|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$770.00
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$770.00 |
| Rate for Payer: Aetna Commercial |
$693.00
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$746.90
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$596.98
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cofinity Commercial |
$723.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$770.00
|
| Rate for Payer: Healthscope Whirlpool |
$746.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$693.00
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.50
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.70
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$546.70
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$677.60
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$51.03
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$45.93
|
| Rate for Payer: ASR ASR |
$49.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.56
|
| Rate for Payer: BCN Commercial |
$39.56
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.82
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Healthscope Whirlpool |
$49.50
|
| Rate for Payer: Mclaren Commercial |
$45.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.91
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$51.03
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$45.93
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: ASR ASR |
$49.50
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.56
|
| Rate for Payer: BCN Commercial |
$39.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Healthscope Whirlpool |
$49.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.47
|
| Rate for Payer: Mclaren Commercial |
$45.93
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.38
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$29.12
|
| Rate for Payer: PHP Medicaid |
$14.48
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.44
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$36.23
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.91
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: VA VA |
$26.47
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$781.74 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| 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 |
$570.66
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| 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 |
$500.06
|
| 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 |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.36
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$417.70
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$411.82 |
| Max. Negotiated Rate |
$588.31 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| Rate for Payer: ASR ASR |
$570.66
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$411.82 |
| Max. Negotiated Rate |
$588.31 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| Rate for Payer: ASR ASR |
$570.66
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$781.74 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| 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 |
$570.66
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| 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 |
$500.06
|
| 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 |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.36
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$417.70
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| 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 |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,913.12 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| Rate for Payer: ASR ASR |
$4,036.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,226.49
|
| Rate for Payer: BCN Commercial |
$3,226.49
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,036.75
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| 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 |
$4,036.75
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,226.49
|
| Rate for Payer: BCN Commercial |
$3,226.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,036.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| 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 |
$3,537.36
|
| 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 |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,787.06
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,954.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,913.12 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| Rate for Payer: ASR ASR |
$4,036.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,226.49
|
| Rate for Payer: BCN Commercial |
$3,226.49
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,036.75
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| 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 |
$4,036.75
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,226.49
|
| Rate for Payer: BCN Commercial |
$3,226.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,036.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| 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 |
$3,537.36
|
| 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 |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,787.06
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,954.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,907.32 |
| Max. Negotiated Rate |
$7,010.46 |
| Rate for Payer: Aetna Commercial |
$6,309.41
|
| Rate for Payer: ASR ASR |
$6,800.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,435.21
|
| Rate for Payer: BCN Commercial |
$5,435.21
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$6,589.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,608.37
|
| Rate for Payer: Healthscope Commercial |
$7,010.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,800.15
|
| Rate for Payer: Mclaren Commercial |
$6,309.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,169.20
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$7,010.46 |
| Rate for Payer: Aetna Commercial |
$6,309.41
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$6,800.15
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,435.21
|
| Rate for Payer: BCN Commercial |
$5,435.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$6,589.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,608.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$7,010.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,800.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$6,309.41
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,379.52
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$4,977.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,169.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,758.88 |
| Max. Negotiated Rate |
$2,512.69 |
| Rate for Payer: Aetna Commercial |
$2,261.42
|
| Rate for Payer: ASR ASR |
$2,437.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,948.09
|
| Rate for Payer: BCN Commercial |
$1,948.09
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$2,361.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,010.15
|
| Rate for Payer: Healthscope Commercial |
$2,512.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,437.31
|
| Rate for Payer: Mclaren Commercial |
