|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$541.99 |
| Rate for Payer: Aetna Commercial |
$487.79
|
| Rate for Payer: ASR ASR |
$525.73
|
| Rate for Payer: ASR Commercial |
$525.73
|
| Rate for Payer: BCBS Trust/PPO |
$441.67
|
| Rate for Payer: BCN Commercial |
$420.20
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$509.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$541.99
|
| Rate for Payer: Healthscope Whirlpool |
$525.73
|
| Rate for Payer: Mclaren Commercial |
$487.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.95
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
IP
|
$662.42
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.57 |
| Max. Negotiated Rate |
$662.42 |
| Rate for Payer: Aetna Commercial |
$596.18
|
| Rate for Payer: ASR ASR |
$642.55
|
| Rate for Payer: ASR Commercial |
$642.55
|
| Rate for Payer: BCBS Trust/PPO |
$539.81
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.94
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.94
|
| Rate for Payer: Healthscope Commercial |
$662.42
|
| Rate for Payer: Healthscope Whirlpool |
$642.55
|
| Rate for Payer: Mclaren Commercial |
$596.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.06
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.93
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
OP
|
$662.42
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$662.42 |
| Rate for Payer: Aetna Commercial |
$596.18
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$642.55
|
| Rate for Payer: ASR Commercial |
$642.55
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$542.46
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$529.94
|
| Rate for Payer: Cash Price |
$529.94
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$662.42
|
| Rate for Payer: Healthscope Whirlpool |
$642.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$596.18
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.06
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.41
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$464.36
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
IP
|
$240.33
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.21 |
| Max. Negotiated Rate |
$240.33 |
| Rate for Payer: Aetna Commercial |
$216.30
|
| Rate for Payer: ASR ASR |
$233.12
|
| Rate for Payer: ASR Commercial |
$233.12
|
| Rate for Payer: BCBS Trust/PPO |
$195.84
|
| Rate for Payer: BCN Commercial |
$186.33
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cofinity Commercial |
$225.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.26
|
| Rate for Payer: Healthscope Commercial |
$240.33
|
| Rate for Payer: Healthscope Whirlpool |
$233.12
|
| Rate for Payer: Mclaren Commercial |
$216.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.28
|
| Rate for Payer: Nomi Health Commercial |
$197.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$211.49
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
OP
|
$240.33
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$216.30
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$233.12
|
| Rate for Payer: ASR Commercial |
$233.12
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$196.81
|
| Rate for Payer: BCN Commercial |
$186.33
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cofinity Commercial |
$225.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$240.33
|
| Rate for Payer: Healthscope Whirlpool |
$233.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$216.30
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.28
|
| Rate for Payer: Nomi Health Commercial |
$197.07
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.58
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$168.47
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$211.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
OP
|
$448.42
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$448.42 |
| Rate for Payer: Aetna Commercial |
$403.58
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$434.97
|
| Rate for Payer: ASR Commercial |
$434.97
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$367.21
|
| Rate for Payer: BCN Commercial |
$347.66
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cofinity Commercial |
$421.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$448.42
|
| Rate for Payer: Healthscope Whirlpool |
$434.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$403.58
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.16
|
| Rate for Payer: Nomi Health Commercial |
$367.70
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.91
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$314.34
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
IP
|
$448.42
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.47 |
| Max. Negotiated Rate |
$448.42 |
| Rate for Payer: Aetna Commercial |
$403.58
|
| Rate for Payer: ASR ASR |
$434.97
|
| Rate for Payer: ASR Commercial |
$434.97
|
| Rate for Payer: BCBS Trust/PPO |
$365.42
|
| Rate for Payer: BCN Commercial |
$347.66
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cofinity Commercial |
$421.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.74
|
| Rate for Payer: Healthscope Commercial |
$448.42
|
| Rate for Payer: Healthscope Whirlpool |
$434.97
|
| Rate for Payer: Mclaren Commercial |
