|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$491.60 |
| Max. Negotiated Rate |
$1,229.00 |
| Rate for Payer: Aetna Commercial |
$1,106.10
|
| Rate for Payer: Aetna Medicare |
$614.50
|
| Rate for Payer: ASR ASR |
$1,192.13
|
| Rate for Payer: ASR Commercial |
$1,192.13
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.43
|
| Rate for Payer: BCN Commercial |
$952.84
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,229.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,192.13
|
| Rate for Payer: Mclaren Commercial |
$1,106.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.85
|
| Rate for Payer: Priority Health Narrow Network |
$861.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.52
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$798.85 |
| Max. Negotiated Rate |
$1,229.00 |
| Rate for Payer: Aetna Commercial |
$1,106.10
|
| Rate for Payer: ASR ASR |
$1,192.13
|
| Rate for Payer: ASR Commercial |
$1,192.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.51
|
| Rate for Payer: BCN Commercial |
$952.84
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,229.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,192.13
|
| Rate for Payer: Mclaren Commercial |
$1,106.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.52
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$1,065.01 |
| Rate for Payer: Aetna Commercial |
$958.51
|
| Rate for Payer: Aetna Medicare |
$532.50
|
| Rate for Payer: ASR ASR |
$1,033.06
|
| Rate for Payer: ASR Commercial |
$1,033.06
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: BCBS Trust/PPO |
$872.14
|
| Rate for Payer: BCN Commercial |
$825.70
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$1,001.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$1,065.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.06
|
| Rate for Payer: Mclaren Commercial |
$958.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$933.16
|
| Rate for Payer: Priority Health Narrow Network |
$746.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$937.21
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$692.26 |
| Max. Negotiated Rate |
$1,065.01 |
| Rate for Payer: Aetna Commercial |
$958.51
|
| Rate for Payer: ASR ASR |
$1,033.06
|
| Rate for Payer: ASR Commercial |
$1,033.06
|
| Rate for Payer: BCBS Trust/PPO |
$867.88
|
| Rate for Payer: BCN Commercial |
$825.70
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$1,001.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$1,065.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.06
|
| Rate for Payer: Mclaren Commercial |
$958.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$937.21
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.62 |
| Max. Negotiated Rate |
$74.04 |
| Rate for Payer: Aetna Commercial |
$66.64
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: ASR ASR |
$71.82
|
| Rate for Payer: ASR Commercial |
$71.82
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS Trust/PPO |
$60.63
|
| Rate for Payer: BCN Commercial |
$57.40
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$69.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$74.04
|
| Rate for Payer: Healthscope Whirlpool |
$71.82
|
| Rate for Payer: Mclaren Commercial |
$66.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.87
|
| Rate for Payer: Priority Health Narrow Network |
$51.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.16
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$74.04 |
| Rate for Payer: Aetna Commercial |
$66.64
|
| Rate for Payer: ASR ASR |
$71.82
|
| Rate for Payer: ASR Commercial |
$71.82
|
| Rate for Payer: BCBS Trust/PPO |
$60.34
|
| Rate for Payer: BCN Commercial |
$57.40
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$69.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$74.04
|
| Rate for Payer: Healthscope Whirlpool |
$71.82
|
| Rate for Payer: Mclaren Commercial |
$66.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.16
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: ASR Commercial |
$47.43
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.04
|
| Rate for Payer: BCN Commercial |
$37.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Healthscope Whirlpool |
$47.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.85
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$34.28
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP DNSP |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.78 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: ASR Commercial |
$47.43
|
| Rate for Payer: BCBS Trust/PPO |
$39.85
|
| Rate for Payer: BCN Commercial |
$37.91
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Healthscope Whirlpool |
$47.43
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$117.49 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: ASR Commercial |
$20.78
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.49
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$93.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.20
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: ASR Commercial |
$20.78
|
| Rate for Payer: BCBS Trust/PPO |
$17.46
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,565.37
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,026.15 |
| Max. Negotiated Rate |
$2,565.37 |
| Rate for Payer: Aetna Commercial |
$2,308.83
|
| Rate for Payer: Aetna Medicare |
$1,282.68
|
| Rate for Payer: ASR ASR |
$2,488.41
|
| Rate for Payer: ASR Commercial |
$2,488.41
|
| Rate for Payer: BCBS Complete |
$1,026.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,100.78
|
| Rate for Payer: BCN Commercial |
$1,988.93
|
| Rate for Payer: Cash Price |
$2,052.30
|
| Rate for Payer: Cofinity Commercial |
$2,411.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.30
|
| Rate for Payer: Healthscope Commercial |
$2,565.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,488.41
|
| Rate for Payer: Mclaren Commercial |
$2,308.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.56
|
| Rate for Payer: Nomi Health Commercial |
$2,103.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,247.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,798.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,257.53
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,565.37
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,667.49 |
| Max. Negotiated Rate |
$2,565.37 |
| Rate for Payer: Aetna Commercial |
