|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,032.27 |
| Max. Negotiated Rate |
$1,588.11 |
| Rate for Payer: Aetna Commercial |
$1,429.30
|
| Rate for Payer: ASR ASR |
$1,540.47
|
| Rate for Payer: ASR Commercial |
$1,540.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.15
|
| Rate for Payer: BCN Commercial |
$1,231.26
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,492.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Healthscope Commercial |
$1,588.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.47
|
| Rate for Payer: Mclaren Commercial |
$1,429.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: Nomi Health Commercial |
$1,302.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.54
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,308.89 |
| Rate for Payer: Aetna Commercial |
$1,178.00
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$1,269.62
|
| Rate for Payer: ASR Commercial |
$1,269.62
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.85
|
| Rate for Payer: BCN Commercial |
$1,014.78
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,230.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,308.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,269.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,178.00
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.85
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$917.53
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$850.78 |
| Max. Negotiated Rate |
$1,308.89 |
| Rate for Payer: Aetna Commercial |
$1,178.00
|
| Rate for Payer: ASR ASR |
$1,269.62
|
| Rate for Payer: ASR Commercial |
$1,269.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,066.61
|
| Rate for Payer: BCN Commercial |
$1,014.78
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,230.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Healthscope Commercial |
$1,308.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,269.62
|
| Rate for Payer: Mclaren Commercial |
$1,178.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.82
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$118.81
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$128.05
|
| Rate for Payer: ASR Commercial |
$128.05
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$108.10
|
| Rate for Payer: BCN Commercial |
$102.35
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$124.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$132.01
|
| Rate for Payer: Healthscope Whirlpool |
$128.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$118.81
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.67
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$92.54
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.81 |
| Max. Negotiated Rate |
$132.01 |
| Rate for Payer: Aetna Commercial |
$118.81
|
| Rate for Payer: ASR ASR |
$128.05
|
| Rate for Payer: ASR Commercial |
$128.05
|
| Rate for Payer: BCBS Trust/PPO |
$107.57
|
| Rate for Payer: BCN Commercial |
$102.35
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$124.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Healthscope Commercial |
$132.01
|
| Rate for Payer: Healthscope Whirlpool |
$128.05
|
| Rate for Payer: Mclaren Commercial |
$118.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.17
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,320.84 |
| Max. Negotiated Rate |
$5,108.99 |
| Rate for Payer: Aetna Commercial |
$4,598.09
|
| Rate for Payer: ASR ASR |
$4,955.72
|
| Rate for Payer: ASR Commercial |
$4,955.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,163.32
|
| Rate for Payer: BCN Commercial |
$3,961.00
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,802.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Healthscope Commercial |
$5,108.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,955.72
|
| Rate for Payer: Mclaren Commercial |
$4,598.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,495.91
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$4,598.09
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$4,955.72
|
| Rate for Payer: ASR Commercial |
$4,955.72
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$4,183.75
|
| Rate for Payer: BCN Commercial |
$3,961.00
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,802.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$5,108.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,955.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$4,598.09
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,476.50
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,581.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,495.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$561.57 |
| Max. Negotiated Rate |
$863.96 |
| Rate for Payer: Aetna Commercial |
$777.56
|
| Rate for Payer: ASR ASR |
$838.04
|
| Rate for Payer: ASR Commercial |
$838.04
|
| Rate for Payer: BCBS Trust/PPO |
$704.04
|
| Rate for Payer: BCN Commercial |
$669.83
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$812.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$863.96
|
| Rate for Payer: Healthscope Whirlpool |
$838.04
|
| Rate for Payer: Mclaren Commercial |
$777.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.28
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$863.96 |
| Rate for Payer: Aetna Commercial |
$777.56
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$838.04
|
| Rate for Payer: ASR Commercial |
$838.04
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$707.50
|
| Rate for Payer: BCN Commercial |
$669.83
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$812.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$863.96
|
| Rate for Payer: Healthscope Whirlpool |
$838.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$777.56
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.00
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$605.64
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$470.99 |
| Max. Negotiated Rate |
$724.60 |
| Rate for Payer: Aetna Commercial |
$652.14
|
| Rate for Payer: ASR ASR |
$702.86
|
| Rate for Payer: ASR Commercial |
$702.86
|
| Rate for Payer: BCBS Trust/PPO |
$590.48
|
| Rate for Payer: BCN Commercial |
$561.78
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Healthscope Commercial |
$724.60
|
| Rate for Payer: Healthscope Whirlpool |
$702.86
|
| Rate for Payer: Mclaren Commercial |
$652.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.65
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$724.60 |
| Rate for Payer: Aetna Commercial |
$652.14
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$702.86
|
| Rate for Payer: ASR Commercial |
$702.86
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$593.37
|
| Rate for Payer: BCN Commercial |
$561.78
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$724.60
|
| Rate for Payer: Healthscope Whirlpool |
$702.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$652.14
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.89
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$507.94
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$612.62 |
| Max. Negotiated Rate |
$942.50 |
| Rate for Payer: Aetna Commercial |
$848.25
|
| Rate for Payer: ASR ASR |
$914.23
|
| Rate for Payer: ASR Commercial |
$914.23
|
| Rate for Payer: BCBS Trust/PPO |
$768.04
|
| Rate for Payer: BCN Commercial |
$730.72
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$885.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Healthscope Commercial |
$942.50
|
| Rate for Payer: Healthscope Whirlpool |
$914.23
|
| Rate for Payer: Mclaren Commercial |
$848.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.40
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$942.50 |
| Rate for Payer: Aetna Commercial |
$848.25
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$914.23
|
| Rate for Payer: ASR Commercial |
$914.23
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$771.81
|
| Rate for Payer: BCN Commercial |
$730.72
