|
HC BIOPSY OF LIP
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
76100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$557.58
|
| Rate for Payer: BCN Commercial |
$557.58
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$655.97
|
| Rate for Payer: Healthscope Whirlpool |
$676.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$592.54
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$474.06
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC BIOPSY OF PROSTATE NONIMAGE-GUIDED
|
Facility
|
OP
|
$9,663.48
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
76100359
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$9,663.48 |
| Rate for Payer: Aetna Commercial |
$8,697.13
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$9,373.58
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$7,967.54
|
| Rate for Payer: BCN Commercial |
$7,967.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$9,083.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$9,373.58
|
| Rate for Payer: Healthscope Whirlpool |
$9,663.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$8,697.13
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,467.14
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$6,774.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,503.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC BIOPSY OF PROSTATE NONIMAGE-GUIDED
|
Facility
|
IP
|
$9,663.48
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
76100359
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,247.61 |
| Max. Negotiated Rate |
$9,663.48 |
| Rate for Payer: Aetna Commercial |
$8,697.13
|
| Rate for Payer: ASR ASR |
$9,373.58
|
| Rate for Payer: BCBS Trust/PPO |
$7,935.65
|
| Rate for Payer: BCN Commercial |
$7,935.65
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$9,083.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Healthscope Commercial |
$9,373.58
|
| Rate for Payer: Healthscope Whirlpool |
$9,663.48
|
| Rate for Payer: Mclaren Commercial |
$8,697.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,503.86
|
|
|
HC BIOPSY OF VAGINA, SIMPLE
|
Facility
|
OP
|
$888.23
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
76100222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$1,422.50 |
| Rate for Payer: Aetna Commercial |
$799.41
|
| Rate for Payer: Aetna Medicare |
$917.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: ASR ASR |
$861.58
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$732.35
|
| Rate for Payer: BCN Commercial |
$732.35
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Commercial |
$834.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$861.58
|
| Rate for Payer: Healthscope Whirlpool |
$888.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$917.74
|
| Rate for Payer: Mclaren Commercial |
$799.41
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$504.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Nomi Health Commercial |
$728.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$1,009.51
|
| Rate for Payer: PHP Medicaid |
$491.91
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,189.25
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Narrow Network |
$951.40
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$1,422.50
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP DNSP |
$917.74
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC BIOPSY OF VAGINA, SIMPLE
|
Facility
|
IP
|
$888.23
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
76100222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.17 |
| Max. Negotiated Rate |
$888.23 |
| Rate for Payer: Aetna Commercial |
$799.41
|
| Rate for Payer: ASR ASR |
$861.58
|
| Rate for Payer: BCBS Trust/PPO |
$729.41
|
| Rate for Payer: BCN Commercial |
$729.41
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Commercial |
$834.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Healthscope Commercial |
$861.58
|
| Rate for Payer: Healthscope Whirlpool |
$888.23
|
| Rate for Payer: Mclaren Commercial |
$799.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Nomi Health Commercial |
$728.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.64
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
IP
|
$4,096.05
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
76100475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,072.04 |
| Max. Negotiated Rate |
$4,096.05 |
| Rate for Payer: Aetna Commercial |
$3,686.45
|
| Rate for Payer: ASR ASR |
$3,973.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,363.68
|
| Rate for Payer: BCN Commercial |
$3,363.68
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cofinity Commercial |
$3,850.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Healthscope Commercial |
$3,973.17
|
| Rate for Payer: Healthscope Whirlpool |
$4,096.05
|
| Rate for Payer: Mclaren Commercial |
$3,686.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Nomi Health Commercial |
$3,358.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,604.52
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
OP
|
$4,096.05
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
76100475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,096.05 |
| Rate for Payer: Aetna Commercial |
$3,686.45
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: ASR ASR |
$3,973.17
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,377.19
|
| Rate for Payer: BCN Commercial |
$3,377.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cofinity Commercial |
$3,850.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,973.17
|
| Rate for Payer: Healthscope Whirlpool |
$4,096.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$3,686.45
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Nomi Health Commercial |
$3,358.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,588.96
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,871.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,604.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC BIOPSY PALATE UVULA
