|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$32.09
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$163.20
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: ASR Commercial |
$158.30
|
| Rate for Payer: BCBS Trust/PPO |
$132.99
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.72
|
| Rate for Payer: Nomi Health Commercial |
$133.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$163.20
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$65.28 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: ASR Commercial |
$158.30
|
| Rate for Payer: BCBS Complete |
$65.28
|
| Rate for Payer: BCBS Trust/PPO |
$133.64
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.72
|
| Rate for Payer: Nomi Health Commercial |
$133.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.00
|
| Rate for Payer: Priority Health Narrow Network |
$114.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$37.01 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: Aetna Medicare |
$23.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$26.41
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.88
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$26.27
|
| Rate for Payer: PHP Medicaid |
$12.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health Narrow Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$37.01
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP DNSP |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: VA VA |
$23.88
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,686.53
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,096.24 |
| Max. Negotiated Rate |
$1,686.53 |
| Rate for Payer: Aetna Commercial |
$1,517.88
|
| Rate for Payer: ASR ASR |
$1,635.93
|
| Rate for Payer: ASR Commercial |
$1,635.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,374.35
|
| Rate for Payer: BCN Commercial |
$1,307.57
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cofinity Commercial |
$1,585.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.22
|
| Rate for Payer: Healthscope Commercial |
$1,686.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.93
|
| Rate for Payer: Mclaren Commercial |
$1,517.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.55
|
| Rate for Payer: Nomi Health Commercial |
$1,382.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.15
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,686.53
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,517.88
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$1,635.93
|
| Rate for Payer: ASR Commercial |
$1,635.93
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.10
|
| Rate for Payer: BCN Commercial |
$1,307.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cofinity Commercial |
$1,585.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,686.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,517.88
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.55
|
| Rate for Payer: Nomi Health Commercial |
$1,382.95
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,477.74
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.16
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS Trust/PPO |
$6.68
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.15
|
| Rate for Payer: Priority Health Narrow Network |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.16
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Trust/PPO |
$6.65
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,105.54
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,894.99
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$2,042.37
|
| Rate for Payer: ASR Commercial |
$2,042.37
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.23
|
| Rate for Payer: BCN Commercial |
$1,632.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cofinity Commercial |
$1,979.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,105.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,042.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,894.99
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.71
|
| Rate for Payer: Nomi Health Commercial |
$1,726.54
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,844.87
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,475.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,852.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,105.54
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,368.60 |
| Max. Negotiated Rate |
$2,105.54 |
| Rate for Payer: Aetna Commercial |
$1,894.99
|
| Rate for Payer: ASR ASR |
$2,042.37
|
| Rate for Payer: ASR Commercial |
$2,042.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,715.80
|
| Rate for Payer: BCN Commercial |
$1,632.43
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cofinity Commercial |
$1,979.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.43
|
| Rate for Payer: Healthscope Commercial |
$2,105.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,042.37
|
| Rate for Payer: Mclaren Commercial |
$1,894.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.71
|
| Rate for Payer: Nomi Health Commercial |
$1,726.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,852.88
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,618.87 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,949.02
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,963.49
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,170.85
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,536.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,136.81
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,038.93 |
| Max. Negotiated Rate |
$3,136.81 |
| Rate for Payer: Aetna Commercial |
$2,823.13
|
| Rate for Payer: ASR ASR |
$3,042.71
|
| Rate for Payer: ASR Commercial |
$3,042.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,556.19
|
| Rate for Payer: BCN Commercial |
$2,431.97
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,509.45
|
| Rate for Payer: Healthscope Commercial |
$3,136.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,042.71
|
| Rate for Payer: Mclaren Commercial |
$2,823.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,666.29
|
| Rate for Payer: Nomi Health Commercial |
$2,572.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,038.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,760.39
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,136.81
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$2,823.13
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$3,042.71
|
| Rate for Payer: ASR Commercial |
$3,042.71
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,568.73
|
| Rate for Payer: BCN Commercial |
$2,431.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,509.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,136.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,042.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$2,823.13
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,666.29
|
| Rate for Payer: Nomi Health Commercial |
$2,572.18
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,038.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,748.47
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,198.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,760.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,179.43
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,961.49
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$2,114.05
|
| Rate for Payer: ASR Commercial |
$2,114.05
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,784.74
|
| Rate for Payer: BCN Commercial |
$1,689.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,743.54
|
| Rate for Payer: Cash Price |
$1,743.54
|
| Rate for Payer: Cofinity Commercial |
$2,048.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,743.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,179.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,961.49
