|
HC GGTP
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: ASR ASR |
$65.96
|
| Rate for Payer: BCBS Trust/PPO |
$52.72
|
| Rate for Payer: BCN Commercial |
$52.72
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Healthscope Commercial |
$68.00
|
| Rate for Payer: Healthscope Whirlpool |
$65.96
|
| Rate for Payer: Mclaren Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.84
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$57.98 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,761.21
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,232.85 |
| Max. Negotiated Rate |
$1,761.21 |
| Rate for Payer: Aetna Commercial |
$1,585.09
|
| Rate for Payer: ASR ASR |
$1,708.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.47
|
| Rate for Payer: BCN Commercial |
$1,365.47
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cofinity Commercial |
$1,655.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.97
|
| Rate for Payer: Healthscope Commercial |
$1,761.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,708.37
|
| Rate for Payer: Mclaren Commercial |
$1,585.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,497.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,549.86
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,761.21
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.18 |
| Max. Negotiated Rate |
$2,114.21 |
| Rate for Payer: Aetna Commercial |
$1,585.09
|
| Rate for Payer: Aetna Medicare |
$1,691.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: ASR ASR |
$1,708.37
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.47
|
| Rate for Payer: BCN Commercial |
$1,365.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cofinity Commercial |
$1,655.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,761.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,708.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,691.37
|
| Rate for Payer: Mclaren Commercial |
$1,585.09
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,497.03
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,860.51
|
| Rate for Payer: PHP Medicaid |
$925.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,602.70
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,549.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: VA VA |
$1,691.37
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,775.59
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$710.24 |
| Max. Negotiated Rate |
$1,775.59 |
| Rate for Payer: Aetna Commercial |
$1,598.03
|
| Rate for Payer: ASR ASR |
$1,722.32
|
| Rate for Payer: BCBS Complete |
$710.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.61
|
| Rate for Payer: BCN Commercial |
$1,376.61
|
| Rate for Payer: Cash Price |
$1,420.47
|
| Rate for Payer: Cofinity Commercial |
$1,669.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.47
|
| Rate for Payer: Healthscope Commercial |
$1,775.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,722.32
|
| Rate for Payer: Mclaren Commercial |
$1,598.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,509.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,615.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,562.52
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,775.59
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,242.91 |
| Max. Negotiated Rate |
$1,775.59 |
| Rate for Payer: Aetna Commercial |
$1,598.03
|
| Rate for Payer: ASR ASR |
$1,722.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.61
|
| Rate for Payer: BCN Commercial |
$1,376.61
|
| Rate for Payer: Cash Price |
$1,420.47
|
| Rate for Payer: Cofinity Commercial |
$1,669.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.47
|
| Rate for Payer: Healthscope Commercial |
$1,775.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,722.32
|
| Rate for Payer: Mclaren Commercial |
$1,598.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,509.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,562.52
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,243.08
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$1,255.01 |
| Rate for Payer: Aetna Commercial |
$1,118.77
|
| Rate for Payer: Aetna Medicare |
$219.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: ASR ASR |
$1,205.79
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$963.76
|
| Rate for Payer: BCN Commercial |
$963.76
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cofinity Commercial |
$1,168.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$1,243.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$219.68
|
| Rate for Payer: Mclaren Commercial |
$1,118.77
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.62
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$241.65
|
| Rate for Payer: PHP Medicaid |
$120.16
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.01
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,004.01
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.91
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,243.08
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.16 |
| Max. Negotiated Rate |
$1,243.08 |
| Rate for Payer: Aetna Commercial |
$1,118.77
|
| Rate for Payer: ASR ASR |
$1,205.79
|
| Rate for Payer: BCBS Trust/PPO |
$963.76
|
| Rate for Payer: BCN Commercial |
$963.76
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cofinity Commercial |
$1,168.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.46
|
| Rate for Payer: Healthscope Commercial |
$1,243.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.79
|
| Rate for Payer: Mclaren Commercial |
$1,118.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.91
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,202.46
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,202.46 |
| Rate for Payer: Aetna Commercial |
$1,082.21
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$1,166.39
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$932.27
|
| Rate for Payer: BCN Commercial |
$932.27
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,130.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$1,202.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,166.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$1,082.21
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.24
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$853.75
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,058.16
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,202.46
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$841.72 |
| Max. Negotiated Rate |
$1,202.46 |
| Rate for Payer: Aetna Commercial |
$1,082.21
|
| Rate for Payer: ASR ASR |
$1,166.39
|
| Rate for Payer: BCBS Trust/PPO |
$932.27
|
| Rate for Payer: BCN Commercial |
$932.27
