for Payer: Mclaren Commercial |
$4,690.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Nomi Health Commercial |
$4,273.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,585.83
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$793.79 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$4,690.05
|
| Rate for Payer: Aetna Medicare |
$5,544.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: ASR ASR |
$5,054.83
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,296.61
|
| Rate for Payer: BCN Commercial |
$4,296.61
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Commercial |
$4,898.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$5,054.83
|
| Rate for Payer: Healthscope Whirlpool |
$5,211.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$4,690.05
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$3,045.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Nomi Health Commercial |
$4,273.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$6,098.93
|
| Rate for Payer: PHP Medicaid |
$2,971.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$992.24
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$793.79
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,585.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$8,593.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP DNSP |
$5,544.48
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$660.93 |
| Max. Negotiated Rate |
$881.24 |
| Rate for Payer: Aetna Commercial |
$793.12
|
| Rate for Payer: ASR ASR |
$854.80
|
| Rate for Payer: BCBS Trust/PPO |
$723.67
|
| Rate for Payer: BCN Commercial |
$723.67
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Commercial |
$828.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Healthscope Commercial |
$854.80
|
| Rate for Payer: Healthscope Whirlpool |
$881.24
|
| Rate for Payer: Mclaren Commercial |
$793.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$722.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$775.49
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$881.24 |
| Rate for Payer: Aetna Commercial |
$793.12
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$854.80
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$726.58
|
| Rate for Payer: BCN Commercial |
$726.58
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Commercial |
$828.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$854.80
|
| Rate for Payer: Healthscope Whirlpool |
$881.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$793.12
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$722.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.85
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$206.28
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$775.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$739.09 |
| Rate for Payer: Aetna Commercial |
$665.18
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$716.92
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$609.38
|
| Rate for Payer: BCN Commercial |
$609.38
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Commercial |
$694.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$716.92
|
| Rate for Payer: Healthscope Whirlpool |
$739.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$665.18
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$606.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$183.04
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$650.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$554.32 |
| Max. Negotiated Rate |
$739.09 |
| Rate for Payer: Aetna Commercial |
$665.18
|
| Rate for Payer: ASR ASR |
$716.92
|
| Rate for Payer: BCBS Trust/PPO |
$606.94
|
| Rate for Payer: BCN Commercial |
$606.94
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Commercial |
$694.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Healthscope Commercial |
$716.92
|
| Rate for Payer: Healthscope Whirlpool |
$739.09
|
| Rate for Payer: Mclaren Commercial |
$665.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$606.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$650.40
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$721.01 |
| Max. Negotiated Rate |
$961.35 |
| Rate for Payer: Aetna Commercial |
$865.22
|
| Rate for Payer: ASR ASR |
$932.51
|
| Rate for Payer: BCBS Trust/PPO |
$789.46
|
| Rate for Payer: BCN Commercial |
$789.46
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Commercial |
$903.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Healthscope Commercial |
$932.51
|
| Rate for Payer: Healthscope Whirlpool |
$961.35
|
| Rate for Payer: Mclaren Commercial |
$865.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$788.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.99
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$961.35 |
| Rate for Payer: Aetna Commercial |
$865.22
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$932.51
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$792.63
|
| Rate for Payer: BCN Commercial |
$792.63
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Commercial |
$903.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$932.51
|
| Rate for Payer: Healthscope Whirlpool |
$961.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$865.22
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$788.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.85
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$206.28
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$604.71 |
| Max. Negotiated Rate |
$806.28 |
| Rate for Payer: Aetna Commercial |
$725.65
|
| Rate for Payer: ASR ASR |
$782.09
|
| Rate for Payer: BCBS Trust/PPO |
$662.12
|
| Rate for Payer: BCN Commercial |
$662.12
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Commercial |
$757.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Healthscope Commercial |
$782.09
|
| Rate for Payer: Healthscope Whirlpool |
$806.28
|
| Rate for Payer: Mclaren Commercial |
$725.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Nomi Health Commercial |
$661.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.53
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$806.28 |
| Rate for Payer: Aetna Commercial |
$725.65
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$782.09
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$664.78
|
| Rate for Payer: BCN Commercial |
$664.78
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Commercial |
$757.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$782.09
|
| Rate for Payer: Healthscope Whirlpool |
$806.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$725.65
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Nomi Health Commercial |
$661.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$183.04
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ARTHROCENTESIS
|
Facility
|
OP
|
$385.45
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.62 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$346.90
|
| Rate for Payer: Aetna Medicare |
$142.62
|
| Rate for Payer: ASR ASR |
$373.89
|
| Rate for Payer: BCBS Complete |
$154.18
|
| Rate for Payer: BCBS Trust/PPO |
$317.80
|
| Rate for Payer: BCN Commercial |
$317.80
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$362.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$373.89
|
| Rate for Payer: Healthscope Whirlpool |
$385.45
|
| Rate for Payer: Mclaren Commercial |
$346.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$337.73
|
| Rate for Payer: Priority Health Narrow Network |
$270.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.20
|
|
|
HC ARTHROCENTESIS
|
Facility
|
IP
|
$385.45
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.09 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$346.90
|
| Rate for Payer: ASR ASR |
$373.89
|
| Rate for Payer: BCBS Trust/PPO |
$316.53
|
| Rate for Payer: BCN Commercial |
