|
HC COLLECT CAPILLARY BLOOD SPECIMEN
|
Facility
|
OP
|
$8.91
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$8.91 |
| Rate for Payer: Aetna Commercial |
$8.02
|
| Rate for Payer: Aetna Medicare |
$3.30
|
| Rate for Payer: ASR ASR |
$8.64
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS Trust/PPO |
$7.35
|
| Rate for Payer: BCN Commercial |
$7.35
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.13
|
| Rate for Payer: Healthscope Commercial |
$8.64
|
| Rate for Payer: Healthscope Whirlpool |
$8.91
|
| Rate for Payer: Mclaren Commercial |
$8.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.57
|
| Rate for Payer: Nomi Health Commercial |
$7.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.64
|
| Rate for Payer: Priority Health Narrow Network |
$2.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.84
|
|
|
HC COLLECT CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$8.91
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$8.91 |
| Rate for Payer: Aetna Commercial |
$8.02
|
| Rate for Payer: ASR ASR |
$8.64
|
| Rate for Payer: BCBS Trust/PPO |
$7.32
|
| Rate for Payer: BCN Commercial |
$7.32
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.13
|
| Rate for Payer: Healthscope Commercial |
$8.64
|
| Rate for Payer: Healthscope Whirlpool |
$8.91
|
| Rate for Payer: Mclaren Commercial |
$8.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.57
|
| Rate for Payer: Nomi Health Commercial |
$7.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.84
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
OP
|
$2,450.59
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$906.72 |
| Max. Negotiated Rate |
$2,450.59 |
| Rate for Payer: Aetna Commercial |
$2,205.53
|
| Rate for Payer: Aetna Medicare |
$906.72
|
| Rate for Payer: ASR ASR |
$2,377.07
|
| Rate for Payer: BCBS Complete |
$980.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.51
|
| Rate for Payer: BCN Commercial |
$2,020.51
|
| Rate for Payer: Cash Price |
$1,960.47
|
| Rate for Payer: Cofinity Commercial |
$2,303.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,960.47
|
| Rate for Payer: Healthscope Commercial |
$2,377.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,450.59
|
| Rate for Payer: Mclaren Commercial |
$2,205.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,960.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,083.00
|
| Rate for Payer: Nomi Health Commercial |
$2,009.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,837.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,147.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,717.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,156.52
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
IP
|
$2,450.59
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,837.94 |
| Max. Negotiated Rate |
$2,450.59 |
| Rate for Payer: Aetna Commercial |
$2,205.53
|
| Rate for Payer: ASR ASR |
$2,377.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,012.42
|
| Rate for Payer: BCN Commercial |
$2,012.42
|
| Rate for Payer: Cash Price |
$1,960.47
|
| Rate for Payer: Cofinity Commercial |
$2,303.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,960.47
|
| Rate for Payer: Healthscope Commercial |
$2,377.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,450.59
|
| Rate for Payer: Mclaren Commercial |
$2,205.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,083.00
|
| Rate for Payer: Nomi Health Commercial |
$2,009.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,837.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,156.52
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
IP
|
$373.92
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$280.44 |
| Max. Negotiated Rate |
$373.92 |
| Rate for Payer: Aetna Commercial |
$336.53
|
| Rate for Payer: ASR ASR |
$362.70
|
| Rate for Payer: BCBS Trust/PPO |
$307.06
|
| Rate for Payer: BCN Commercial |
$307.06
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$351.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Healthscope Commercial |
$362.70
|
| Rate for Payer: Healthscope Whirlpool |
$373.92
|
| Rate for Payer: Mclaren Commercial |
$336.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.05
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
OP
|
$373.92
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$373.92 |
| Rate for Payer: Aetna Commercial |
$336.53
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$362.70
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$308.30
|
| Rate for Payer: BCN Commercial |
$308.30
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$351.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$362.70
|
| Rate for Payer: Healthscope Whirlpool |
$373.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$336.53
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$327.63
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$262.12
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC COLONOSCOPY
|
Facility
|
IP
|
$2,663.93
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,997.95 |
| Max. Negotiated Rate |
$2,663.93 |
| Rate for Payer: Aetna Commercial |
$2,397.54
|
| Rate for Payer: ASR ASR |
$2,584.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,187.62
|
| Rate for Payer: BCN Commercial |
$2,187.62
|
| Rate for Payer: Cash Price |
$2,131.14
|
| Rate for Payer: Cofinity Commercial |
