|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
IP
|
$430.93
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$430.93 |
| Rate for Payer: Aetna Commercial |
$387.84
|
| Rate for Payer: ASR ASR |
$418.00
|
| Rate for Payer: BCBS Trust/PPO |
$353.88
|
| Rate for Payer: BCN Commercial |
$353.88
|
| 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: Healthscope Commercial |
$418.00
|
| Rate for Payer: Healthscope Whirlpool |
$430.93
|
| Rate for Payer: Mclaren Commercial |
$387.84
|
| 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: UHC All Payor (Choice/PPO) + Core |
$379.22
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
OP
|
$335.35
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$335.35 |
| Rate for Payer: Aetna Commercial |
$301.81
|
| 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 |
$325.29
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$276.50
|
| Rate for Payer: BCN Commercial |
$276.50
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cofinity Commercial |
$315.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$325.29
|
| Rate for Payer: Healthscope Whirlpool |
$335.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$301.81
|
| 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 |
$285.05
|
| Rate for Payer: Nomi Health Commercial |
$274.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.51
|
| 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 |
$293.83
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$235.08
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.11
|
| 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, VULVA
|
Facility
|
IP
|
$335.35
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.51 |
| Max. Negotiated Rate |
$335.35 |
| Rate for Payer: Aetna Commercial |
$301.81
|
| Rate for Payer: ASR ASR |
$325.29
|
| Rate for Payer: BCBS Trust/PPO |
$275.39
|
| Rate for Payer: BCN Commercial |
$275.39
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cofinity Commercial |
$315.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.28
|
| Rate for Payer: Healthscope Commercial |
$325.29
|
| Rate for Payer: Healthscope Whirlpool |
$335.35
|
| Rate for Payer: Mclaren Commercial |
$301.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.05
|
| Rate for Payer: Nomi Health Commercial |
$274.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.11
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$653.44 |
| Max. Negotiated Rate |
$871.25 |
| Rate for Payer: Aetna Commercial |
$784.12
|
| Rate for Payer: ASR ASR |
$845.11
|
| Rate for Payer: BCBS Trust/PPO |
$715.47
|
| Rate for Payer: BCN Commercial |
$715.47
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Commercial |
$818.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Healthscope Commercial |
$845.11
|
| Rate for Payer: Healthscope Whirlpool |
$871.25
|
| Rate for Payer: Mclaren Commercial |
$784.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.56
|
| Rate for Payer: Nomi Health Commercial |
$714.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.70
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$871.25 |
| Rate for Payer: Aetna Commercial |
$784.12
|
| 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 |
$845.11
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$718.35
|
| Rate for Payer: BCN Commercial |
$718.35
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Commercial |
$818.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$845.11
|
| Rate for Payer: Healthscope Whirlpool |
$871.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$784.12
|
| 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 |
$740.56
|
| Rate for Payer: Nomi Health Commercial |
$714.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| 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 |
$763.39
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$610.75
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.70
|
| 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 COMBI CATH SUPPLY
|
Facility
|
OP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.59 |
| Max. Negotiated Rate |
$125.93 |
| Rate for Payer: Aetna Commercial |
$113.34
|
| Rate for Payer: Aetna Medicare |
$46.59
|
| Rate for Payer: ASR ASR |
$122.15
|
| Rate for Payer: BCBS Complete |
$50.37
|
| Rate for Payer: BCBS Trust/PPO |
$103.83
|
| Rate for Payer: BCN Commercial |
$103.83
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Commercial |
$118.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Healthscope Whirlpool |
$125.93
|
| Rate for Payer: Mclaren Commercial |
$113.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$103.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.34
|
| Rate for Payer: Priority Health Narrow Network |
$88.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.82
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
IP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.45 |
| Max. Negotiated Rate |
$125.93 |
| Rate for Payer: Aetna Commercial |
$113.34
|
| Rate for Payer: ASR ASR |
$122.15
|
| Rate for Payer: BCBS Trust/PPO |
$103.41
|
| Rate for Payer: BCN Commercial |
$103.41
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Commercial |
$118.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Healthscope Whirlpool |
$125.93
|
| Rate for Payer: Mclaren Commercial |
$113.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$103.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.82
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$163.16 |
| Max. Negotiated Rate |
$217.55 |
| Rate for Payer: Aetna Commercial |
$195.79
|
| Rate for Payer: ASR ASR |
$211.02
|
| Rate for Payer: BCBS Trust/PPO |
$178.65
|
| Rate for Payer: BCN Commercial |
$178.65
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$204.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$211.02
|
| Rate for Payer: Healthscope Whirlpool |
$217.55
|
| Rate for Payer: Mclaren Commercial |
$195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.44
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$329.08 |
| Rate for Payer: Aetna Commercial |
$195.79
|
| Rate for Payer: Aetna Medicare |
$80.49
|
| Rate for Payer: ASR ASR |
$211.02
|
| Rate for Payer: BCBS Complete |
$87.02
|
| Rate for Payer: BCBS Trust/PPO |
$179.37
|
| Rate for Payer: BCN Commercial |
$179.37
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$204.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$211.02
|
| Rate for Payer: Healthscope Whirlpool |
$217.55
|
| Rate for Payer: Mclaren Commercial |
$195.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$329.08
|
| Rate for Payer: Priority Health Narrow Network |
$263.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.44
|
|
|
HC COMMON REED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC COMMON REED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.13 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$81.17
|
| Rate for Payer: BCN Commercial |
$81.17
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$36.57
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Complete |
$39.54
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$81.49