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,852.52
|
| Rate for Payer: Nomi Health Commercial |
$1,787.13
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,909.62
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,527.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,917.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,179.43
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,416.63 |
| Max. Negotiated Rate |
$2,179.43 |
| Rate for Payer: Aetna Commercial |
$1,961.49
|
| Rate for Payer: ASR ASR |
$2,114.05
|
| Rate for Payer: ASR Commercial |
$2,114.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.02
|
| Rate for Payer: BCN Commercial |
$1,689.71
|
| Rate for Payer: Cash Price |
$1,743.54
|
| Rate for Payer: Cofinity Commercial |
$2,048.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,743.54
|
| Rate for Payer: Healthscope Commercial |
$2,179.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.05
|
| Rate for Payer: Mclaren Commercial |
$1,961.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,852.52
|
| Rate for Payer: Nomi Health Commercial |
$1,787.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,917.90
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$1,316.29 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$849.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,061.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,061.53
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Complete |
$477.94
|
| Rate for Payer: BCBS MAPPO |
$849.22
|
| Rate for Payer: BCBS Trust/PPO |
$553.79
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: BCN Medicare Advantage |
$849.22
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.22
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$849.22
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$455.18
|
| Rate for Payer: Mclaren Medicare |
$849.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.68
|
| Rate for Payer: Meridian Medicaid |
$477.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$976.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Medicare |
$806.76
|
| Rate for Payer: PACE SWMI |
$849.22
|
| Rate for Payer: PHP Commercial |
$934.14
|
| Rate for Payer: PHP Medicaid |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$849.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.54
|
| Rate for Payer: Priority Health Medicare |
$849.22
|
| Rate for Payer: Priority Health Narrow Network |
$474.06
|
| Rate for Payer: Railroad Medicare Medicare |
$849.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.22
|
| Rate for Payer: UHC Exchange |
$1,316.29
|
| Rate for Payer: UHC Medicare Advantage |
$849.22
|
| Rate for Payer: UHCCP DNSP |
$849.22
|
| Rate for Payer: UHCCP Medicaid |
$455.18
|
| Rate for Payer: VA VA |
$849.22
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$551.08
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$4,015.74 |
| Rate for Payer: Aetna Commercial |
$3,614.17
|
| Rate for Payer: Aetna Medicare |
$1,444.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: ASR ASR |
$3,895.27
|
| Rate for Payer: ASR Commercial |
$3,895.27
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,288.49
|
| Rate for Payer: BCN Commercial |
$3,113.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,774.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$4,015.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,895.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,444.66
|
| Rate for Payer: Mclaren Commercial |
$3,614.17
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$1,589.13
|
| Rate for Payer: PHP Medicaid |
$774.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,518.59
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,815.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,533.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,239.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP DNSP |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,610.23 |
| Max. Negotiated Rate |
$4,015.74 |
| Rate for Payer: Aetna Commercial |
$3,614.17
|
| Rate for Payer: ASR ASR |
$3,895.27
|
| Rate for Payer: ASR Commercial |
$3,895.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,272.43
|
| Rate for Payer: BCN Commercial |
$3,113.40
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,774.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$4,015.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,895.27
|
| Rate for Payer: Mclaren Commercial |
$3,614.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,533.85
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
OP
|
$390.69
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$390.69 |
| Rate for Payer: Aetna Commercial |
$351.62
|
| Rate for Payer: Aetna Medicare |
$226.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: ASR ASR |
$378.97
|
| Rate for Payer: ASR Commercial |
$378.97
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCBS Trust/PPO |
$319.94
|
| Rate for Payer: BCN Commercial |
$302.90
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$367.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$390.69
|
| Rate for Payer: Healthscope Whirlpool |
$378.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$226.48
|
| Rate for Payer: Mclaren Commercial |
$351.62
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$320.37
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$249.13
|
| Rate for Payer: PHP Medicaid |
$121.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.32
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health Narrow Network |
$273.87
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$351.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP DNSP |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$226.48
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$390.69
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.95 |
| Max. Negotiated Rate |
$390.69 |
| Rate for Payer: Aetna Commercial |
$351.62
|
| Rate for Payer: ASR ASR |
$378.97
|
| Rate for Payer: ASR Commercial |
$378.97
|
| Rate for Payer: BCBS Trust/PPO |
$318.37
|
| Rate for Payer: BCN Commercial |
$302.90
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$367.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Healthscope Commercial |
$390.69
|
| Rate for Payer: Healthscope Whirlpool |
$378.97
|
| Rate for Payer: Mclaren Commercial |
$351.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$320.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.81
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
OP
|
$4,182.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,182.00 |
| Rate for Payer: Aetna Commercial |
$3,763.80
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$4,056.54
|
| Rate for Payer: ASR Commercial |
$4,056.54
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,424.64
|
| Rate for Payer: BCN Commercial |
$3,242.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,182.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,056.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$3,763.80
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,554.70
|
| Rate for Payer: Nomi Health Commercial |
$3,429.24
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,718.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,664.27
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,931.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,680.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
IP
|
$4,182.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,718.30 |
| 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: ASR Commercial |
$4,056.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,407.91
|
| 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 Commercial |
$3,554.70
|
| Rate for Payer: Nomi Health Commercial |
$3,429.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,718.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,680.16
|
|
