|
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 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 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 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 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 |
$1,020.81 |
| Max. Negotiated Rate |
$4,024.27 |
| Rate for Payer: Aetna Commercial |
$3,621.84
|
| Rate for Payer: Aetna Medicare |
$1,904.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: ASR ASR |
$3,903.54
|
| Rate for Payer: ASR Commercial |
$3,903.54
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,295.47
|
| Rate for Payer: BCN Commercial |
$3,120.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| 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 |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$4,024.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,903.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,904.50
|
| Rate for Payer: Mclaren Commercial |
$3,621.84
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| 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 |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,094.95
|
| Rate for Payer: PHP Medicaid |
$1,020.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,615.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,526.07
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,821.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,541.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$2,951.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP DNSP |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
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
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$2,951.97 |
| Rate for Payer: Aetna Commercial |
$2,414.87
|
| Rate for Payer: Aetna Medicare |
$1,904.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: ASR ASR |
$2,602.69
|
| Rate for Payer: ASR Commercial |
$2,602.69
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.26
|
| Rate for Payer: BCN Commercial |
$2,080.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| 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 |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,683.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,904.50
|
| Rate for Payer: Mclaren Commercial |
$2,414.87
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| 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 |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,094.95
|
| Rate for Payer: PHP Medicaid |
$1,020.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.01
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$2,951.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP DNSP |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
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 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 |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| 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 |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| 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 |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| 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 |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
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 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 |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| 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 |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| 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 |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| 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 |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
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 HIP SNG NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| 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 |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| 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 |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| 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 |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
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 |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,140.56
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,229.27
|
| Rate for Payer: ASR Commercial |
$1,229.27
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.78
|
| Rate for Payer: BCN Commercial |
$982.53
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| 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 |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,267.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,140.56
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| 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 |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| 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 |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$888.37
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,558.71
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,563.16 |
| Max. Negotiated Rate |
$8,558.71 |
| Rate for Payer: Aetna Commercial |
$7,702.84
|
| Rate for Payer: ASR ASR |
$8,301.95
|
| Rate for Payer: ASR Commercial |
$8,301.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,974.49
|
| Rate for Payer: BCN Commercial |
$6,635.57
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cofinity Commercial |
$8,045.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,846.97
|
| Rate for Payer: Healthscope Commercial |
$8,558.71
|
| Rate for Payer: Healthscope Whirlpool |
$8,301.95
|
| Rate for Payer: Mclaren Commercial |
$7,702.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,274.90
|
| Rate for Payer: Nomi Health Commercial |
$7,018.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,563.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,531.66
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,558.71
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,966.68 |
| Max. Negotiated Rate |
$11,470.81 |
| Rate for Payer: Aetna Commercial |
$7,702.84
|
| Rate for Payer: Aetna Medicare |
$7,400.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,250.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,250.65
|
| Rate for Payer: ASR ASR |
$8,301.95
|
| Rate for Payer: ASR Commercial |
$8,301.95
|
| Rate for Payer: BCBS Complete |
$4,165.01
|
| Rate for Payer: BCBS MAPPO |
$7,400.52
|
| Rate for Payer: BCBS Trust/PPO |
$7,008.73
|
| Rate for Payer: BCN Commercial |
$6,635.57
|
| Rate for Payer: BCN Medicare Advantage |
$7,400.52
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cofinity Commercial |
