|
HC CT PELVIS ANGIO
|
Facility
|
IP
|
$1,988.20
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,491.15 |
| Max. Negotiated Rate |
$1,988.20 |
| Rate for Payer: Aetna Commercial |
$1,789.38
|
| Rate for Payer: ASR ASR |
$1,928.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.71
|
| Rate for Payer: BCN Commercial |
$1,632.71
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,868.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,928.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,988.20
|
| Rate for Payer: Mclaren Commercial |
$1,789.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,749.62
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
OP
|
$1,988.20
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,988.20 |
| Rate for Payer: Aetna Commercial |
$1,789.38
|
| 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 |
$1,928.55
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.27
|
| Rate for Payer: BCN Commercial |
$1,639.27
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,868.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,928.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,988.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,789.38
|
| 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 |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| 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 |
$982.97
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$786.37
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,749.62
|
| 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 PELVIS W CON
|
Facility
|
OP
|
$1,975.52
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,975.52 |
| Rate for Payer: Aetna Commercial |
$1,777.97
|
| 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 |
$1,916.25
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.82
|
| Rate for Payer: BCN Commercial |
$1,628.82
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,580.42
|
| Rate for Payer: Cash Price |
$1,580.42
|
| Rate for Payer: Cofinity Commercial |
$1,856.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,916.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,975.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,777.97
|
| 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 |
$1,679.19
|
| Rate for Payer: Nomi Health Commercial |
$1,619.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,481.64
|
| 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 |
$907.91
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$726.33
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.46
|
| 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 PELVIS W CON
|
Facility
|
IP
|
$1,975.52
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,481.64 |
| Max. Negotiated Rate |
$1,975.52 |
| Rate for Payer: Aetna Commercial |
$1,777.97
|
| Rate for Payer: ASR ASR |
$1,916.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.30
|
| Rate for Payer: BCN Commercial |
$1,622.30
|
| Rate for Payer: Cash Price |
$1,580.42
|
| Rate for Payer: Cofinity Commercial |
$1,856.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.42
|
| Rate for Payer: Healthscope Commercial |
$1,916.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,975.52
|
| Rate for Payer: Mclaren Commercial |
$1,777.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.19
|
| Rate for Payer: Nomi Health Commercial |
$1,619.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,481.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.46
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,086.41 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.69
|
| Rate for Payer: ASR ASR |
$1,405.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.55
|
| Rate for Payer: BCN Commercial |
$1,189.55
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,361.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,405.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,448.55
|
| Rate for Payer: Mclaren Commercial |
$1,303.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,448.55
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.69
|
| 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 |
$1,405.09
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.33
|
| Rate for Payer: BCN Commercial |
$1,194.33
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,361.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,405.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,448.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,303.69
|
| 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 |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.41
|
| 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 |
$863.13
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$690.51
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
| 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 PELVIS WO W CON
|
Facility
|
OP
|
$2,249.81
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$2,249.81 |
| Rate for Payer: Aetna Commercial |
$2,024.83
|
| 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 |
$2,182.32
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.97
|
| Rate for Payer: BCN Commercial |
$1,854.97
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,799.85
|
| Rate for Payer: Cash Price |
$1,799.85
|
| Rate for Payer: Cofinity Commercial |
$2,114.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$2,182.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,249.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$2,024.83
|
| 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 |
$1,912.34
|
| Rate for Payer: Nomi Health Commercial |
$1,844.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.36
|
| 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 |
$1,032.60
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$826.08
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,979.83
|
| 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 PELVIS WO W CON
|
Facility
|
IP
|
$2,249.81
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,687.36 |
| Max. Negotiated Rate |
$2,249.81 |
| Rate for Payer: Aetna Commercial |
$2,024.83
|
| Rate for Payer: ASR ASR |
$2,182.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,847.54
|
| Rate for Payer: BCN Commercial |
$1,847.54
|
| Rate for Payer: Cash Price |
$1,799.85
|
| Rate for Payer: Cofinity Commercial |
$2,114.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.85
|
| Rate for Payer: Healthscope Commercial |
$2,182.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,249.81
|
| Rate for Payer: Mclaren Commercial |
$2,024.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.34
|
| Rate for Payer: Nomi Health Commercial |
$1,844.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,979.83
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: Aetna Medicare |
$625.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$827.52
|
| Rate for Payer: BCN Commercial |
$827.52
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$343.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$687.55
|
| Rate for Payer: PHP Medicaid |
$335.03
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$879.41
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$703.57
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$968.83
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP DNSP |
$625.05
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$752.75 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Trust/PPO |
$824.21
|
| Rate for Payer: BCN Commercial |
$824.21
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$752.75 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Trust/PPO |
$824.21
|
| Rate for Payer: BCN Commercial |
$824.21
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: Aetna Medicare |
$625.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$827.52
|
| Rate for Payer: BCN Commercial |
$827.52
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$343.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$687.55
|