$2,308.83
|
| Rate for Payer: ASR ASR |
$2,488.41
|
| Rate for Payer: ASR Commercial |
$2,488.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,090.52
|
| Rate for Payer: BCN Commercial |
$1,988.93
|
| Rate for Payer: Cash Price |
$2,052.30
|
| Rate for Payer: Cofinity Commercial |
$2,411.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.30
|
| Rate for Payer: Healthscope Commercial |
$2,565.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,488.41
|
| Rate for Payer: Mclaren Commercial |
$2,308.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.56
|
| Rate for Payer: Nomi Health Commercial |
$2,103.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,257.53
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,576.94
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,025.01 |
| Max. Negotiated Rate |
$1,576.94 |
| Rate for Payer: Aetna Commercial |
$1,419.25
|
| Rate for Payer: ASR ASR |
$1,529.63
|
| Rate for Payer: ASR Commercial |
$1,529.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.05
|
| Rate for Payer: BCN Commercial |
$1,222.60
|
| Rate for Payer: Cash Price |
$1,261.55
|
| Rate for Payer: Cofinity Commercial |
$1,482.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.55
|
| Rate for Payer: Healthscope Commercial |
$1,576.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,529.63
|
| Rate for Payer: Mclaren Commercial |
$1,419.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.40
|
| Rate for Payer: Nomi Health Commercial |
$1,293.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,387.71
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,576.94
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$630.78 |
| Max. Negotiated Rate |
$1,576.94 |
| Rate for Payer: Aetna Commercial |
$1,419.25
|
| Rate for Payer: Aetna Medicare |
$788.47
|
| Rate for Payer: ASR ASR |
$1,529.63
|
| Rate for Payer: ASR Commercial |
$1,529.63
|
| Rate for Payer: BCBS Complete |
$630.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,291.36
|
| Rate for Payer: BCN Commercial |
$1,222.60
|
| Rate for Payer: Cash Price |
$1,261.55
|
| Rate for Payer: Cofinity Commercial |
$1,482.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.55
|
| Rate for Payer: Healthscope Commercial |
$1,576.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,529.63
|
| Rate for Payer: Mclaren Commercial |
$1,419.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.40
|
| Rate for Payer: Nomi Health Commercial |
$1,293.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,387.71
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$4,024.27
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$4,024.27 |
| Rate for Payer: Aetna Commercial |
$3,621.84
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$3,903.54
|
| Rate for Payer: ASR Commercial |
$3,903.54
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,295.47
|
| Rate for Payer: BCN Commercial |
$3,120.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cofinity Commercial |
$3,782.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$4,024.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,903.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$3,621.84
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.63
|
| Rate for Payer: Nomi Health Commercial |
$3,299.90
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,615.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.27
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,574.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,541.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$4,024.27
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,615.78 |
| Max. Negotiated Rate |
$4,024.27 |
| Rate for Payer: Aetna Commercial |
$3,621.84
|
| Rate for Payer: ASR ASR |
$3,903.54
|
| Rate for Payer: ASR Commercial |
$3,903.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,279.38
|
| Rate for Payer: BCN Commercial |
$3,120.02
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cofinity Commercial |
$3,782.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.42
|
| Rate for Payer: Healthscope Commercial |
$4,024.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,903.54
|
| Rate for Payer: Mclaren Commercial |
$3,621.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.63
|
| Rate for Payer: Nomi Health Commercial |
$3,299.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,615.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,541.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,683.19
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.07 |
| Max. Negotiated Rate |
$2,683.19 |
| Rate for Payer: Aetna Commercial |
$2,414.87
|
| Rate for Payer: ASR ASR |
$2,602.69
|
| Rate for Payer: ASR Commercial |
$2,602.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.53
|
| Rate for Payer: BCN Commercial |
$2,080.28
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,522.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Healthscope Commercial |
$2,683.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.69
|
| Rate for Payer: Mclaren Commercial |
$2,414.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.21
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$2,965.58 |
| Rate for Payer: Aetna Commercial |
$2,414.87
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$2,602.69
|
| Rate for Payer: ASR Commercial |
$2,602.69
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.26
|
| Rate for Payer: BCN Commercial |
$2,080.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,522.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,683.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$2,414.87
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.27
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,574.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,267.29 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.71
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.40
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,267.29 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.71
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.40
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.40
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,267.29 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.71
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.40
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