|
Facility
|
IP
|
$4,109.58
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
76100466
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,082.18 |
| Max. Negotiated Rate |
$4,109.58 |
| Rate for Payer: Aetna Commercial |
$3,698.62
|
| Rate for Payer: ASR ASR |
$3,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,374.79
|
| Rate for Payer: BCN Commercial |
$3,374.79
|
| Rate for Payer: Cash Price |
$3,287.66
|
| Rate for Payer: Cofinity Commercial |
$3,863.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,287.66
|
| Rate for Payer: Healthscope Commercial |
$3,986.29
|
| Rate for Payer: Healthscope Whirlpool |
$4,109.58
|
| Rate for Payer: Mclaren Commercial |
$3,698.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,493.14
|
| Rate for Payer: Nomi Health Commercial |
$3,369.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,082.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,616.43
|
|
|
HC BIOPSY PALATE UVULA
|
Facility
|
OP
|
$4,109.58
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
76100466
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,109.58 |
| Rate for Payer: Aetna Commercial |
$3,698.62
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: ASR ASR |
$3,986.29
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,388.35
|
| Rate for Payer: BCN Commercial |
$3,388.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,287.66
|
| Rate for Payer: Cash Price |
$3,287.66
|
| Rate for Payer: Cofinity Commercial |
$3,863.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,287.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,986.29
|
| Rate for Payer: Healthscope Whirlpool |
$4,109.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$3,698.62
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,493.14
|
| Rate for Payer: Nomi Health Commercial |
$3,369.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,082.18
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,600.81
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,880.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,616.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC BIOPSY PANCREAS
|
Facility
|
OP
|
$1,086.05
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
36100211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.54 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$977.45
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,053.47
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$895.45
|
| Rate for Payer: BCN Commercial |
$895.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cofinity Commercial |
$1,020.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,053.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$977.45
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.14
|
| Rate for Payer: Nomi Health Commercial |
$890.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.54
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,623.36
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,298.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY PANCREAS
|
Facility
|
IP
|
$1,086.05
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
36100211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.54 |
| Max. Negotiated Rate |
$1,086.05 |
| Rate for Payer: Aetna Commercial |
$977.45
|
| Rate for Payer: ASR ASR |
$1,053.47
|
| Rate for Payer: BCBS Trust/PPO |
$891.86
|
| Rate for Payer: BCN Commercial |
$891.86
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cofinity Commercial |
$1,020.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.84
|
| Rate for Payer: Healthscope Commercial |
$1,053.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.05
|
| Rate for Payer: Mclaren Commercial |
$977.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.14
|
| Rate for Payer: Nomi Health Commercial |
$890.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.72
|
|
|
HC BIOPSY PENIS DEEP STRUCTURES
|
Facility
|
OP
|
$7,452.33
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
76100348
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$7,452.33 |
| Rate for Payer: Aetna Commercial |
$6,707.10
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$7,228.76
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,144.45
|
| Rate for Payer: BCN Commercial |
$6,144.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cofinity Commercial |
$7,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,961.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,228.76
|
| Rate for Payer: Healthscope Whirlpool |
$7,452.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$6,707.10
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,334.48
|
| Rate for Payer: Nomi Health Commercial |
$6,110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,589.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,529.73
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$5,224.08
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,558.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BIOPSY PENIS DEEP STRUCTURES
|
Facility
|
IP
|
$7,452.33
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
76100348
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$5,589.25 |
| Max. Negotiated Rate |
$7,452.33 |
| Rate for Payer: Aetna Commercial |
$6,707.10
|
| Rate for Payer: ASR ASR |
$7,228.76
|
| Rate for Payer: BCBS Trust/PPO |
$6,119.85
|
| Rate for Payer: BCN Commercial |
$6,119.85
|
| Rate for Payer: Cash Price |
$5,961.86
|
| Rate for Payer: Cofinity Commercial |
$7,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,961.86
|
| Rate for Payer: Healthscope Commercial |
$7,228.76
|
| Rate for Payer: Healthscope Whirlpool |
$7,452.33
|
| Rate for Payer: Mclaren Commercial |
$6,707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,334.48
|
| Rate for Payer: Nomi Health Commercial |
$6,110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,589.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,558.05