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$885.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$942.50
|
| Rate for Payer: Healthscope Whirlpool |
$914.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$848.25
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.82
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$660.69
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$513.81 |
| Max. Negotiated Rate |
$790.47 |
| Rate for Payer: Aetna Commercial |
$711.42
|
| Rate for Payer: ASR ASR |
$766.76
|
| Rate for Payer: ASR Commercial |
$766.76
|
| Rate for Payer: BCBS Trust/PPO |
$644.15
|
| Rate for Payer: BCN Commercial |
$612.85
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Healthscope Commercial |
$790.47
|
| Rate for Payer: Healthscope Whirlpool |
$766.76
|
| Rate for Payer: Mclaren Commercial |
$711.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.61
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$790.47 |
| Rate for Payer: Aetna Commercial |
$711.42
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$766.76
|
| Rate for Payer: ASR Commercial |
$766.76
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$647.32
|
| Rate for Payer: BCN Commercial |
$612.85
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$790.47
|
| Rate for Payer: Healthscope Whirlpool |
$766.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$711.42
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.61
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$554.12
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC ARTHROCENTESIS
|
Facility
|
IP
|
$377.89
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$377.89 |
| Rate for Payer: Aetna Commercial |
$340.10
|
| Rate for Payer: ASR ASR |
$366.55
|
| Rate for Payer: ASR Commercial |
$366.55
|
| Rate for Payer: BCBS Trust/PPO |
$307.94
|
| Rate for Payer: BCN Commercial |
$292.98
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$355.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$377.89
|
| Rate for Payer: Healthscope Whirlpool |
$366.55
|
| Rate for Payer: Mclaren Commercial |
$340.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.54
|
|
|
HC ARTHROCENTESIS
|
Facility
|
OP
|
$377.89
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.16 |
| Max. Negotiated Rate |
$377.89 |
| Rate for Payer: Aetna Commercial |
$340.10
|
| Rate for Payer: Aetna Medicare |
$188.94
|
| Rate for Payer: ASR ASR |
$366.55
|
| Rate for Payer: ASR Commercial |
$366.55
|
| Rate for Payer: BCBS Complete |
$151.16
|
| Rate for Payer: BCBS Trust/PPO |
$309.45
|
| Rate for Payer: BCN Commercial |
$292.98
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$355.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$377.89
|
| Rate for Payer: Healthscope Whirlpool |
$366.55
|
| Rate for Payer: Mclaren Commercial |
$340.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.11
|
| Rate for Payer: Priority Health Narrow Network |
$264.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.54
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$340.34 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| Rate for Payer: ASR ASR |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Trust/PPO |
$277.34
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.50
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$278.70
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.21
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$238.58
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$393.87
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$424.50
|
| Rate for Payer: ASR Commercial |
$424.50
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$358.38
|
| Rate for Payer: BCN Commercial |
$339.29
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$411.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$424.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$393.87
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.45
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$306.78
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$437.63 |
| Rate for Payer: Aetna Commercial |
$393.87
|
| Rate for Payer: ASR ASR |
$424.50
|
| Rate for Payer: ASR Commercial |
$424.50
|
| Rate for Payer: BCBS Trust/PPO |
$356.62
|
| Rate for Payer: BCN Commercial |
$339.29
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$411.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$424.50
|
| Rate for Payer: Mclaren Commercial |
$393.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.11
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,463.18
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$951.07 |
| Max. Negotiated Rate |
$1,463.18 |
| Rate for Payer: Aetna Commercial |
$1,316.86
|
| Rate for Payer: ASR ASR |
$1,419.28
|
| Rate for Payer: ASR Commercial |
$1,419.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,192.35
|
| Rate for Payer: BCN Commercial |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cofinity Commercial |
$1,375.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.54
|
| Rate for Payer: Healthscope Commercial |
$1,463.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,419.28
|
| Rate for Payer: Mclaren Commercial |
$1,316.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.70
|
| Rate for Payer: Nomi Health Commercial |
$1,199.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,287.60
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,463.18
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,463.18 |
| Rate for Payer: Aetna Commercial |
$1,316.86
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,419.28
|
| Rate for Payer: ASR Commercial |
$1,419.28
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.20
|
| Rate for Payer: BCN Commercial |
$1,134.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cofinity Commercial |
$1,375.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,463.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,419.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$1,316.86
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.70
|
| Rate for Payer: Nomi Health Commercial |
$1,199.81
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,282.04
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.69
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,287.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,084.72
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,084.72 |
| Rate for Payer: Aetna Commercial |
$976.25
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,052.18
|
| Rate for Payer: ASR Commercial |
$1,052.18
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$888.28
|
| Rate for Payer: BCN Commercial |
$840.98
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cofinity Commercial |
$1,019.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,084.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,052.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$976.25
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.01
|
| Rate for Payer: Nomi Health Commercial |
$889.47
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.43
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$760.39
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$954.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,084.72
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$705.07 |
| Max. Negotiated Rate |
$1,084.72 |
| Rate for Payer: Aetna Commercial |
$976.25
|
| Rate for Payer: ASR ASR |
$1,052.18
|
| Rate for Payer: ASR Commercial |
$1,052.18
|
| Rate for Payer: BCBS Trust/PPO |
$883.94
|
| Rate for Payer: BCN Commercial |
$840.98
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cofinity Commercial |
$1,019.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.78
|
| Rate for Payer: Healthscope Commercial |
$1,084.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,052.18
|
| Rate for Payer: Mclaren Commercial |
$976.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.01
|
| Rate for Payer: Nomi Health Commercial |
$889.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$954.55
|
|
