|
HC COLD SNARE POLYPECTOMY
|
Facility
|
IP
|
$545.16
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$354.35 |
| Max. Negotiated Rate |
$545.16 |
| Rate for Payer: Aetna Commercial |
$490.64
|
| Rate for Payer: ASR ASR |
$528.81
|
| Rate for Payer: ASR Commercial |
$528.81
|
| Rate for Payer: BCBS Trust/PPO |
$444.25
|
| Rate for Payer: BCN Commercial |
$422.66
|
| Rate for Payer: Cash Price |
$436.13
|
| Rate for Payer: Cofinity Commercial |
$512.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.13
|
| Rate for Payer: Healthscope Commercial |
$545.16
|
| Rate for Payer: Healthscope Whirlpool |
$528.81
|
| Rate for Payer: Mclaren Commercial |
$490.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.39
|
| Rate for Payer: Nomi Health Commercial |
$447.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.74
|
|
|
HC COLD SNARE POLYPECTOMY
|
Facility
|
OP
|
$545.16
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$218.06 |
| Max. Negotiated Rate |
$545.16 |
| Rate for Payer: Aetna Commercial |
$490.64
|
| Rate for Payer: Aetna Medicare |
$272.58
|
| Rate for Payer: ASR ASR |
$528.81
|
| Rate for Payer: ASR Commercial |
$528.81
|
| Rate for Payer: BCBS Complete |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$446.43
|
| Rate for Payer: BCN Commercial |
$422.66
|
| Rate for Payer: Cash Price |
$436.13
|
| Rate for Payer: Cofinity Commercial |
$512.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.13
|
| Rate for Payer: Healthscope Commercial |
$545.16
|
| Rate for Payer: Healthscope Whirlpool |
$528.81
|
| Rate for Payer: Mclaren Commercial |
$490.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.39
|
| Rate for Payer: Nomi Health Commercial |
$447.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.67
|
| Rate for Payer: Priority Health Narrow Network |
$382.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.74
|
|
|
HC COLLAGEN IMPLANT
|
Facility
|
OP
|
$1,880.98
|
|
|
Service Code
|
HCPCS L8603
|
| Hospital Charge Code |
27800005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$752.39 |
| Max. Negotiated Rate |
$1,880.98 |
| Rate for Payer: Aetna Commercial |
$1,692.88
|
| Rate for Payer: Aetna Medicare |
$940.49
|
| Rate for Payer: ASR ASR |
$1,824.55
|
| Rate for Payer: ASR Commercial |
$1,824.55
|
| Rate for Payer: BCBS Complete |
$752.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.33
|
| Rate for Payer: BCN Commercial |
$1,458.32
|
| Rate for Payer: Cash Price |
$1,504.78
|
| Rate for Payer: Cofinity Commercial |
$1,768.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,504.78
|
| Rate for Payer: Healthscope Commercial |
$1,880.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,824.55
|
| Rate for Payer: Mclaren Commercial |
$1,692.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,598.83
|
| Rate for Payer: Nomi Health Commercial |
$1,542.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,318.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,655.26
|
|
|
HC COLLAGEN IMPLANT
|
Facility
|
IP
|
$1,880.98
|
|
|
Service Code
|
HCPCS L8603
|
| Hospital Charge Code |
27800005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,222.64 |
| Max. Negotiated Rate |
$1,880.98 |
| Rate for Payer: Aetna Commercial |
$1,692.88
|
| Rate for Payer: ASR ASR |
$1,824.55
|
| Rate for Payer: ASR Commercial |
$1,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.81
|
| Rate for Payer: BCN Commercial |
$1,458.32
|
| Rate for Payer: Cash Price |
$1,504.78
|
| Rate for Payer: Cofinity Commercial |
$1,768.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,504.78
|
| Rate for Payer: Healthscope Commercial |
$1,880.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,824.55
|
| Rate for Payer: Mclaren Commercial |
$1,692.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,598.83
|
| Rate for Payer: Nomi Health Commercial |
$1,542.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,655.26
|
|
|
HC COLL CAPILLARY BLOOD SPECIMEN
|
Facility
|
OP
|
$8.74
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$8.74 |
| Rate for Payer: Aetna Commercial |
$7.87
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: ASR ASR |
$8.48
|
| Rate for Payer: ASR Commercial |
$8.48
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: BCBS Trust/PPO |
$7.16
|
| Rate for Payer: BCN Commercial |
$6.78
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.99
|
| Rate for Payer: Healthscope Commercial |
$8.74
|
| Rate for Payer: Healthscope Whirlpool |
$8.48
|
| Rate for Payer: Mclaren Commercial |
$7.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.43
|
| Rate for Payer: Nomi Health Commercial |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.30
|
| Rate for Payer: Priority Health Narrow Network |
$2.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.69