|
|
|
HC BIOPSY PENIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$4,369.68
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
76100388
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,277.26 |
| Max. Negotiated Rate |
$4,369.68 |
| Rate for Payer: Aetna Commercial |
$3,932.71
|
| Rate for Payer: ASR ASR |
$4,238.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,588.38
|
| Rate for Payer: BCN Commercial |
$3,588.38
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cofinity Commercial |
$4,107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,495.74
|
| Rate for Payer: Healthscope Commercial |
$4,238.59
|
| Rate for Payer: Healthscope Whirlpool |
$4,369.68
|
| Rate for Payer: Mclaren Commercial |
$3,932.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,714.23
|
| Rate for Payer: Nomi Health Commercial |
$3,583.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,277.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,845.32
|
|
|
HC BIOPSY PENIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$4,369.68
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
76100388
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$4,369.68 |
| Rate for Payer: Aetna Commercial |
$3,932.71
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$4,238.59
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,602.80
|
| Rate for Payer: BCN Commercial |
$3,602.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cash Price |
$3,495.74
|
| Rate for Payer: Cofinity Commercial |
$4,107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,495.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,238.59
|
| Rate for Payer: Healthscope Whirlpool |
$4,369.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$3,932.71
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,714.23
|
| Rate for Payer: Nomi Health Commercial |
$3,583.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,277.26
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,828.71
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,063.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,845.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY PLEURA
|
Facility
|
IP
|
$944.37
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
36100048
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$708.28 |
| Max. Negotiated Rate |
$944.37 |
| Rate for Payer: Aetna Commercial |
$849.93
|
| Rate for Payer: ASR ASR |
$916.04
|
| Rate for Payer: BCBS Trust/PPO |
$775.52
|
| Rate for Payer: BCN Commercial |
$775.52
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cofinity Commercial |
$887.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.50
|
| Rate for Payer: Healthscope Commercial |
$916.04
|
| Rate for Payer: Healthscope Whirlpool |
$944.37
|
| Rate for Payer: Mclaren Commercial |
$849.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.71
|
| Rate for Payer: Nomi Health Commercial |
$774.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.05
|
|
|
HC BIOPSY PLEURA
|
Facility
|
OP
|
$944.37
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
36100048
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$662.00 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$849.93
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$916.04
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$778.63
|
| Rate for Payer: BCN Commercial |
$778.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cash Price |
$755.50
|
| Rate for Payer: Cofinity Commercial |
$887.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$916.04
|
| Rate for Payer: Healthscope Whirlpool |
$944.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$849.93
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.71
|
| Rate for Payer: Nomi Health Commercial |
$774.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.28
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$827.46
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$662.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY PROSTATE
|
Facility
|
OP
|
$2,056.30
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
36100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$760.83 |
| Max. Negotiated Rate |
$2,056.30 |
| Rate for Payer: Aetna Commercial |
$1,850.67
|
| Rate for Payer: Aetna Medicare |
$760.83
|
| Rate for Payer: ASR ASR |
$1,994.61
|
| Rate for Payer: BCBS Complete |
$822.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,695.42
|
| Rate for Payer: BCN Commercial |
$1,695.42
|
| Rate for Payer: Cash Price |
$1,645.04
|
| Rate for Payer: Cofinity Commercial |
$1,932.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,645.04
|
| Rate for Payer: Healthscope Commercial |
$1,994.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,056.30
|
| Rate for Payer: Mclaren Commercial |
$1,850.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,645.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.86
|
| Rate for Payer: Nomi Health Commercial |
$1,686.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,801.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,441.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.54
|
|
|
HC BIOPSY PROSTATE
|
Facility
|
IP
|
$2,056.30
|
|
|
Service Code
|
CPT 55700
|
| Hospital Charge Code |
36100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,542.22 |
| Max. Negotiated Rate |
$2,056.30 |
| Rate for Payer: Aetna Commercial |
$1,850.67
|
| Rate for Payer: ASR ASR |
$1,994.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.63
|
| Rate for Payer: BCN Commercial |
$1,688.63
|
| Rate for Payer: Cash Price |
$1,645.04
|
| Rate for Payer: Cofinity Commercial |
$1,932.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,645.04
|
| Rate for Payer: Healthscope Commercial |
$1,994.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,056.30
|
| Rate for Payer: Mclaren Commercial |
$1,850.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.86
|
| Rate for Payer: Nomi Health Commercial |