$2,504.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,131.14
|
| Rate for Payer: Healthscope Commercial |
$2,584.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,663.93
|
| Rate for Payer: Mclaren Commercial |
$2,397.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,264.34
|
| Rate for Payer: Nomi Health Commercial |
$2,184.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,997.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,344.26
|
|
|
HC COLONOSCOPY
|
Facility
|
OP
|
$2,663.93
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$985.65 |
| Max. Negotiated Rate |
$2,663.93 |
| Rate for Payer: Aetna Commercial |
$2,397.54
|
| Rate for Payer: Aetna Medicare |
$985.65
|
| Rate for Payer: ASR ASR |
$2,584.01
|
| Rate for Payer: BCBS Complete |
$1,065.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,196.41
|
| Rate for Payer: BCN Commercial |
$2,196.41
|
| Rate for Payer: Cash Price |
$2,131.14
|
| Rate for Payer: Cofinity Commercial |
$2,504.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,131.14
|
| Rate for Payer: Healthscope Commercial |
$2,584.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,663.93
|
| Rate for Payer: Mclaren Commercial |
$2,397.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,131.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,264.34
|
| Rate for Payer: Nomi Health Commercial |
$2,184.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,997.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,334.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,867.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,344.26
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,856.06
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,142.05 |
| Max. Negotiated Rate |
$2,856.06 |
| Rate for Payer: Aetna Commercial |
$2,570.45
|
| Rate for Payer: ASR ASR |
$2,770.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.40
|
| Rate for Payer: BCN Commercial |
$2,345.40
|
| Rate for Payer: Cash Price |
$2,284.85
|
| Rate for Payer: Cofinity Commercial |
$2,684.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,284.85
|
| Rate for Payer: Healthscope Commercial |
$2,770.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,856.06
|
| Rate for Payer: Mclaren Commercial |
$2,570.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,427.65
|
| Rate for Payer: Nomi Health Commercial |
$2,341.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,513.33
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,856.06
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,056.74 |
| Max. Negotiated Rate |
$2,856.06 |
| Rate for Payer: Aetna Commercial |
$2,570.45
|
| Rate for Payer: Aetna Medicare |
$1,056.74
|
| Rate for Payer: ASR ASR |
$2,770.38
|
| Rate for Payer: BCBS Complete |
$1,142.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,354.82
|
| Rate for Payer: BCN Commercial |
$2,354.82
|
| Rate for Payer: Cash Price |
$2,284.85
|
| Rate for Payer: Cofinity Commercial |
$2,684.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,284.85
|
| Rate for Payer: Healthscope Commercial |
$2,770.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,856.06
|
| Rate for Payer: Mclaren Commercial |
$2,570.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,427.65
|
| Rate for Payer: Nomi Health Commercial |
$2,341.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,502.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,002.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,513.33
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$7,108.93
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,331.70 |
| Max. Negotiated Rate |
$7,108.93 |
| Rate for Payer: Aetna Commercial |
$6,398.04
|
| Rate for Payer: ASR ASR |
$6,895.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,837.85
|
| Rate for Payer: BCN Commercial |
$5,837.85
|
| Rate for Payer: Cash Price |
$5,687.14
|
| Rate for Payer: Cofinity Commercial |
$6,682.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,687.14
|
| Rate for Payer: Healthscope Commercial |
$6,895.66
|
| Rate for Payer: Healthscope Whirlpool |
$7,108.93
|
| Rate for Payer: Mclaren Commercial |
$6,398.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,042.59
|
| Rate for Payer: Nomi Health Commercial |
$5,829.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,331.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,255.86
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$7,108.93
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$331.06 |
| Max. Negotiated Rate |
$7,108.93 |
| Rate for Payer: Aetna Commercial |
$6,398.04
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$6,895.66
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$5,861.31
|
| Rate for Payer: BCCCP Commercial |
$331.06
|
| Rate for Payer: BCN Commercial |
$5,861.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$5,687.14
|
| Rate for Payer: Cash Price |
$5,687.14
|
| Rate for Payer: Cofinity Commercial |
$6,682.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,687.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$6,895.66
|
| Rate for Payer: Healthscope Whirlpool |
$7,108.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$6,398.04
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,042.59
|
| Rate for Payer: Nomi Health Commercial |
$5,829.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,331.70
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,228.84