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,130.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Healthscope Commercial |
$1,202.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,166.39
|
| Rate for Payer: Mclaren Commercial |
$1,082.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,058.16
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,322.71
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$925.90 |
| Max. Negotiated Rate |
$1,322.71 |
| Rate for Payer: Aetna Commercial |
$1,190.44
|
| Rate for Payer: ASR ASR |
$1,283.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.50
|
| Rate for Payer: BCN Commercial |
$1,025.50
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cofinity Commercial |
$1,243.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,058.17
|
| Rate for Payer: Healthscope Commercial |
$1,322.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,283.03
|
| Rate for Payer: Mclaren Commercial |
$1,190.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,124.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,163.98
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,322.71
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,322.71 |
| Rate for Payer: Aetna Commercial |
$1,190.44
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$1,283.03
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.50
|
| Rate for Payer: BCN Commercial |
$1,025.50
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cofinity Commercial |
$1,243.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,058.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$1,322.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,283.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$1,190.44
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,124.30
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,203.67
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$939.12
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,163.98
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,251.48
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,251.48 |
| Rate for Payer: Aetna Commercial |
$1,126.33
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$1,213.94
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$970.27
|
| Rate for Payer: BCN Commercial |
$970.27
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cofinity Commercial |
$1,176.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,001.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$1,251.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,213.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$1,126.33
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,063.76
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.85
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$888.55
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,101.30
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,251.48
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$876.04 |
| Max. Negotiated Rate |
$1,251.48 |
| Rate for Payer: Aetna Commercial |
$1,126.33
|
| Rate for Payer: ASR ASR |
$1,213.94
|
| Rate for Payer: BCBS Trust/PPO |
$970.27
|
| Rate for Payer: BCN Commercial |
$970.27
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cofinity Commercial |
$1,176.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,001.18
|
| Rate for Payer: Healthscope Commercial |
$1,251.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,213.94
|
| Rate for Payer: Mclaren Commercial |
$1,126.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,063.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,101.30
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,007.19 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.66
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$617.67
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$869.96 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$704.62
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$227.98 |
| Max. Negotiated Rate |
$704.62 |
| Rate for Payer: Aetna Commercial |
$634.16
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$683.48
|
| Rate for Payer: BCBS Complete |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$546.29
|
| Rate for Payer: BCN Commercial |
$546.29
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cofinity Commercial |
$662.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$704.62
|
| Rate for Payer: Healthscope Whirlpool |
$683.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$634.16
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$598.93
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$227.98
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.20
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$500.28
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.07
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$704.62
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$493.23 |
| Max. Negotiated Rate |
$704.62 |
| Rate for Payer: Aetna Commercial |
$634.16
|
| Rate for Payer: ASR ASR |
$683.48
|
| Rate for Payer: BCBS Trust/PPO |
$546.29
|
| Rate for Payer: BCN Commercial |
$546.29
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cofinity Commercial |
$662.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.70
|
| Rate for Payer: Healthscope Commercial |
$704.62
|
| Rate for Payer: Healthscope Whirlpool |
$683.48
|
| Rate for Payer: Mclaren Commercial |
$634.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$598.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.07
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,007.19 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.66
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$617.67
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$869.96 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,007.19 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.66
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$617.67
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$869.96 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$869.96 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,007.19 |
| Rate for Payer: Aetna Commercial |
$782.96
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$843.86
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.48
|
| Rate for Payer: BCN Commercial |
$674.48
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$817.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$869.96
|
| Rate for Payer: Healthscope Whirlpool |
$843.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$782.96
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.83
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$715.86
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.56
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