$316.53
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$362.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$373.89
|
| Rate for Payer: Healthscope Whirlpool |
$385.45
|
| Rate for Payer: Mclaren Commercial |
$346.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.20
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$312.44
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$336.74
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$286.23
|
| Rate for Payer: BCN Commercial |
$286.23
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$336.74
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$312.44
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.36 |
| Max. Negotiated Rate |
$347.15 |
| Rate for Payer: Aetna Commercial |
$312.44
|
| Rate for Payer: ASR ASR |
$336.74
|
| Rate for Payer: BCBS Trust/PPO |
$285.08
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$336.74
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Mclaren Commercial |
$312.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.49
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$432.99
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.04
|
| Rate for Payer: BCN Commercial |
$368.04
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.79 |
| Max. Negotiated Rate |
$446.38 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| Rate for Payer: ASR ASR |
$432.99
|
| Rate for Payer: BCBS Trust/PPO |
$366.57
|
| Rate for Payer: BCN Commercial |
$366.57
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,492.44
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,492.44 |
| Rate for Payer: Aetna Commercial |
$1,343.20
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,447.67
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.52
|
| Rate for Payer: BCN Commercial |
$1,230.52
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cofinity Commercial |
$1,402.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,447.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$1,343.20
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.57
|
| Rate for Payer: Nomi Health Commercial |
$1,223.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.33
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,307.68
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.20
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,492.44
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,119.33 |
| Max. Negotiated Rate |
$1,492.44 |
| Rate for Payer: Aetna Commercial |
$1,343.20
|
| Rate for Payer: ASR ASR |
$1,447.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.59
|
| Rate for Payer: BCN Commercial |
$1,225.59
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cofinity Commercial |
$1,402.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.95
|
| Rate for Payer: Healthscope Commercial |
$1,447.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.44
|
| Rate for Payer: Mclaren Commercial |
$1,343.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.57
|
| Rate for Payer: Nomi Health Commercial |
$1,223.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.35
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,106.41
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$829.81 |
| Max. Negotiated Rate |
$1,106.41 |
| Rate for Payer: Aetna Commercial |
$995.77
|
| Rate for Payer: ASR ASR |
$1,073.22
|
| Rate for Payer: BCBS Trust/PPO |
$908.58
|
| Rate for Payer: BCN Commercial |
$908.58
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cofinity Commercial |
$1,040.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.13
|
| Rate for Payer: Healthscope Commercial |
$1,073.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,106.41
|
| Rate for Payer: Mclaren Commercial |
$995.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.45
|
| Rate for Payer: Nomi Health Commercial |
$907.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$829.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$973.64
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,106.41
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,106.41 |
| Rate for Payer: Aetna Commercial |
$995.77
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,073.22
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$912.24
|
| Rate for Payer: BCN Commercial |
$912.24
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cofinity Commercial |
$1,040.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,073.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,106.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$995.77
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.45
|
| Rate for Payer: Nomi Health Commercial |
$907.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$829.81
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$969.44
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$775.59
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$973.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$335.76
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.82 |
| Max. Negotiated Rate |
$335.76 |
| Rate for Payer: Aetna Commercial |
$302.18
|
| Rate for Payer: ASR ASR |
$325.69
|
| Rate for Payer: BCBS Trust/PPO |
$275.73
|
| Rate for Payer: BCN Commercial |
$275.73
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cofinity Commercial |
$315.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.61
|
| Rate for Payer: Healthscope Commercial |
$325.69
|
| Rate for Payer: Healthscope Whirlpool |
$335.76
|
| Rate for Payer: Mclaren Commercial |
$302.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.40
|
| Rate for Payer: Nomi Health Commercial |
$275.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.47
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$335.76
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$302.18
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$325.69
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$276.83
|
| Rate for Payer: BCN Commercial |
$276.83
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cofinity Commercial |
$315.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$325.69
|
| Rate for Payer: Healthscope Whirlpool |
$335.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$302.18
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.40
|
| Rate for Payer: Nomi Health Commercial |
$275.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.82
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
OP
|
$429.70
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$386.73
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$416.81
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$354.29
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cofinity Commercial |
$403.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$416.81
|
| Rate for Payer: Healthscope Whirlpool |
$429.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$386.73
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.25
|
| Rate for Payer: Nomi Health Commercial |
$352.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.27
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
IP
|
$429.70
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$429.70 |
| Rate for Payer: Aetna Commercial |
$386.73
|
| Rate for Payer: ASR ASR |
$416.81
|
| Rate for Payer: BCBS Trust/PPO |
$352.87
|
| Rate for Payer: BCN Commercial |
$352.87
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cofinity Commercial |
$403.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.76
|
| Rate for Payer: Healthscope Commercial |
$416.81
|
| Rate for Payer: Healthscope Whirlpool |
$429.70
|
| Rate for Payer: Mclaren Commercial |
$386.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.25
|
| Rate for Payer: Nomi Health Commercial |
$352.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.14
|
|