$403.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.16
|
| Rate for Payer: Nomi Health Commercial |
$367.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.61
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
OP
|
$696.44
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,046.87 |
| Rate for Payer: Aetna Commercial |
$626.80
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$675.55
|
| Rate for Payer: ASR Commercial |
$675.55
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$570.31
|
| Rate for Payer: BCN Commercial |
$539.95
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$654.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$696.44
|
| Rate for Payer: Healthscope Whirlpool |
$675.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$626.80
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.22
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$488.20
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
IP
|
$696.44
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$452.69 |
| Max. Negotiated Rate |
$696.44 |
| Rate for Payer: Aetna Commercial |
$626.80
|
| Rate for Payer: ASR ASR |
$675.55
|
| Rate for Payer: ASR Commercial |
$675.55
|
| Rate for Payer: BCBS Trust/PPO |
$567.53
|
| Rate for Payer: BCN Commercial |
$539.95
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$654.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Healthscope Commercial |
$696.44
|
| Rate for Payer: Healthscope Whirlpool |
$675.55
|
| Rate for Payer: Mclaren Commercial |
$626.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.87
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
OP
|
$197.68
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$24.12 |
| Max. Negotiated Rate |
$197.68 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: ASR ASR |
$191.75
|
| Rate for Payer: ASR Commercial |
$191.75
|
| Rate for Payer: BCBS Complete |
$25.33
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.88
|
| Rate for Payer: BCN Commercial |
$153.26
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$185.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$197.68
|
| Rate for Payer: Healthscope Whirlpool |
$191.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.00
|
| Rate for Payer: Mclaren Commercial |
$177.91
|
| Rate for Payer: Mclaren Medicaid |
$24.12
|
| Rate for Payer: Mclaren Medicare |
$45.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$25.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: PACE Medicare |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Medicaid |
$24.12
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.21
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health Narrow Network |
$138.57
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Exchange |
$69.75
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP DNSP |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: VA VA |
$45.00
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
IP
|
$197.68
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$128.49 |
| Max. Negotiated Rate |
$197.68 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: ASR ASR |
$191.75
|
| Rate for Payer: ASR Commercial |
$191.75
|
| Rate for Payer: BCBS Trust/PPO |
$161.09
|
| Rate for Payer: BCN Commercial |
$153.26
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$185.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$197.68
|
| Rate for Payer: Healthscope Whirlpool |
$191.75
|
| Rate for Payer: Mclaren Commercial |
$177.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.96
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
IP
|
$262.13
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$170.38 |
| Max. Negotiated Rate |
$262.13 |
| Rate for Payer: Aetna Commercial |
$235.92
|
| Rate for Payer: ASR ASR |
$254.27
|
| Rate for Payer: ASR Commercial |
$254.27
|
| Rate for Payer: BCBS Trust/PPO |
$213.61
|
| Rate for Payer: BCN Commercial |
$203.23
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cofinity Commercial |
$246.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.70
|
| Rate for Payer: Healthscope Commercial |
$262.13
|
| Rate for Payer: Healthscope Whirlpool |
$254.27
|
| Rate for Payer: Mclaren Commercial |
$235.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.81
|
| Rate for Payer: Nomi Health Commercial |
$214.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.67
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
OP
|
$262.13
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$262.13 |
| Rate for Payer: Aetna Commercial |
$235.92
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$254.27
|
| Rate for Payer: ASR Commercial |
$254.27
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$214.66
|
| Rate for Payer: BCN Commercial |
$203.23
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cofinity Commercial |
$246.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$262.13
|
| Rate for Payer: Healthscope Whirlpool |
$254.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$235.92
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.81
|
| Rate for Payer: Nomi Health Commercial |
$214.95
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.68
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$183.75
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
IP
|