|
|
|
HC COLL CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$8.74
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$8.74 |
| Rate for Payer: Aetna Commercial |
$7.87
|
| Rate for Payer: ASR ASR |
$8.48
|
| Rate for Payer: ASR Commercial |
$8.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.12
|
| Rate for Payer: BCN Commercial |
$6.78
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.99
|
| Rate for Payer: Healthscope Commercial |
$8.74
|
| Rate for Payer: Healthscope Whirlpool |
$8.48
|
| Rate for Payer: Mclaren Commercial |
$7.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.43
|
| Rate for Payer: Nomi Health Commercial |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.69
|
|
|
HC COLLECT CAPILLARY BLOOD SPECIMEN
|
Facility
|
OP
|
$8.74
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$8.74 |
| Rate for Payer: Aetna Commercial |
$7.87
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: ASR ASR |
$8.48
|
| Rate for Payer: ASR Commercial |
$8.48
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: BCBS Trust/PPO |
$7.16
|
| Rate for Payer: BCN Commercial |
$6.78
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.99
|
| Rate for Payer: Healthscope Commercial |
$8.74
|
| Rate for Payer: Healthscope Whirlpool |
$8.48
|
| Rate for Payer: Mclaren Commercial |
$7.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.43
|
| Rate for Payer: Nomi Health Commercial |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.30
|
| Rate for Payer: Priority Health Narrow Network |
$2.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.69
|
|
|
HC COLLECT CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$8.74
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$8.74 |
| Rate for Payer: Aetna Commercial |
$7.87
|
| Rate for Payer: ASR ASR |
$8.48
|
| Rate for Payer: ASR Commercial |
$8.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.12
|
| Rate for Payer: BCN Commercial |
$6.78
|
| Rate for Payer: Cash Price |
$6.99
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.99
|
| Rate for Payer: Healthscope Commercial |
$8.74
|
| Rate for Payer: Healthscope Whirlpool |
$8.48
|
| Rate for Payer: Mclaren Commercial |
$7.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.43
|
| Rate for Payer: Nomi Health Commercial |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.69
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
IP
|
$2,402.54
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,561.65 |
| Max. Negotiated Rate |
$2,402.54 |
| Rate for Payer: Aetna Commercial |
$2,162.29
|
| Rate for Payer: ASR ASR |
$2,330.46
|
| Rate for Payer: ASR Commercial |
$2,330.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,957.83
|
| Rate for Payer: BCN Commercial |
$1,862.69
|
| Rate for Payer: Cash Price |
$1,922.03
|
| Rate for Payer: Cofinity Commercial |
$2,258.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,922.03
|
| Rate for Payer: Healthscope Commercial |
$2,402.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,330.46
|
| Rate for Payer: Mclaren Commercial |
$2,162.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,042.16
|
| Rate for Payer: Nomi Health Commercial |
$1,970.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,561.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,114.24
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
OP
|
$2,402.54
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$961.02 |
| Max. Negotiated Rate |
$2,402.54 |
| Rate for Payer: Aetna Commercial |
$2,162.29
|
| Rate for Payer: Aetna Medicare |
$1,201.27
|
| Rate for Payer: ASR ASR |
$2,330.46
|
| Rate for Payer: ASR Commercial |
$2,330.46
|
| Rate for Payer: BCBS Complete |
$961.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,967.44
|
| Rate for Payer: BCN Commercial |
$1,862.69
|
| Rate for Payer: Cash Price |
$1,922.03
|
| Rate for Payer: Cofinity Commercial |
$2,258.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,922.03
|
| Rate for Payer: Healthscope Commercial |
$2,402.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,330.46
|
| Rate for Payer: Mclaren Commercial |
$2,162.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,042.16
|
| Rate for Payer: Nomi Health Commercial |
$1,970.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,561.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,105.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,684.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,114.24
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
OP
|
$366.59
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$472.90 |
| Rate for Payer: Aetna Commercial |
$329.93
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$355.59
|
| Rate for Payer: ASR Commercial |
$355.59
