|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$90.78 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$88.06
|
| Rate for Payer: ASR Commercial |
$88.06
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$74.34
|
| Rate for Payer: BCN Commercial |
$70.38
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$90.78
|
| Rate for Payer: Healthscope Whirlpool |
$88.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$81.70
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.54
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$63.64
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$90.78 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: ASR ASR |
$88.06
|
| Rate for Payer: ASR Commercial |
$88.06
|
| Rate for Payer: BCBS Trust/PPO |
$73.98
|
| Rate for Payer: BCN Commercial |
$70.38
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$90.78
|
| Rate for Payer: Healthscope Whirlpool |
$88.06
|
| Rate for Payer: Mclaren Commercial |
$81.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.89
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: ASR ASR |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$47.38
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$47.61
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.94
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$759.14
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$818.19
|
| Rate for Payer: ASR Commercial |
$818.19
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$690.73
|
| Rate for Payer: BCN Commercial |
$653.96
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$792.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$843.49
|
| Rate for Payer: Healthscope Whirlpool |
$818.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$759.14
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.07
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$591.29
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$548.27 |
| Max. Negotiated Rate |
$843.49 |
| Rate for Payer: Aetna Commercial |
$759.14
|
| Rate for Payer: ASR ASR |
$818.19
|
| Rate for Payer: ASR Commercial |
$818.19
|
| Rate for Payer: BCBS Trust/PPO |
$687.36
|
| Rate for Payer: BCN Commercial |
$653.96
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$792.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Healthscope Commercial |
$843.49
|
| Rate for Payer: Healthscope Whirlpool |
$818.19
|
| Rate for Payer: Mclaren Commercial |
$759.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.27
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$347.59
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$374.62
|
| Rate for Payer: ASR Commercial |
$374.62
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$316.27
|
| Rate for Payer: BCN Commercial |
$299.43
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$363.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$386.21
|
| Rate for Payer: Healthscope Whirlpool |
$374.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.40
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$270.73
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$386.21 |
| Rate for Payer: Aetna Commercial |
$347.59
|
| Rate for Payer: ASR ASR |
$374.62
|
| Rate for Payer: ASR Commercial |
$374.62
|
| Rate for Payer: BCBS Trust/PPO |
$314.72
|
| Rate for Payer: BCN Commercial |
$299.43
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$363.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$386.21
|
| Rate for Payer: Healthscope Whirlpool |
$374.62
|
| Rate for Payer: Mclaren Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.86
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.35 |
| Max. Negotiated Rate |
$3,128.23 |
| Rate for Payer: Aetna Commercial |
$2,815.41
|
| Rate for Payer: ASR ASR |
$3,034.38
|
| Rate for Payer: ASR Commercial |
$3,034.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.19
|
| Rate for Payer: BCN Commercial |
$2,425.32
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,940.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Healthscope Commercial |
$3,128.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.38
|
| Rate for Payer: Mclaren Commercial |
$2,815.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,752.84
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,128.23 |
| Rate for Payer: Aetna Commercial |
$2,815.41
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$3,034.38
|
| Rate for Payer: ASR Commercial |
$3,034.38
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.71
|
| Rate for Payer: BCN Commercial |
$2,425.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,940.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$3,128.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,815.41
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,740.96
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,192.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,752.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$3,900.94
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$4,204.35
|
| Rate for Payer: ASR Commercial |
$4,204.35
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,549.42
|
| Rate for Payer: BCN Commercial |
$3,360.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$4,074.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$4,334.38
|
| Rate for Payer: Healthscope Whirlpool |
$4,204.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$3,900.94
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: Nomi Health Commercial |
$3,554.19
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,797.78
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$3,038.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,814.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,817.35 |
| Max. Negotiated Rate |
$4,334.38 |
| Rate for Payer: Aetna Commercial |
$3,900.94
|
| Rate for Payer: ASR ASR |
$4,204.35
|
| Rate for Payer: ASR Commercial |
$4,204.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,532.09
|
| Rate for Payer: BCN Commercial |
$3,360.44
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$4,074.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Healthscope Commercial |
$4,334.38
|
| Rate for Payer: Healthscope Whirlpool |
$4,204.35
|
| Rate for Payer: Mclaren Commercial |
$3,900.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: Nomi Health Commercial |
$3,554.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,814.25
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,653.80 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$2,289.87
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$2,467.97
|
| Rate for Payer: ASR Commercial |
$2,467.97
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,083.53
|
| Rate for Payer: BCN Commercial |
$1,972.60
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$2,391.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$2,544.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,467.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$2,289.87
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: Nomi Health Commercial |
$2,086.33
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,229.32
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,783.55
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,238.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,653.80 |
| Max. Negotiated Rate |
$2,544.30 |
| Rate for Payer: Aetna Commercial |
$2,289.87
|
| Rate for Payer: ASR ASR |
$2,467.97
|
| Rate for Payer: ASR Commercial |
$2,467.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.35
|
| Rate for Payer: BCN Commercial |
$1,972.60
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$2,391.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Healthscope Commercial |
$2,544.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,467.97
|
| Rate for Payer: Mclaren Commercial |
$2,289.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: Nomi Health Commercial |
$2,086.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,238.98
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,999.24 |
| Max. Negotiated Rate |
$4,614.21 |
| Rate for Payer: Aetna Commercial |
$4,152.79
|
| Rate for Payer: ASR ASR |
$4,475.78
|
| Rate for Payer: ASR Commercial |
$4,475.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,760.12
