|
HC CT BRAIN W CON
|
Facility
|
OP
|
$1,655.16
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,655.16 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,605.51
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,364.68
|
| Rate for Payer: BCN Commercial |
$1,364.68
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cofinity Commercial |
$1,555.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,324.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,605.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,655.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,489.64
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,406.89
|
| Rate for Payer: Nomi Health Commercial |
$1,357.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,241.37
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$880.69
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$704.55
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,456.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,158.32 |
| Max. Negotiated Rate |
$1,544.42 |
| Rate for Payer: Aetna Commercial |
$1,389.98
|
| Rate for Payer: ASR ASR |
$1,498.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.28
|
| Rate for Payer: BCN Commercial |
$1,268.28
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Commercial |
$1,451.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Healthscope Commercial |
$1,498.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.42
|
| Rate for Payer: Mclaren Commercial |
$1,389.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Nomi Health Commercial |
$1,266.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.09
|
|
|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,544.42 |
| Rate for Payer: Aetna Commercial |
$1,389.98
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,498.09
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.37
|
| Rate for Payer: BCN Commercial |
$1,273.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Commercial |
$1,451.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,498.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,389.98
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Nomi Health Commercial |
$1,266.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$749.94
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$599.95
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,862.42
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,396.82 |
| Max. Negotiated Rate |
$1,862.42 |
| Rate for Payer: Aetna Commercial |
$1,676.18
|
| Rate for Payer: ASR ASR |
$1,806.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.42
|
| Rate for Payer: BCN Commercial |
$1,529.42
|
| Rate for Payer: Cash Price |
$1,489.94
|
| Rate for Payer: Cofinity Commercial |
$1,750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,489.94
|
| Rate for Payer: Healthscope Commercial |
$1,806.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,862.42
|
| Rate for Payer: Mclaren Commercial |
$1,676.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,583.06
|
| Rate for Payer: Nomi Health Commercial |
$1,527.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,396.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,638.93
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,862.42
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,862.42 |
| Rate for Payer: Aetna Commercial |
$1,676.18
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,806.55
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.57
|
| Rate for Payer: BCN Commercial |
$1,535.57
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,489.94
|
| Rate for Payer: Cash Price |
$1,489.94
|
| Rate for Payer: Cofinity Commercial |
$1,750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,489.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,806.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,862.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,676.18
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,583.06
|
| Rate for Payer: Nomi Health Commercial |
$1,527.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,396.82
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,048.94
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$839.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,638.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,109.36
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,582.02 |
| Max. Negotiated Rate |
$2,109.36 |
| Rate for Payer: Aetna Commercial |
$1,898.42
|
| Rate for Payer: ASR ASR |
$2,046.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.21
|
| Rate for Payer: BCN Commercial |
$1,732.21
|
| Rate for Payer: Cash Price |
$1,687.49
|
| Rate for Payer: Cofinity Commercial |
$1,982.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,687.49
|
| Rate for Payer: Healthscope Commercial |
$2,046.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,109.36
|
| Rate for Payer: Mclaren Commercial |
$1,898.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,792.96
|
| Rate for Payer: Nomi Health Commercial |
$1,729.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,856.24
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,109.36
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$2,109.36 |
| Rate for Payer: Aetna Commercial |
$1,898.42
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$2,046.08
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.17
|
| Rate for Payer: BCN Commercial |
$1,739.17
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,687.49
|
| Rate for Payer: Cash Price |
$1,687.49
|
| Rate for Payer: Cofinity Commercial |
$1,982.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,687.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$2,046.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,109.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,898.42
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,792.96
|
| Rate for Payer: Nomi Health Commercial |
$1,729.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.02
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,011.42
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$809.14
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,856.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$1,544.37
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,544.37 |
| Rate for Payer: Aetna Commercial |
$1,389.93
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,498.04
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.33
|
| Rate for Payer: BCN Commercial |
$1,273.33
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,451.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,498.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,389.93
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,353.18
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,082.60
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$1,544.37
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,158.28 |
| Max. Negotiated Rate |
$1,544.37 |
| Rate for Payer: Aetna Commercial |
$1,389.93
|
| Rate for Payer: ASR ASR |
$1,498.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.24
|
| Rate for Payer: BCN Commercial |