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$300.20
|
| Rate for Payer: BCN Commercial |
$284.22
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$344.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$366.59
|
| Rate for Payer: Healthscope Whirlpool |
$355.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$329.93
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.21
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$256.98
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
IP
|
$366.59
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$238.28 |
| Max. Negotiated Rate |
$366.59 |
| Rate for Payer: Aetna Commercial |
$329.93
|
| Rate for Payer: ASR ASR |
$355.59
|
| Rate for Payer: ASR Commercial |
$355.59
|
| Rate for Payer: BCBS Trust/PPO |
$298.73
|
| Rate for Payer: BCN Commercial |
$284.22
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$344.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Healthscope Commercial |
$366.59
|
| Rate for Payer: Healthscope Whirlpool |
$355.59
|
| Rate for Payer: Mclaren Commercial |
$329.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.60
|
|
|
HC COLONOSCOPY
|
Facility
|
IP
|
$2,611.70
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,697.60 |
| Max. Negotiated Rate |
$2,611.70 |
| Rate for Payer: Aetna Commercial |
$2,350.53
|
| Rate for Payer: ASR ASR |
$2,533.35
|
| Rate for Payer: ASR Commercial |
$2,533.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,128.27
|
| Rate for Payer: BCN Commercial |
$2,024.85
|
| Rate for Payer: Cash Price |
$2,089.36
|
| Rate for Payer: Cofinity Commercial |
$2,455.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,089.36
|
| Rate for Payer: Healthscope Commercial |
$2,611.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,533.35
|
| Rate for Payer: Mclaren Commercial |
$2,350.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,219.94
|
| Rate for Payer: Nomi Health Commercial |
$2,141.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,697.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,298.30
|
|
|
HC COLONOSCOPY
|
Facility
|
OP
|
$2,611.70
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,044.68 |
| Max. Negotiated Rate |
$2,611.70 |
| Rate for Payer: Aetna Commercial |
$2,350.53
|
| Rate for Payer: Aetna Medicare |
$1,305.85
|
| Rate for Payer: ASR ASR |
$2,533.35
|
| Rate for Payer: ASR Commercial |
$2,533.35
|
| Rate for Payer: BCBS Complete |
$1,044.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,138.72
|
| Rate for Payer: BCN Commercial |
$2,024.85
|
| Rate for Payer: Cash Price |
$2,089.36
|
| Rate for Payer: Cofinity Commercial |
$2,455.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,089.36
|
| Rate for Payer: Healthscope Commercial |
$2,611.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,533.35
|
| Rate for Payer: Mclaren Commercial |
$2,350.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,219.94
|
| Rate for Payer: Nomi Health Commercial |
$2,141.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,697.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,830.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,298.30
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,800.06
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,820.04 |
| Max. Negotiated Rate |
$2,800.06 |
| Rate for Payer: Aetna Commercial |
$2,520.05
|
| Rate for Payer: ASR ASR |
$2,716.06
|
| Rate for Payer: ASR Commercial |
$2,716.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,281.77
|
| Rate for Payer: BCN Commercial |
$2,170.89
|
| Rate for Payer: Cash Price |
$2,240.05
|
| Rate for Payer: Cofinity Commercial |
$2,632.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,240.05
|
| Rate for Payer: Healthscope Commercial |
$2,800.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,716.06
|
| Rate for Payer: Mclaren Commercial |
$2,520.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,380.05
|
| Rate for Payer: Nomi Health Commercial |
$2,296.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,464.05
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,800.06
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,120.02 |
| Max. Negotiated Rate |
$2,800.06 |
| Rate for Payer: Aetna Commercial |
$2,520.05
|
| Rate for Payer: Aetna Medicare |
$1,400.03
|
| Rate for Payer: ASR ASR |
$2,716.06
|
| Rate for Payer: ASR Commercial |
$2,716.06
|
| Rate for Payer: BCBS Complete |
$1,120.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,292.97
|
| Rate for Payer: BCN Commercial |
$2,170.89
|
| Rate for Payer: Cash Price |
$2,240.05
|
| Rate for Payer: Cofinity Commercial |
$2,632.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,240.05
|
| Rate for Payer: Healthscope Commercial |
$2,800.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,716.06