$973.97
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$633.08 |
| Max. Negotiated Rate |
$973.97 |
| Rate for Payer: Aetna Commercial |
$876.57
|
| Rate for Payer: ASR ASR |
$944.75
|
| Rate for Payer: ASR Commercial |
$944.75
|
| Rate for Payer: BCBS Trust/PPO |
$793.69
|
| Rate for Payer: BCN Commercial |
$755.12
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cofinity Commercial |
$915.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$779.18
|
| Rate for Payer: Healthscope Commercial |
$973.97
|
| Rate for Payer: Healthscope Whirlpool |
$944.75
|
| Rate for Payer: Mclaren Commercial |
$876.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$827.87
|
| Rate for Payer: Nomi Health Commercial |
$798.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$857.09
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$973.97
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$973.97 |
| Rate for Payer: Aetna Commercial |
$876.57
|
| Rate for Payer: Aetna Medicare |
$323.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.36
|
| Rate for Payer: ASR ASR |
$944.75
|
| Rate for Payer: ASR Commercial |
$944.75
|
| Rate for Payer: BCBS Complete |
$182.06
|
| Rate for Payer: BCBS MAPPO |
$323.49
|
| Rate for Payer: BCBS Trust/PPO |
$797.58
|
| Rate for Payer: BCN Commercial |
$755.12
|
| Rate for Payer: BCN Medicare Advantage |
$323.49
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cofinity Commercial |
$915.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$779.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.49
|
| Rate for Payer: Healthscope Commercial |
$973.97
|
| Rate for Payer: Healthscope Whirlpool |
$944.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$323.49
|
| Rate for Payer: Mclaren Commercial |
$876.57
|
| Rate for Payer: Mclaren Medicaid |
$173.39
|
| Rate for Payer: Mclaren Medicare |
$323.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.66
|
| Rate for Payer: Meridian Medicaid |
$182.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$827.87
|
| Rate for Payer: Nomi Health Commercial |
$798.66
|
| Rate for Payer: PACE Medicare |
$307.32
|
| Rate for Payer: PACE SWMI |
$323.49
|
| Rate for Payer: PHP Commercial |
$355.84
|
| Rate for Payer: PHP Medicaid |
$173.39
|
| Rate for Payer: PHP Medicare Advantage |
$323.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$853.39
|
| Rate for Payer: Priority Health Medicare |
$323.49
|
| Rate for Payer: Priority Health Narrow Network |
$682.75
|
| Rate for Payer: Railroad Medicare Medicare |
$323.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$857.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.49
|
| Rate for Payer: UHC Exchange |
$501.41
|
| Rate for Payer: UHC Medicare Advantage |
$323.49
|
| Rate for Payer: UHCCP DNSP |
$323.49
|
| Rate for Payer: UHCCP Medicaid |
$173.39
|
| Rate for Payer: VA VA |
$323.49
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$882.55 |
| Rate for Payer: Aetna Commercial |
$794.29
|
| Rate for Payer: Aetna Medicare |
$323.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.36
|
| Rate for Payer: ASR ASR |
$856.07
|
| Rate for Payer: ASR Commercial |
$856.07
|
| Rate for Payer: BCBS Complete |
$182.06
|
| Rate for Payer: BCBS MAPPO |
$323.49
|
| Rate for Payer: BCBS Trust/PPO |
$722.72
|
| Rate for Payer: BCN Commercial |
$684.24
|
| Rate for Payer: BCN Medicare Advantage |
$323.49
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$829.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.49
|
| Rate for Payer: Healthscope Commercial |
$882.55
|
| Rate for Payer: Healthscope Whirlpool |
$856.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$323.49
|
| Rate for Payer: Mclaren Commercial |
$794.29
|
| Rate for Payer: Mclaren Medicaid |
$173.39
|
| Rate for Payer: Mclaren Medicare |
$323.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.66
|
| Rate for Payer: Meridian Medicaid |
$182.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: PACE Medicare |
$307.32
|
| Rate for Payer: PACE SWMI |
$323.49
|
| Rate for Payer: PHP Commercial |
$355.84
|
| Rate for Payer: PHP Medicaid |
$173.39
|
| Rate for Payer: PHP Medicare Advantage |
$323.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.29
|
| Rate for Payer: Priority Health Medicare |
$323.49
|
| Rate for Payer: Priority Health Narrow Network |
$618.67
|
| Rate for Payer: Railroad Medicare Medicare |
$323.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.49
|
| Rate for Payer: UHC Exchange |
$501.41
|
| Rate for Payer: UHC Medicare Advantage |
$323.49
|
| Rate for Payer: UHCCP DNSP |
$323.49
|
| Rate for Payer: UHCCP Medicaid |
$173.39
|
| Rate for Payer: VA VA |
$323.49
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$573.66 |
| Max. Negotiated Rate |
$882.55 |
| Rate for Payer: Aetna Commercial |
$794.29
|
| Rate for Payer: ASR ASR |
$856.07
|
| Rate for Payer: ASR Commercial |
$856.07
|
| Rate for Payer: BCBS Trust/PPO |
$719.19
|
| Rate for Payer: BCN Commercial |
$684.24
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$829.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Healthscope Commercial |
$882.55
|
| Rate for Payer: Healthscope Whirlpool |
$856.07
|
| Rate for Payer: Mclaren Commercial |
$794.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.64
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$286.16 |