$1,268.24
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,451.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Healthscope Commercial |
$1,498.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.37
|
| Rate for Payer: Mclaren Commercial |
$1,389.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.05
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,771.89
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,771.89 |
| Rate for Payer: Aetna Commercial |
$1,594.70
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,718.73
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.92
|
| Rate for Payer: BCN Commercial |
$1,460.92
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,417.51
|
| Rate for Payer: Cash Price |
$1,417.51
|
| Rate for Payer: Cofinity Commercial |
$1,665.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,718.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,771.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,594.70
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,506.11
|
| Rate for Payer: Nomi Health Commercial |
$1,452.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.92
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,176.06
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$940.85
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,559.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,771.89
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,328.92 |
| Max. Negotiated Rate |
$1,771.89 |
| Rate for Payer: Aetna Commercial |
$1,594.70
|
| Rate for Payer: ASR ASR |
$1,718.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,455.08
|
| Rate for Payer: BCN Commercial |
$1,455.08
|
| Rate for Payer: Cash Price |
$1,417.51
|
| Rate for Payer: Cofinity Commercial |
$1,665.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.51
|
| Rate for Payer: Healthscope Commercial |
$1,718.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,771.89
|
| Rate for Payer: Mclaren Commercial |
$1,594.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,506.11
|
| Rate for Payer: Nomi Health Commercial |
$1,452.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,559.26
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,544.37
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,158.28 |
| Max. Negotiated Rate |
$1,544.37 |
| Rate for Payer: Aetna Commercial |
$1,389.93
|
| Rate for Payer: ASR ASR |
$1,498.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.24
|
| Rate for Payer: BCN Commercial |
$1,268.24
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,451.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Healthscope Commercial |
$1,498.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.37
|
| Rate for Payer: Mclaren Commercial |
$1,389.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.05
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,544.37
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,544.37 |
| Rate for Payer: Aetna Commercial |
$1,389.93
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,498.04
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.33
|
| Rate for Payer: BCN Commercial |
$1,273.33
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,451.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,498.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,544.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,389.93
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$907.91
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$726.33
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,097.05
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,572.79 |
| Max. Negotiated Rate |
$2,097.05 |
| Rate for Payer: Aetna Commercial |
$1,887.35
|
| Rate for Payer: ASR ASR |
$2,034.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.10
|
| Rate for Payer: BCN Commercial |
$1,722.10
|
| Rate for Payer: Cash Price |
$1,677.64
|
| Rate for Payer: Cofinity Commercial |
$1,971.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.64
|
| Rate for Payer: Healthscope Commercial |
$2,034.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,097.05
|
| Rate for Payer: Mclaren Commercial |
$1,887.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.49
|
| Rate for Payer: Nomi Health Commercial |
$1,719.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,572.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,845.40
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,097.05
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$2,097.05 |
| Rate for Payer: Aetna Commercial |
$1,887.35
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$2,034.14
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.02
|
| Rate for Payer: BCN Commercial |
$1,729.02
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,677.64
|
| Rate for Payer: Cash Price |
$1,677.64
|
| Rate for Payer: Cofinity Commercial |
$1,971.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$2,034.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,097.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,887.35
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.49
|
| Rate for Payer: Nomi Health Commercial |
$1,719.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,572.79
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,263.21
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.57
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,845.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,408.02
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,408.02 |
| Rate for Payer: Aetna Commercial |
$1,267.22
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$1,365.78
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.91
|
| Rate for Payer: BCN Commercial |
$1,160.91
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,126.42
|
| Rate for Payer: Cash Price |
$1,126.42
|
| Rate for Payer: Cofinity Commercial |
$1,323.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,365.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,408.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,267.22
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,196.82
|
| Rate for Payer: Nomi Health Commercial |
$1,154.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.02
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,233.71
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$987.02
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,408.02
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,056.02 |
| Max. Negotiated Rate |
$1,408.02 |
| Rate for Payer: Aetna Commercial |
$1,267.22
|
| Rate for Payer: ASR ASR |
$1,365.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.27
|
| Rate for Payer: BCN Commercial |
$1,156.27
|
| Rate for Payer: Cash Price |
$1,126.42
|
| Rate for Payer: Cofinity Commercial |
$1,323.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.42
|
| Rate for Payer: Healthscope Commercial |
$1,365.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,408.02
|
| Rate for Payer: Mclaren Commercial |
$1,267.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,196.82
|
| Rate for Payer: Nomi Health Commercial |
$1,154.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.06