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.58
|
| Rate for Payer: Priority Health Narrow Network |
$53.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
IP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$503.84 |
| Max. Negotiated Rate |
$671.79 |
| Rate for Payer: Aetna Commercial |
$604.61
|
| Rate for Payer: ASR ASR |
$651.64
|
| Rate for Payer: BCBS Trust/PPO |
$551.67
|
| Rate for Payer: BCN Commercial |
$551.67
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Commercial |
$631.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Healthscope Commercial |
$651.64
|
| Rate for Payer: Healthscope Whirlpool |
$671.79
|
| Rate for Payer: Mclaren Commercial |
$604.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Nomi Health Commercial |
$550.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$591.18
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
OP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$248.56 |
| Max. Negotiated Rate |
$671.79 |
| Rate for Payer: Aetna Commercial |
$604.61
|
| Rate for Payer: Aetna Medicare |
$248.56
|
| Rate for Payer: ASR ASR |
$651.64
|
| Rate for Payer: BCBS Complete |
$268.72
|
| Rate for Payer: BCBS Trust/PPO |
$553.89
|
| Rate for Payer: BCN Commercial |
$553.89
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Commercial |
$631.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Healthscope Commercial |
$651.64
|
| Rate for Payer: Healthscope Whirlpool |
$671.79
|
| Rate for Payer: Mclaren Commercial |
$604.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$537.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Nomi Health Commercial |
$550.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$588.62
|
| Rate for Payer: Priority Health Narrow Network |
$470.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$591.18
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
IP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.59 |
| Max. Negotiated Rate |
$243.45 |
| Rate for Payer: Aetna Commercial |
$219.10
|
| Rate for Payer: ASR ASR |
$236.15
|
| Rate for Payer: BCBS Trust/PPO |
$199.92
|
| Rate for Payer: BCN Commercial |
$199.92
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Commercial |
$228.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Healthscope Commercial |
$236.15
|
| Rate for Payer: Healthscope Whirlpool |
$243.45
|
| Rate for Payer: Mclaren Commercial |
$219.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Nomi Health Commercial |
$199.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.24
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
OP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.08 |
| Max. Negotiated Rate |
$243.45 |
| Rate for Payer: Aetna Commercial |
$219.10
|
| Rate for Payer: Aetna Medicare |
$90.08
|
| Rate for Payer: ASR ASR |
$236.15
|
| Rate for Payer: BCBS Complete |
$97.38
|
| Rate for Payer: BCBS Trust/PPO |
$200.72
|
| Rate for Payer: BCN Commercial |
$200.72
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Commercial |
$228.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Healthscope Commercial |
$236.15
|
| Rate for Payer: Healthscope Whirlpool |
$243.45
|
| Rate for Payer: Mclaren Commercial |
$219.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Nomi Health Commercial |
$199.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$213.31
|
| Rate for Payer: Priority Health Narrow Network |
$170.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.24
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Medicare |
$4.62
|
| Rate for Payer: ASR ASR |
$12.11
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$10.29
|
| Rate for Payer: BCN Commercial |
$10.29
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.11
|
| Rate for Payer: Healthscope Whirlpool |
$12.48
|
| Rate for Payer: Mclaren Commercial |
$11.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.93
|
| Rate for Payer: Priority Health Narrow Network |
$8.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.98
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: ASR ASR |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$10.25
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.11
|
| Rate for Payer: Healthscope Whirlpool |
$12.48
|
| Rate for Payer: Mclaren Commercial |
$11.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.98
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$16.15
|
| Rate for Payer: BCBS Trust/PPO |
$13.67
|
| Rate for Payer: BCN Commercial |
$13.67
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$16.15
|
| Rate for Payer: Healthscope Whirlpool |
$16.65
|
| Rate for Payer: Mclaren Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Nomi Health Commercial |
$13.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.65
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$14.98
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: ASR ASR |
$16.15
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS Trust/PPO |
$13.73
|
| Rate for Payer: BCN Commercial |
$13.73
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$16.15
|
| Rate for Payer: Healthscope Whirlpool |
$16.65
|
| Rate for Payer: Mclaren Commercial |
$14.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Nomi Health Commercial |
$13.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14.59
|
| Rate for Payer: Priority Health Narrow Network |
$11.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.65
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.38 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Trust/PPO |
$52.97
|
| Rate for Payer: BCN Commercial |
$52.97
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS Trust/PPO |
$53.18
|
| Rate for Payer: BCN Commercial |
$53.18
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.51
|
| Rate for Payer: Priority Health Narrow Network |
$45.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
OP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$345.41 |
| Rate for Payer: Aetna Commercial |
$310.87
|
| Rate for Payer: Aetna Medicare |
$127.80
|
| Rate for Payer: ASR ASR |
$335.05
|
| Rate for Payer: BCBS Complete |
$138.16
|
| Rate for Payer: BCBS Trust/PPO |
$284.79
|
| Rate for Payer: BCN Commercial |
$284.79
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$324.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$335.05
|
| Rate for Payer: Healthscope Whirlpool |
$345.41
|
| Rate for Payer: Mclaren Commercial |
$310.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.65
|
| Rate for Payer: Priority Health Narrow Network |
$242.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.96
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
IP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$259.06 |
| Max. Negotiated Rate |
$345.41 |
| Rate for Payer: Aetna Commercial |
$310.87
|
| Rate for Payer: ASR ASR |
$335.05
|
| Rate for Payer: BCBS Trust/PPO |
$283.65
|
| Rate for Payer: BCN Commercial |
$283.65
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$324.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$335.05
|
| Rate for Payer: Healthscope Whirlpool |
$345.41
|
| Rate for Payer: Mclaren Commercial |
$310.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.96
|
|
