|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$901.11
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$360.44 |
| Max. Negotiated Rate |
$901.11 |
| Rate for Payer: Aetna Commercial |
$811.00
|
| Rate for Payer: ASR ASR |
$874.08
|
| Rate for Payer: BCBS Complete |
$360.44
|
| Rate for Payer: BCBS Trust/PPO |
$698.63
|
| Rate for Payer: BCN Commercial |
$698.63
|
| Rate for Payer: Cash Price |
$720.89
|
| Rate for Payer: Cofinity Commercial |
$847.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.89
|
| Rate for Payer: Healthscope Commercial |
$901.11
|
| Rate for Payer: Healthscope Whirlpool |
$874.08
|
| Rate for Payer: Mclaren Commercial |
$811.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$820.01
|
| Rate for Payer: Priority Health Narrow Network |
$639.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.98
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,198.74
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,939.12 |
| Max. Negotiated Rate |
$4,198.74 |
| Rate for Payer: Aetna Commercial |
$3,778.87
|
| Rate for Payer: ASR ASR |
$4,072.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,255.28
|
| Rate for Payer: BCN Commercial |
$3,255.28
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cofinity Commercial |
$3,946.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.99
|
| Rate for Payer: Healthscope Commercial |
$4,198.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,072.78
|
| Rate for Payer: Mclaren Commercial |
$3,778.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,568.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.89
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,198.74
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,198.74 |
| Rate for Payer: Aetna Commercial |
$3,778.87
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$4,072.78
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,255.28
|
| Rate for Payer: BCN Commercial |
$3,255.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cofinity Commercial |
$3,946.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,198.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,072.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,778.87
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,568.93
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,820.85
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,981.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.86
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$174.29
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,053.41
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$821.36 |
| Max. Negotiated Rate |
$2,053.41 |
| Rate for Payer: Aetna Commercial |
$1,848.07
|
| Rate for Payer: ASR ASR |
$1,991.81
|
| Rate for Payer: BCBS Complete |
$821.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.01
|
| Rate for Payer: BCN Commercial |
$1,592.01
|
| Rate for Payer: Cash Price |
$1,642.73
|
| Rate for Payer: Cofinity Commercial |
$1,930.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,642.73
|
| Rate for Payer: Healthscope Commercial |
$2,053.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,991.81
|
| Rate for Payer: Mclaren Commercial |
$1,848.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,745.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,868.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,457.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,807.00
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,053.41
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,437.39 |
| Max. Negotiated Rate |
$2,053.41 |
| Rate for Payer: Aetna Commercial |
$1,848.07
|
| Rate for Payer: ASR ASR |
$1,991.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.01
|
| Rate for Payer: BCN Commercial |
$1,592.01
|
| Rate for Payer: Cash Price |
$1,642.73
|
| Rate for Payer: Cofinity Commercial |
$1,930.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,642.73
|
| Rate for Payer: Healthscope Commercial |
$2,053.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,991.81
|
| Rate for Payer: Mclaren Commercial |
$1,848.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,745.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,807.00
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,182.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,927.40 |
| Max. Negotiated Rate |
$4,182.00 |
| Rate for Payer: Aetna Commercial |
$3,763.80
|
| Rate for Payer: ASR ASR |
$4,056.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.30
|
| Rate for Payer: BCN Commercial |
$3,242.30
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$3,931.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Healthscope Commercial |
$4,182.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,056.54
|
| Rate for Payer: Mclaren Commercial |
$3,763.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,554.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,927.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,680.16
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,182.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,182.00 |
| Rate for Payer: Aetna Commercial |
$3,763.80
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$4,056.54
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.30
|
| Rate for Payer: BCN Commercial |
$3,242.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$3,931.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,182.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,056.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,763.80
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,554.70
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,927.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.88
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,680.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,091.76
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.64 |
| Max. Negotiated Rate |
$3,091.76 |
| Rate for Payer: Aetna Commercial |
$2,782.58
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$2,999.01
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,397.04
|
| Rate for Payer: BCN Commercial |
$2,397.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cofinity Commercial |
$2,906.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,473.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$3,091.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,999.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$2,782.58
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,628.00
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,164.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$810.80
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$648.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,720.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,091.76
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,164.23 |
| Max. Negotiated Rate |
$3,091.76 |
| Rate for Payer: Aetna Commercial |
$2,782.58
|
| Rate for Payer: ASR ASR |
$2,999.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,397.04
|
| Rate for Payer: BCN Commercial |
$2,397.04
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cofinity Commercial |
$2,906.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,473.41
|
| Rate for Payer: Healthscope Commercial |
$3,091.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,999.01
|
| Rate for Payer: Mclaren Commercial |
$2,782.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,628.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,164.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,720.75
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.06 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,112.41
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.67 |
| Max. Negotiated Rate |
$3,112.41 |
| Rate for Payer: Aetna Commercial |
$2,801.17
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$3,019.04
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,413.05
|