| Rate for Payer: PHP Medicaid |
$335.03
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$879.41
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$703.57
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$968.83
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP DNSP |
$625.05
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,118.51
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$413.85 |
| Max. Negotiated Rate |
$1,118.51 |
| Rate for Payer: Aetna Commercial |
$1,006.66
|
| Rate for Payer: Aetna Medicare |
$413.85
|
| Rate for Payer: ASR ASR |
$1,084.95
|
| Rate for Payer: BCBS Complete |
$447.40
|
| Rate for Payer: BCBS Trust/PPO |
$922.21
|
| Rate for Payer: BCN Commercial |
$922.21
|
| Rate for Payer: Cash Price |
$894.81
|
| Rate for Payer: Cofinity Commercial |
$1,051.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.81
|
| Rate for Payer: Healthscope Commercial |
$1,084.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.51
|
| Rate for Payer: Mclaren Commercial |
$1,006.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$894.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.73
|
| Rate for Payer: Nomi Health Commercial |
$917.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$980.04
|
| Rate for Payer: Priority Health Narrow Network |
$784.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.29
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,118.51
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$838.88 |
| Max. Negotiated Rate |
$1,118.51 |
| Rate for Payer: Aetna Commercial |
$1,006.66
|
| Rate for Payer: ASR ASR |
$1,084.95
|
| Rate for Payer: BCBS Trust/PPO |
$918.52
|
| Rate for Payer: BCN Commercial |
$918.52
|
| Rate for Payer: Cash Price |
$894.81
|
| Rate for Payer: Cofinity Commercial |
$1,051.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.81
|
| Rate for Payer: Healthscope Commercial |
$1,084.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.51
|
| Rate for Payer: Mclaren Commercial |
$1,006.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.73
|
| Rate for Payer: Nomi Health Commercial |
$917.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.29
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$449.45
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$337.09 |
| Max. Negotiated Rate |
$449.45 |
| Rate for Payer: Aetna Commercial |
$404.50
|
| Rate for Payer: ASR ASR |
$435.97
|
| Rate for Payer: BCBS Trust/PPO |
$369.09
|
| Rate for Payer: BCN Commercial |
$369.09
|
| Rate for Payer: Cash Price |
$359.56
|
| Rate for Payer: Cofinity Commercial |
$422.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.56
|
| Rate for Payer: Healthscope Commercial |
$435.97
|
| Rate for Payer: Healthscope Whirlpool |
$449.45
|
| Rate for Payer: Mclaren Commercial |
$404.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.03
|
| Rate for Payer: Nomi Health Commercial |
$368.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$395.52
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$449.45
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$449.45 |
| Rate for Payer: Aetna Commercial |
$404.50
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$435.97
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$370.57
|
| Rate for Payer: BCN Commercial |
$370.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$359.56
|
| Rate for Payer: Cash Price |
$359.56
|
| Rate for Payer: Cofinity Commercial |
$422.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$435.97
|
| Rate for Payer: Healthscope Whirlpool |
$449.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$404.50
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.03
|
| Rate for Payer: Nomi Health Commercial |
$368.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.09
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.84
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$151.07
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$395.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$608.63
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$456.47 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$547.77
|
| Rate for Payer: ASR ASR |
$590.37
|
| Rate for Payer: BCBS Trust/PPO |
$499.81
|
| Rate for Payer: BCN Commercial |
$499.81
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cofinity Commercial |
$572.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.90
|
| Rate for Payer: Healthscope Commercial |
$590.37
|
| Rate for Payer: Healthscope Whirlpool |
$608.63
|
| Rate for Payer: Mclaren Commercial |
$547.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.34
|
| Rate for Payer: Nomi Health Commercial |
$499.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$535.59
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$608.63
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$547.77
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$590.37
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$501.82
|
| Rate for Payer: BCN Commercial |
$501.82
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cofinity Commercial |
$572.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$590.37
|
| Rate for Payer: Healthscope Whirlpool |
$608.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$547.77
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.34
|
| Rate for Payer: Nomi Health Commercial |
$499.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.47
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$426.65
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$535.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$539.70 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Trust/PPO |
$590.94
|
| Rate for Payer: BCN Commercial |
$590.94
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$593.31
|
| Rate for Payer: BCN Commercial |
$593.31
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$698.50
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$558.80
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$593.31
|
| Rate for Payer: BCN Commercial |
$593.31
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$698.50
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$558.80
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$539.70 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Trust/PPO |
$590.94
|
| Rate for Payer: BCN Commercial |
$590.94
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$539.70 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Trust/PPO |
$590.94
|
| Rate for Payer: BCN Commercial |
$590.94
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$719.60 |
| Rate for Payer: Aetna Commercial |
$647.64
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$698.01
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$593.31
|
| Rate for Payer: BCN Commercial |
$593.31
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$676.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$698.01
|
| Rate for Payer: Healthscope Whirlpool |
$719.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$647.64
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$698.50
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$558.80
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,666.95
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,250.21 |
| Max. Negotiated Rate |
$1,666.95 |
| Rate for Payer: Aetna Commercial |
$1,500.26
|
| Rate for Payer: ASR ASR |
$1,616.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,368.90
|
| Rate for Payer: BCN Commercial |
$1,368.90
|
| Rate for Payer: Cash Price |
$1,333.56
|
| Rate for Payer: Cofinity Commercial |
$1,566.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.56
|
| Rate for Payer: Healthscope Commercial |
$1,616.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,666.95
|
| Rate for Payer: Mclaren Commercial |
$1,500.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.91
|
| Rate for Payer: Nomi Health Commercial |
$1,366.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,250.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.92
|
|