$2,261.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,211.17
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.18 |
| Max. Negotiated Rate |
$2,512.69 |
| Rate for Payer: Aetna Commercial |
$2,261.42
|
| Rate for Payer: Aetna Medicare |
$1,691.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: ASR ASR |
$2,437.31
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,948.09
|
| Rate for Payer: BCN Commercial |
$1,948.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$2,361.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,010.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$2,512.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,437.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,691.37
|
| Rate for Payer: Mclaren Commercial |
$2,261.42
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,860.51
|
| Rate for Payer: PHP Medicaid |
$925.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,286.55
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,211.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: VA VA |
$1,691.37
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,682.15 |
| Max. Negotiated Rate |
$3,971.90 |
| Rate for Payer: Aetna Commercial |
$3,574.71
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$3,852.74
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.41
|
| Rate for Payer: BCN Commercial |
$3,079.41
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$3,733.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,971.90
|
| Rate for Payer: Healthscope Whirlpool |
$3,852.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$3,574.71
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,614.43
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,820.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,495.27
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,780.33 |
| Max. Negotiated Rate |
$3,971.90 |
| Rate for Payer: Aetna Commercial |
$3,574.71
|
| Rate for Payer: ASR ASR |
$3,852.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.41
|
| Rate for Payer: BCN Commercial |
$3,079.41
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$3,733.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.52
|
| Rate for Payer: Healthscope Commercial |
$3,971.90
|
| Rate for Payer: Healthscope Whirlpool |
$3,852.74
|
| Rate for Payer: Mclaren Commercial |
$3,574.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,495.27
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,066.36 |
| Max. Negotiated Rate |
$2,951.94 |
| Rate for Payer: Aetna Commercial |
$2,656.75
|
| Rate for Payer: ASR ASR |
$2,863.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.64
|
| Rate for Payer: BCN Commercial |
$2,288.64
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,774.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,361.55
|
| Rate for Payer: Healthscope Commercial |
$2,951.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,863.38
|
| Rate for Payer: Mclaren Commercial |
$2,656.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,597.71
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,951.94 |
| Rate for Payer: Aetna Commercial |
$2,656.75
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$2,863.38
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.64
|
| Rate for Payer: BCN Commercial |
$2,288.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,774.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,361.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,951.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,863.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,656.75
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,686.27
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,597.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$211.07 |
| Max. Negotiated Rate |
$1,494.17 |
| Rate for Payer: Aetna Commercial |
$1,344.75
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.34
|
| Rate for Payer: ASR ASR |
$1,449.34
|
| Rate for Payer: BCBS Complete |
$221.64
|
| Rate for Payer: BCBS MAPPO |
$385.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.43
|
| Rate for Payer: BCN Commercial |
$1,158.43
|
| Rate for Payer: BCN Medicare Advantage |
$385.87
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,404.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,195.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.87
|
| Rate for Payer: Healthscope Commercial |
$1,494.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,449.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$385.87
|
| Rate for Payer: Mclaren Commercial |
$1,344.75
|
| Rate for Payer: Mclaren Medicaid |
$211.07
|
| Rate for Payer: Mclaren Medicare |
$385.87
|
| Rate for Payer: Meridian Medicaid |
$221.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: PACE Medicare |
$366.58
|
| Rate for Payer: PACE SWMI |
$385.87
|
| Rate for Payer: PHP Commercial |
$424.46
|
| Rate for Payer: PHP Medicaid |
$211.07
|
| Rate for Payer: PHP Medicare Advantage |
$385.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,359.69
|
| Rate for Payer: Priority Health Medicare |
$385.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.86
|
| Rate for Payer: Railroad Medicare Medicare |
$385.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,314.87
|
| Rate for Payer: UHC Medicare Advantage |
$397.45
|
| Rate for Payer: VA VA |
$385.87
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$1,045.92 |
| Max. Negotiated Rate |
$1,494.17 |
| Rate for Payer: Aetna Commercial |
$1,344.75
|
| Rate for Payer: ASR ASR |
$1,449.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.43
|
| Rate for Payer: BCN Commercial |
$1,158.43
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,404.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,195.34
|
| Rate for Payer: Healthscope Commercial |
$1,494.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,449.34
|
| Rate for Payer: Mclaren Commercial |
$1,344.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,314.87
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$377.63 |
| Max. Negotiated Rate |
$539.47 |
| Rate for Payer: Aetna Commercial |
$485.52
|
| Rate for Payer: ASR ASR |
$523.29
|
| Rate for Payer: BCBS Trust/PPO |
$418.25
|
| Rate for Payer: BCN Commercial |
$418.25
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$507.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.58
|
| Rate for Payer: Healthscope Commercial |
$539.47
|
| Rate for Payer: Healthscope Whirlpool |
$523.29
|
| Rate for Payer: Mclaren Commercial |
$485.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.73
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$215.79 |
| Max. Negotiated Rate |
$539.47 |
| Rate for Payer: Aetna Commercial |
$485.52
|
| Rate for Payer: ASR ASR |
$523.29
|
| Rate for Payer: BCBS Complete |
$215.79
|
| Rate for Payer: BCBS Trust/PPO |
$418.25
|
| Rate for Payer: BCN Commercial |
$418.25
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$507.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.58
|
| Rate for Payer: Healthscope Commercial |
$539.47
|
| Rate for Payer: Healthscope Whirlpool |
$523.29
|
| Rate for Payer: Mclaren Commercial |
$485.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.92
|
| Rate for Payer: Priority Health Narrow Network |
$383.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.73
|
|