| Rate for Payer: BCN Commercial |
$2,413.05
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cofinity Commercial |
$2,925.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$3,112.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,019.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$2,801.17
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.55
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.84
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$136.67
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.92
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,112.41
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,178.69 |
| Max. Negotiated Rate |
$3,112.41 |
| Rate for Payer: Aetna Commercial |
$2,801.17
|
| Rate for Payer: ASR ASR |
$3,019.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,413.05
|
| Rate for Payer: BCN Commercial |
$2,413.05
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cofinity Commercial |
$2,925.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.93
|
| Rate for Payer: Healthscope Commercial |
$3,112.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,019.04
|
| Rate for Payer: Mclaren Commercial |
$2,801.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.92
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$3,984.73
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$3,984.73 |
| Rate for Payer: Aetna Commercial |
$3,586.26
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$3,865.19
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,089.36
|
| Rate for Payer: BCN Commercial |
$3,089.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cofinity Commercial |
$3,745.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,187.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$3,984.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,865.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,586.26
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,387.02
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.88
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,506.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$3,984.73
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,789.31 |
| Max. Negotiated Rate |
$3,984.73 |
| Rate for Payer: Aetna Commercial |
$3,586.26
|
| Rate for Payer: ASR ASR |
$3,865.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,089.36
|
| Rate for Payer: BCN Commercial |
$3,089.36
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cofinity Commercial |
$3,745.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,187.78
|
| Rate for Payer: Healthscope Commercial |
$3,984.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,865.19
|
| Rate for Payer: Mclaren Commercial |
$3,586.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,506.56
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$951.66
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.16 |
| Max. Negotiated Rate |
$951.66 |
| Rate for Payer: Aetna Commercial |
$856.49
|
| Rate for Payer: ASR ASR |
$923.11
|
| Rate for Payer: BCBS Trust/PPO |
$737.82
|
| Rate for Payer: BCN Commercial |
$737.82
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$894.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Healthscope Commercial |
$951.66
|
| Rate for Payer: Healthscope Whirlpool |
$923.11
|
| Rate for Payer: Mclaren Commercial |
$856.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.46
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$951.66
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$174.29 |
| Max. Negotiated Rate |
$951.66 |
| Rate for Payer: Aetna Commercial |
$856.49
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$923.11
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$737.82
|
| Rate for Payer: BCN Commercial |
$737.82
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$894.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$951.66
|
| Rate for Payer: Healthscope Whirlpool |
$923.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$856.49
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.86
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$174.29
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.46
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.71
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.57
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.57
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Mclaren Medicare |
$8.57
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.86
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Medicare |
$8.14
|
| Rate for Payer: PACE SWMI |
$8.57
|
| Rate for Payer: PHP Commercial |
$9.43
|
| Rate for Payer: PHP Medicaid |
$4.69
|
| Rate for Payer: PHP Medicare Advantage |
$8.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.80
|
| Rate for Payer: Priority Health Medicare |
$8.57
|
| Rate for Payer: Priority Health Narrow Network |
$9.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
| Rate for Payer: UHC Medicare Advantage |
$8.83
|
| Rate for Payer: VA VA |
$8.57
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
IP
|
$363.14
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$254.20 |
| Max. Negotiated Rate |
$363.14 |
| Rate for Payer: Aetna Commercial |
$326.83
|
| Rate for Payer: ASR ASR |
$352.25
|
| Rate for Payer: BCBS Trust/PPO |
$281.54
|
| Rate for Payer: BCN Commercial |
$281.54
|
| Rate for Payer: Cash Price |
$290.51
|
| Rate for Payer: Cofinity Commercial |
$341.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.51
|
| Rate for Payer: Healthscope Commercial |
$363.14
|
| Rate for Payer: Healthscope Whirlpool |
$352.25
|
| Rate for Payer: Mclaren Commercial |
$326.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.56
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
OP
|
$363.14
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$145.26 |
| Max. Negotiated Rate |
$363.14 |
| Rate for Payer: Aetna Commercial |
$326.83
|
| Rate for Payer: ASR ASR |
$352.25
|
| Rate for Payer: BCBS Complete |
$145.26
|
| Rate for Payer: BCBS Trust/PPO |
$281.54
|
| Rate for Payer: BCN Commercial |
$281.54
|
| Rate for Payer: Cash Price |
$290.51
|
| Rate for Payer: Cofinity Commercial |
$341.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.51
|
| Rate for Payer: Healthscope Commercial |
$363.14
|
| Rate for Payer: Healthscope Whirlpool |
$352.25
|
| Rate for Payer: Mclaren Commercial |
$326.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.46
|
| Rate for Payer: Priority Health Narrow Network |
$257.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.56
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
IP
|
$5.53
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$5.53 |
| Rate for Payer: Aetna Commercial |
$4.98
|
| Rate for Payer: ASR ASR |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$4.29
|
| Rate for Payer: BCN Commercial |
$4.29
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Cofinity Commercial |
$5.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.42
|
| Rate for Payer: Healthscope Commercial |
$5.53
|
| Rate for Payer: Healthscope Whirlpool |
$5.36
|
| Rate for Payer: Mclaren Commercial |
$4.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.87
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
OP
|
$5.53
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$5.53 |
| Rate for Payer: Aetna Commercial |
$4.98
|
| Rate for Payer: ASR ASR |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.21
|
| Rate for Payer: BCBS Trust/PPO |
$4.29
|
| Rate for Payer: BCN Commercial |
$4.29
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Cofinity Commercial |
$5.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.42
|
| Rate for Payer: Healthscope Commercial |
$5.53
|
| Rate for Payer: Healthscope Whirlpool |
$5.36
|
| Rate for Payer: Mclaren Commercial |
$4.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.03
|
| Rate for Payer: Priority Health Narrow Network |
$3.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.87
|
|