| Max. Negotiated Rate |
$440.24 |
| Rate for Payer: Aetna Commercial |
$396.22
|
| Rate for Payer: ASR ASR |
$427.03
|
| Rate for Payer: ASR Commercial |
$427.03
|
| Rate for Payer: BCBS Trust/PPO |
$358.75
|
| Rate for Payer: BCN Commercial |
$341.32
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$413.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Healthscope Commercial |
$440.24
|
| Rate for Payer: Healthscope Whirlpool |
$427.03
|
| Rate for Payer: Mclaren Commercial |
$396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.41
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$440.24 |
| Rate for Payer: Aetna Commercial |
$396.22
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$427.03
|
| Rate for Payer: ASR Commercial |
$427.03
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$360.51
|
| Rate for Payer: BCN Commercial |
$341.32
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$413.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$440.24
|
| Rate for Payer: Healthscope Whirlpool |
$427.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$396.22
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.74
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$308.61
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Trust/PPO |
$357.46
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$501.41 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: Aetna Medicare |
$323.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.36
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Complete |
$182.06
|
| Rate for Payer: BCBS MAPPO |
$323.49
|
| Rate for Payer: BCBS Trust/PPO |
$359.21
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: BCN Medicare Advantage |
$323.49
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.49
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$323.49
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Mclaren Medicaid |
$173.39
|
| Rate for Payer: Mclaren Medicare |
$323.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.66
|
| Rate for Payer: Meridian Medicaid |
$182.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Medicare |
$307.32
|
| Rate for Payer: PACE SWMI |
$323.49
|
| Rate for Payer: PHP Commercial |
$355.84
|
| Rate for Payer: PHP Medicaid |
$173.39
|
| Rate for Payer: PHP Medicare Advantage |
$323.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.35
|
| Rate for Payer: Priority Health Medicare |
$323.49
|
| Rate for Payer: Priority Health Narrow Network |
$307.49
|
| Rate for Payer: Railroad Medicare Medicare |
$323.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.49
|
| Rate for Payer: UHC Exchange |
$501.41
|
| Rate for Payer: UHC Medicare Advantage |
$323.49
|
| Rate for Payer: UHCCP DNSP |
$323.49
|
| Rate for Payer: UHCCP Medicaid |
$173.39
|
| Rate for Payer: VA VA |
$323.49
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$501.41 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: Aetna Medicare |
$323.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.36
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Complete |
$182.06
|
| Rate for Payer: BCBS MAPPO |
$323.49
|
| Rate for Payer: BCBS Trust/PPO |
$359.21
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: BCN Medicare Advantage |
$323.49
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.49
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$323.49
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Mclaren Medicaid |
$173.39
|
| Rate for Payer: Mclaren Medicare |
$323.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.66
|
| Rate for Payer: Meridian Medicaid |
$182.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Medicare |
$307.32
|
| Rate for Payer: PACE SWMI |
$323.49
|
| Rate for Payer: PHP Commercial |
$355.84
|
| Rate for Payer: PHP Medicaid |
$173.39
|
| Rate for Payer: PHP Medicare Advantage |
$323.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.35
|
| Rate for Payer: Priority Health Medicare |
$323.49
|
| Rate for Payer: Priority Health Narrow Network |
$307.49
|
| Rate for Payer: Railroad Medicare Medicare |
$323.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.49
|
| Rate for Payer: UHC Exchange |
$501.41
|
| Rate for Payer: UHC Medicare Advantage |
$323.49
|
| Rate for Payer: UHCCP DNSP |
$323.49
|
| Rate for Payer: UHCCP Medicaid |
$173.39
|
| Rate for Payer: VA VA |
$323.49
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Trust/PPO |
$357.46
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.24 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: Aetna Medicare |
$780.30
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: ASR Commercial |
$1,513.78
|
| Rate for Payer: BCBS Complete |
$624.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.98
|
| Rate for Payer: BCN Commercial |
$1,209.93
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,513.78
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,367.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,014.39 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: ASR Commercial |
$1,513.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.73
|
| Rate for Payer: BCN Commercial |
$1,209.93
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,513.78
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
|