|
| Rate for Payer: BCN Commercial |
$3,577.40
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$4,337.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Healthscope Commercial |
$4,614.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,475.78
|
| Rate for Payer: Mclaren Commercial |
$4,152.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: Nomi Health Commercial |
$3,783.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,060.50
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$4,614.21 |
| Rate for Payer: Aetna Commercial |
$4,152.79
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$4,475.78
|
| Rate for Payer: ASR Commercial |
$4,475.78
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,778.58
|
| Rate for Payer: BCN Commercial |
$3,577.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$4,337.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$4,614.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,475.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$4,152.79
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: Nomi Health Commercial |
$3,783.65
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,042.97
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$3,234.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,060.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.81 |
| Max. Negotiated Rate |
$414.53 |
| Rate for Payer: Aetna Commercial |
$373.08
|
| Rate for Payer: Aetna Medicare |
$207.26
|
| Rate for Payer: ASR ASR |
$402.09
|
| Rate for Payer: ASR Commercial |
$402.09
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: BCBS Trust/PPO |
$339.46
|
| Rate for Payer: BCN Commercial |
$321.39
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$389.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$414.53
|
| Rate for Payer: Healthscope Whirlpool |
$402.09
|
| Rate for Payer: Mclaren Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.21
|
| Rate for Payer: Priority Health Narrow Network |
$290.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.79
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$269.44 |
| Max. Negotiated Rate |
$414.53 |
| Rate for Payer: Aetna Commercial |
$373.08
|
| Rate for Payer: ASR ASR |
$402.09
|
| Rate for Payer: ASR Commercial |
$402.09
|
| Rate for Payer: BCBS Trust/PPO |
$337.80
|
| Rate for Payer: BCN Commercial |
$321.39
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$389.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$414.53
|
| Rate for Payer: Healthscope Whirlpool |
$402.09
|
| Rate for Payer: Mclaren Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.79
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
IP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.00 |
| Max. Negotiated Rate |
$493.85 |
| Rate for Payer: Aetna Commercial |
$444.46
|
| Rate for Payer: ASR ASR |
$479.03
|
| Rate for Payer: ASR Commercial |
$479.03
|
| Rate for Payer: BCBS Trust/PPO |
$402.44
|
| Rate for Payer: BCN Commercial |
$382.88
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$464.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Healthscope Commercial |
$493.85
|
| Rate for Payer: Healthscope Whirlpool |
$479.03
|
| Rate for Payer: Mclaren Commercial |
$444.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: Nomi Health Commercial |
$404.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$434.59
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
OP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.00 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$444.46
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$479.03
|
| Rate for Payer: ASR Commercial |
$479.03
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$404.41
|
| Rate for Payer: BCN Commercial |
$382.88
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$464.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$493.85
|
| Rate for Payer: Healthscope Whirlpool |
$479.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$444.46
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: Nomi Health Commercial |
$404.96
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.95
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$555.16
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$434.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.58 |
| Max. Negotiated Rate |
$233.68 |
| Rate for Payer: Aetna Commercial |
$210.31
|
| Rate for Payer: Aetna Medicare |
$90.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: ASR ASR |
$226.67
|
| Rate for Payer: ASR Commercial |
$226.67
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$191.36
|
| Rate for Payer: BCN Commercial |
$181.17
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$219.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$233.68
|
| Rate for Payer: Healthscope Whirlpool |
$226.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.63
|
| Rate for Payer: Mclaren Commercial |
$210.31
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: Nomi Health Commercial |
$191.62
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$99.69
|
| Rate for Payer: PHP Medicaid |
$48.58
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.37
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$65.90
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$140.48
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP DNSP |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$90.63
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$151.89 |
| Max. Negotiated Rate |
$233.68 |
| Rate for Payer: Aetna Commercial |
$210.31
|
| Rate for Payer: ASR ASR |
$226.67
|
| Rate for Payer: ASR Commercial |
$226.67
|
| Rate for Payer: BCBS Trust/PPO |
$190.43
|
| Rate for Payer: BCN Commercial |
$181.17
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$219.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Healthscope Commercial |
$233.68
|
| Rate for Payer: Healthscope Whirlpool |
$226.67
|
| Rate for Payer: Mclaren Commercial |
$210.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: Nomi Health Commercial |
$191.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.64
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$1,043.48 |
| Max. Negotiated Rate |
$1,605.35 |
| Rate for Payer: Aetna Commercial |
$1,444.82
|
| Rate for Payer: ASR ASR |
$1,557.19
|
| Rate for Payer: ASR Commercial |
$1,557.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.20
|
| Rate for Payer: BCN Commercial |
$1,244.63
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,509.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,605.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,557.19
|
| Rate for Payer: Mclaren Commercial |
$1,444.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: Nomi Health Commercial |
$1,316.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,412.71
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$642.14 |
| Max. Negotiated Rate |
$1,605.35 |
| Rate for Payer: Aetna Commercial |
$1,444.82
|
| Rate for Payer: Aetna Medicare |
$802.68
|
| Rate for Payer: ASR ASR |
$1,557.19
|
| Rate for Payer: ASR Commercial |
$1,557.19
|
| Rate for Payer: BCBS Complete |
$642.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.62
|
| Rate for Payer: BCN Commercial |
$1,244.63
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,509.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,605.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,557.19
|
| Rate for Payer: Mclaren Commercial |
$1,444.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: Nomi Health Commercial |
$1,316.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,125.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,412.71
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.23 |
| Max. Negotiated Rate |
$14,889.58 |
| Rate for Payer: Aetna Commercial |
$13,400.62
|
| Rate for Payer: ASR ASR |
$14,442.89
|
| Rate for Payer: ASR Commercial |
$14,442.89
|
| Rate for Payer: BCBS Trust/PPO |
$12,133.52
|
| Rate for Payer: BCN Commercial |
$11,543.89
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$13,996.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$14,889.58
|
| Rate for Payer: Healthscope Whirlpool |
$14,442.89
|
| Rate for Payer: Mclaren Commercial |
$13,400.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,102.83
|
|