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$4,983.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,255.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$8,271.18
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,203.39 |
| Max. Negotiated Rate |
$8,271.18 |
| Rate for Payer: Aetna Commercial |
$7,444.06
|
| Rate for Payer: ASR ASR |
$8,023.04
|
| Rate for Payer: BCBS Trust/PPO |
$6,792.29
|
| Rate for Payer: BCN Commercial |
$6,792.29
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,774.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Healthscope Commercial |
$8,023.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,271.18
|
| Rate for Payer: Mclaren Commercial |
$7,444.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,278.64
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$8,271.18
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$8,271.18 |
| Rate for Payer: Aetna Commercial |
$7,444.06
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$8,023.04
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,819.59
|
| Rate for Payer: BCCCP Commercial |
$295.08
|
| Rate for Payer: BCN Commercial |
$6,819.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,774.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$8,023.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,271.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,444.06
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,247.21
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,798.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,278.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
IP
|
$290.77
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.08 |
| Max. Negotiated Rate |
$290.77 |
| Rate for Payer: Aetna Commercial |
$261.69
|
| Rate for Payer: ASR ASR |
$282.05
|
| Rate for Payer: BCBS Trust/PPO |
$238.78
|
| Rate for Payer: BCN Commercial |
$238.78
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cofinity Commercial |
$273.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.62
|
| Rate for Payer: Healthscope Commercial |
$282.05
|
| Rate for Payer: Healthscope Whirlpool |
$290.77
|
| Rate for Payer: Mclaren Commercial |
$261.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.15
|
| Rate for Payer: Nomi Health Commercial |
$238.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$255.88
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
OP
|
$290.77
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$261.69
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$282.05
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$239.74
|
| Rate for Payer: BCCCP Commercial |
$122.41
|
| Rate for Payer: BCN Commercial |
$239.74
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cofinity Commercial |
$273.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$282.05
|
| Rate for Payer: Healthscope Whirlpool |
$290.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$261.69
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.15
|
| Rate for Payer: Nomi Health Commercial |
$238.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.08
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.77
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$203.83
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$255.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
OP
|
$434.56
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$470.63 |
| Rate for Payer: Aetna Commercial |
$391.10
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$421.52
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$358.29
|
| Rate for Payer: BCCCP Commercial |
$146.69
|
| Rate for Payer: BCN Commercial |
$358.29
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Commercial |
$408.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$421.52
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$391.10
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$356.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$380.76
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$304.63
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
IP
|
$434.56
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.92 |
| Max. Negotiated Rate |
$434.56 |
| Rate for Payer: Aetna Commercial |
$391.10
|
| Rate for Payer: ASR ASR |
$421.52
|
| Rate for Payer: BCBS Trust/PPO |
$356.86
|
| Rate for Payer: BCN Commercial |
$356.86
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Commercial |
$408.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Healthscope Commercial |
$421.52
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Mclaren Commercial |
$391.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$356.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.41
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
OP
|
$434.56
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.18 |
| Max. Negotiated Rate |
$470.63 |
| Rate for Payer: Aetna Commercial |
$391.10
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$421.52
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$358.29
|
| Rate for Payer: BCCCP Commercial |
$157.18
|
| Rate for Payer: BCN Commercial |
$358.29
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Commercial |
$408.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$421.52
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$391.10