$1,686.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.54
|
|
|
HC BIOPSY PROSTATE EA ADDL CT/MR GUIDED TARGETED LESION
|
Facility
|
IP
|
$2,056.00
|
|
|
Service Code
|
CPT 55715
|
| Hospital Charge Code |
76100565
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,542.00 |
| Max. Negotiated Rate |
$2,056.00 |
| Rate for Payer: Aetna Commercial |
$1,850.40
|
| Rate for Payer: ASR ASR |
$1,994.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.39
|
| Rate for Payer: BCN Commercial |
$1,688.39
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Commercial |
$1,932.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.80
|
| Rate for Payer: Healthscope Commercial |
$1,994.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,056.00
|
| Rate for Payer: Mclaren Commercial |
$1,850.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.60
|
| Rate for Payer: Nomi Health Commercial |
$1,685.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.28
|
|
|
HC BIOPSY PROSTATE EA ADDL CT/MR GUIDED TARGETED LESION
|
Facility
|
OP
|
$2,056.00
|
|
|
Service Code
|
CPT 55715
|
| Hospital Charge Code |
76100565
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.38 |
| Max. Negotiated Rate |
$2,056.00 |
| Rate for Payer: Aetna Commercial |
$1,850.40
|
| Rate for Payer: Aetna Medicare |
$760.72
|
| Rate for Payer: ASR ASR |
$1,994.32
|
| Rate for Payer: BCBS Complete |
$822.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,695.17
|
| Rate for Payer: BCN Commercial |
$1,695.17
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Commercial |
$1,932.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.80
|
| Rate for Payer: Healthscope Commercial |
$1,994.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,056.00
|
| Rate for Payer: Mclaren Commercial |
$1,850.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,644.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.60
|
| Rate for Payer: Nomi Health Commercial |
$1,685.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.47
|
| Rate for Payer: Priority Health Narrow Network |
$104.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.28
|
|
|
HC BIOPSY PROSTATE TRANSRECT MRI-ULS-FUSION GUIDE TARGET LESION ONLY
|
Facility
|
OP
|
$9,003.00
|
|
|
Service Code
|
CPT 55711
|
| Hospital Charge Code |
76100564
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$9,003.00 |
| Rate for Payer: Aetna Commercial |
$8,102.70
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$8,732.91
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$7,422.97
|
| Rate for Payer: BCN Commercial |
$7,422.97
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Commercial |
$8,462.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,732.91
|
| Rate for Payer: Healthscope Whirlpool |
$9,003.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$8,102.70
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$7,382.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,781.40
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$3,025.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,922.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC BIOPSY PROSTATE TRANSRECT MRI-ULS-FUSION GUIDE TARGET LESION ONLY
|
Facility
|
IP
|
$9,003.00
|
|
|
Service Code
|
CPT 55711
|
| Hospital Charge Code |
76100564
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,752.25 |
| Max. Negotiated Rate |
$9,003.00 |
| Rate for Payer: Aetna Commercial |
$8,102.70
|
| Rate for Payer: ASR ASR |
$8,732.91
|
| Rate for Payer: BCBS Trust/PPO |
$7,393.26
|
| Rate for Payer: BCN Commercial |
$7,393.26
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Commercial |
$8,462.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Healthscope Commercial |
$8,732.91
|
| Rate for Payer: Healthscope Whirlpool |
$9,003.00
|
| Rate for Payer: Mclaren Commercial |
$8,102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$7,382.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,922.64
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS GUIDE
|
Facility
|
IP
|
$9,003.00
|
|
|
Service Code
|
CPT 55707
|
| Hospital Charge Code |
76100562
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,752.25 |
| Max. Negotiated Rate |
$9,003.00 |
| Rate for Payer: Aetna Commercial |
$8,102.70
|
| Rate for Payer: ASR ASR |
$8,732.91
|
| Rate for Payer: BCBS Trust/PPO |
$7,393.26
|
| Rate for Payer: BCN Commercial |
$7,393.26
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Commercial |
$8,462.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Healthscope Commercial |
$8,732.91
|
| Rate for Payer: Healthscope Whirlpool |
$9,003.00
|
| Rate for Payer: Mclaren Commercial |
$8,102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$7,382.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,922.64
|
|
|
HC BIOPSY PROSTATE TRANSRECT ULS GUIDE
|
Facility
|
OP
|
$9,003.00
|
|
|
Service Code
|
CPT 55707
|
| Hospital Charge Code |
76100562
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$9,003.00 |
| Rate for Payer: Aetna Commercial |
$8,102.70
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$8,732.91
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$7,422.97
|
| Rate for Payer: BCN Commercial |
$7,422.97
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cash Price |
$7,202.40
|
| Rate for Payer: Cofinity Commercial |
$8,462.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,202.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,732.91
|
| Rate for Payer: Healthscope Whirlpool |
$9,003.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$8,102.70
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,652.55
|
| Rate for Payer: Nomi Health Commercial |
$7,382.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,752.25
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,781.40
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$3,025.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,922.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