$8,045.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,846.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,400.52
|
| Rate for Payer: Healthscope Commercial |
$8,558.71
|
| Rate for Payer: Healthscope Whirlpool |
$8,301.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,400.52
|
| Rate for Payer: Mclaren Commercial |
$7,702.84
|
| Rate for Payer: Mclaren Medicaid |
$3,966.68
|
| Rate for Payer: Mclaren Medicare |
$7,400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,770.55
|
| Rate for Payer: Meridian Medicaid |
$4,165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,510.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,274.90
|
| Rate for Payer: Nomi Health Commercial |
$7,018.14
|
| Rate for Payer: PACE Medicare |
$7,030.49
|
| Rate for Payer: PACE SWMI |
$7,400.52
|
| Rate for Payer: PHP Commercial |
$8,140.57
|
| Rate for Payer: PHP Medicaid |
$3,966.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,400.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,563.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,499.14
|
| Rate for Payer: Priority Health Medicare |
$7,400.52
|
| Rate for Payer: Priority Health Narrow Network |
$5,999.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7,400.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,531.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,400.52
|
| Rate for Payer: UHC Exchange |
$11,470.81
|
| Rate for Payer: UHC Medicare Advantage |
$7,400.52
|
| Rate for Payer: UHCCP DNSP |
$7,400.52
|
| Rate for Payer: UHCCP Medicaid |
$3,966.68
|
| Rate for Payer: VA VA |
$7,400.52
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,775.93
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,404.35 |
| Max. Negotiated Rate |
$6,775.93 |
| Rate for Payer: Aetna Commercial |
$6,098.34
|
| Rate for Payer: ASR ASR |
$6,572.65
|
| Rate for Payer: ASR Commercial |
$6,572.65
|
| Rate for Payer: BCBS Trust/PPO |
$5,521.71
|
| Rate for Payer: BCN Commercial |
$5,253.38
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cofinity Commercial |
$6,369.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,420.74
|
| Rate for Payer: Healthscope Commercial |
$6,775.93
|
| Rate for Payer: Healthscope Whirlpool |
$6,572.65
|
| Rate for Payer: Mclaren Commercial |
$6,098.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,759.54
|
| Rate for Payer: Nomi Health Commercial |
$5,556.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,404.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,962.82
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,775.93
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,404.35 |
| Max. Negotiated Rate |
$19,450.56 |
| Rate for Payer: Aetna Commercial |
$6,098.34
|
| Rate for Payer: Aetna Medicare |
$12,548.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,685.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,685.94
|
| Rate for Payer: ASR ASR |
$6,572.65
|
| Rate for Payer: ASR Commercial |
$6,572.65
|
| Rate for Payer: BCBS Complete |
$7,062.44
|
| Rate for Payer: BCBS MAPPO |
$12,548.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,548.81
|
| Rate for Payer: BCN Commercial |
$5,253.38
|
| Rate for Payer: BCN Medicare Advantage |
$12,548.75
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cofinity Commercial |
$6,369.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,420.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,548.75
|
| Rate for Payer: Healthscope Commercial |
$6,775.93
|
| Rate for Payer: Healthscope Whirlpool |
$6,572.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,548.75
|
| Rate for Payer: Mclaren Commercial |
$6,098.34
|
| Rate for Payer: Mclaren Medicaid |
$6,726.13
|
| Rate for Payer: Mclaren Medicare |
$12,548.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,176.19
|
| Rate for Payer: Meridian Medicaid |
$7,062.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,431.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,759.54
|
| Rate for Payer: Nomi Health Commercial |
$5,556.26
|
| Rate for Payer: PACE Medicare |
$11,921.31
|
| Rate for Payer: PACE SWMI |
$12,548.75
|
| Rate for Payer: PHP Commercial |
$13,803.62
|
| Rate for Payer: PHP Medicaid |
$6,726.13
|
| Rate for Payer: PHP Medicare Advantage |
$12,548.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,726.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,404.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,937.07
|
| Rate for Payer: Priority Health Medicare |
$12,548.75
|
| Rate for Payer: Priority Health Narrow Network |
$4,749.93
|
| Rate for Payer: Railroad Medicare Medicare |
$12,548.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,962.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,548.75
|
| Rate for Payer: UHC Exchange |
$19,450.56
|
| Rate for Payer: UHC Medicare Advantage |
$12,548.75
|
| Rate for Payer: UHCCP DNSP |
$12,548.75
|
| Rate for Payer: UHCCP Medicaid |
$6,726.13
|
| Rate for Payer: VA VA |
$12,548.75
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Trust/PPO |
$890.21
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.97 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$546.21
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS Trust/PPO |
$894.58
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.18
|
| Rate for Payer: Priority Health Narrow Network |
$765.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$2,951.97 |
| Rate for Payer: Aetna Commercial |
$2,414.90
|
| Rate for Payer: Aetna Medicare |
$1,904.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: ASR ASR |
$2,602.72
|
| Rate for Payer: ASR Commercial |
$2,602.72
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.29
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,683.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,904.50
|
| Rate for Payer: Mclaren Commercial |
$2,414.90
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,094.95
|
| Rate for Payer: PHP Medicaid |
$1,020.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.04
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$2,951.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP DNSP |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$2,683.22 |
| Rate for Payer: Aetna Commercial |
$2,414.90
|
| Rate for Payer: ASR ASR |
$2,602.72
|
| Rate for Payer: ASR Commercial |
$2,602.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.56
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,683.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.72
|
| Rate for Payer: Mclaren Commercial |
$2,414.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.23
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Trust/PPO |
$890.21
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