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$356.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$380.76
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$304.63
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
IP
|
$434.56
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.92 |
| Max. Negotiated Rate |
$434.56 |
| Rate for Payer: Aetna Commercial |
$391.10
|
| Rate for Payer: ASR ASR |
$421.52
|
| Rate for Payer: BCBS Trust/PPO |
$356.86
|
| Rate for Payer: BCN Commercial |
$356.86
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Commercial |
$408.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Healthscope Commercial |
$421.52
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Mclaren Commercial |
$391.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$356.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.41
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
OP
|
$375.67
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$470.63 |
| Rate for Payer: Aetna Commercial |
$338.10
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$364.40
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$309.74
|
| Rate for Payer: BCCCP Commercial |
$164.88
|
| Rate for Payer: BCN Commercial |
$309.74
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cofinity Commercial |
$353.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$364.40
|
| Rate for Payer: Healthscope Whirlpool |
$375.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$338.10
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.32
|
| Rate for Payer: Nomi Health Commercial |
$308.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.75
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$329.16
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$263.34
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
IP
|
$375.67
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.75 |
| Max. Negotiated Rate |
$375.67 |
| Rate for Payer: Aetna Commercial |
$338.10
|
| Rate for Payer: ASR ASR |
$364.40
|
| Rate for Payer: BCBS Trust/PPO |
$308.50
|
| Rate for Payer: BCN Commercial |
$308.50
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cofinity Commercial |
$353.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.54
|
| Rate for Payer: Healthscope Commercial |
$364.40
|
| Rate for Payer: Healthscope Whirlpool |
$375.67
|
| Rate for Payer: Mclaren Commercial |
$338.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.32
|
| Rate for Payer: Nomi Health Commercial |
$308.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.59
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
IP
|
$888.23
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.17 |
| Max. Negotiated Rate |
$888.23 |
| Rate for Payer: Aetna Commercial |
$799.41
|
| Rate for Payer: ASR ASR |
$861.58
|
| Rate for Payer: BCBS Trust/PPO |
$729.41
|
| Rate for Payer: BCN Commercial |
$729.41
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Commercial |
$834.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Healthscope Commercial |
$861.58
|
| Rate for Payer: Healthscope Whirlpool |
$888.23
|
| Rate for Payer: Mclaren Commercial |
$799.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Nomi Health Commercial |
$728.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.64
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
OP
|
$888.23
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$1,422.50 |
| Rate for Payer: Aetna Commercial |
$799.41
|
| Rate for Payer: Aetna Medicare |
$917.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: ASR ASR |
$861.58
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$732.35
|
| Rate for Payer: BCN Commercial |
$732.35
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Commercial |
$834.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$861.58
|
| Rate for Payer: Healthscope Whirlpool |
$888.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$917.74
|
| Rate for Payer: Mclaren Commercial |
$799.41
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$504.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Nomi Health Commercial |
$728.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$1,009.51
|
| Rate for Payer: PHP Medicaid |
$491.91
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$778.27
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Narrow Network |
$622.65
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$1,422.50
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP DNSP |
$917.74
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
OP
|
$430.93
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$470.63 |
| Rate for Payer: Aetna Commercial |
$387.84
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$418.00
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$355.30
|
| Rate for Payer: BCN Commercial |
$355.30
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cofinity Commercial |
$405.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$418.00
|
| Rate for Payer: Healthscope Whirlpool |
$430.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$387.84
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.29
|
| Rate for Payer: Nomi Health Commercial |
$353.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.20
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$377.58
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$302.08
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