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$867.61 |
| Max. Negotiated Rate |
$1,156.81 |
| Rate for Payer: Aetna Commercial |
$1,041.13
|
| Rate for Payer: ASR ASR |
$1,122.11
|
| Rate for Payer: BCBS Trust/PPO |
$949.97
|
| Rate for Payer: BCN Commercial |
$949.97
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$1,087.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,122.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.81
|
| Rate for Payer: Mclaren Commercial |
$1,041.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,017.99
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$428.02 |
| Max. Negotiated Rate |
$1,156.81 |
| Rate for Payer: Aetna Commercial |
$1,041.13
|
| Rate for Payer: Aetna Medicare |
$428.02
|
| Rate for Payer: ASR ASR |
$1,122.11
|
| Rate for Payer: BCBS Complete |
$462.72
|
| Rate for Payer: BCBS Trust/PPO |
$953.79
|
| Rate for Payer: BCN Commercial |
$953.79
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$1,087.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,122.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.81
|
| Rate for Payer: Mclaren Commercial |
$1,041.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$925.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,013.60
|
| Rate for Payer: Priority Health Narrow Network |
$810.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,017.99
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,623.54
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,217.65 |
| Max. Negotiated Rate |
$1,623.54 |
| Rate for Payer: Aetna Commercial |
$1,461.19
|
| Rate for Payer: ASR ASR |
$1,574.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.25
|
| Rate for Payer: BCN Commercial |
$1,333.25
|
| Rate for Payer: Cash Price |
$1,298.83
|
| Rate for Payer: Cofinity Commercial |
$1,526.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.83
|
| Rate for Payer: Healthscope Commercial |
$1,574.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,623.54
|
| Rate for Payer: Mclaren Commercial |
$1,461.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.01
|
| Rate for Payer: Nomi Health Commercial |
$1,331.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,217.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,428.72
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,623.54
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,623.54 |
| Rate for Payer: Aetna Commercial |
$1,461.19
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,574.83
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.61
|
| Rate for Payer: BCN Commercial |
$1,338.61
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,298.83
|
| Rate for Payer: Cash Price |
$1,298.83
|
| Rate for Payer: Cofinity Commercial |
$1,526.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,574.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,623.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,461.19
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.01
|
| Rate for Payer: Nomi Health Commercial |
$1,331.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,217.65
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,006.58
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$805.27
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,428.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,439.10
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,079.33 |
| Max. Negotiated Rate |
$1,439.10 |
| Rate for Payer: Aetna Commercial |
$1,295.19
|
| Rate for Payer: ASR ASR |
$1,395.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.79
|
| Rate for Payer: BCN Commercial |
$1,181.79
|
| Rate for Payer: Cash Price |
$1,151.28
|
| Rate for Payer: Cofinity Commercial |
$1,352.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.28
|
| Rate for Payer: Healthscope Commercial |
$1,395.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,439.10
|
| Rate for Payer: Mclaren Commercial |
$1,295.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.23
|
| Rate for Payer: Nomi Health Commercial |
$1,180.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,266.41
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,439.10
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,439.10 |
| Rate for Payer: Aetna Commercial |
$1,295.19
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,395.93
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.54
|
| Rate for Payer: BCN Commercial |
$1,186.54
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,151.28
|
| Rate for Payer: Cash Price |
$1,151.28
|
| Rate for Payer: Cofinity Commercial |
$1,352.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,395.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,439.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,295.19
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.23
|
| Rate for Payer: Nomi Health Commercial |
$1,180.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.33
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$967.84
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$774.27
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,266.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,528.66
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,146.49 |
| Max. Negotiated Rate |
$1,528.66 |
| Rate for Payer: Aetna Commercial |
$1,375.79
|
| Rate for Payer: ASR ASR |
$1,482.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,255.34
|
| Rate for Payer: BCN Commercial |
$1,255.34
|
| Rate for Payer: Cash Price |
$1,222.93
|
| Rate for Payer: Cofinity Commercial |
$1,436.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,222.93
|
| Rate for Payer: Healthscope Commercial |
$1,482.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,528.66
|
| Rate for Payer: Mclaren Commercial |
$1,375.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,299.36
|
| Rate for Payer: Nomi Health Commercial |
$1,253.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,146.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,345.22
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,528.66
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,528.66 |
| Rate for Payer: Aetna Commercial |
$1,375.79
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,482.80
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.38
|
| Rate for Payer: BCN Commercial |
$1,260.38
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,222.93
|
| Rate for Payer: Cash Price |
$1,222.93
|
| Rate for Payer: Cofinity Commercial |
$1,436.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,222.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,482.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,528.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,375.79
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,299.36
|
| Rate for Payer: Nomi Health Commercial |
$1,253.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,146.49
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,078.61
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$862.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,345.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