|
| Rate for Payer: Mclaren Commercial |
$2,520.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,380.05
|
| Rate for Payer: Nomi Health Commercial |
$2,296.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,453.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,464.05
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$6,969.54
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,530.20 |
| Max. Negotiated Rate |
$6,969.54 |
| Rate for Payer: Aetna Commercial |
$6,272.59
|
| Rate for Payer: ASR ASR |
$6,760.45
|
| Rate for Payer: ASR Commercial |
$6,760.45
|
| Rate for Payer: BCBS Trust/PPO |
$5,679.48
|
| Rate for Payer: BCN Commercial |
$5,403.48
|
| Rate for Payer: Cash Price |
$5,575.63
|
| Rate for Payer: Cofinity Commercial |
$6,551.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,575.63
|
| Rate for Payer: Healthscope Commercial |
$6,969.54
|
| Rate for Payer: Healthscope Whirlpool |
$6,760.45
|
| Rate for Payer: Mclaren Commercial |
$6,272.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,924.11
|
| Rate for Payer: Nomi Health Commercial |
$5,715.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,530.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,133.20
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$6,969.54
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$331.06 |
| Max. Negotiated Rate |
$6,969.54 |
| Rate for Payer: Aetna Commercial |
$6,272.59
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$6,760.45
|
| Rate for Payer: ASR Commercial |
$6,760.45
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,707.36
|
| Rate for Payer: BCCCP Commercial |
$331.06
|
| Rate for Payer: BCN Commercial |
$5,403.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$5,575.63
|
| Rate for Payer: Cash Price |
$5,575.63
|
| Rate for Payer: Cofinity Commercial |
$6,551.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,575.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$6,969.54
|
| Rate for Payer: Healthscope Whirlpool |
$6,760.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$6,272.59
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,924.11
|
| Rate for Payer: Nomi Health Commercial |
$5,715.02
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,530.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,106.71
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,885.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,133.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$8,109.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$8,109.00 |
| Rate for Payer: Aetna Commercial |
$7,298.10
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$7,865.73
|
| Rate for Payer: ASR Commercial |
$7,865.73
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,640.46
|
| Rate for Payer: BCCCP Commercial |
$295.08
|
| Rate for Payer: BCN Commercial |
$6,286.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$7,622.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$8,109.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,865.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$7,298.10
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,105.11
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$5,684.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,135.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$8,109.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,270.85 |
| Max. Negotiated Rate |
$8,109.00 |
| Rate for Payer: Aetna Commercial |
$7,298.10
|
| Rate for Payer: ASR ASR |
$7,865.73
|
| Rate for Payer: ASR Commercial |
$7,865.73
|
| Rate for Payer: BCBS Trust/PPO |
$6,608.02
|
| Rate for Payer: BCN Commercial |
$6,286.91
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$7,622.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Healthscope Commercial |
$8,109.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,865.73
|
| Rate for Payer: Mclaren Commercial |
$7,298.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,135.92
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
OP
|
$285.07
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$256.56
|
| Rate for Payer: Aetna Medicare |
$197.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: ASR ASR |
$276.52
|
| Rate for Payer: ASR Commercial |
$276.52
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$233.44
|
| Rate for Payer: BCCCP Commercial |
$122.41
|
| Rate for Payer: BCN Commercial |
$221.01
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$228.06
|
| Rate for Payer: Cash Price |
$228.06
|
| Rate for Payer: Cofinity Commercial |
$267.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Healthscope Whirlpool |
$276.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$197.10
|
| Rate for Payer: Mclaren Commercial |
$256.56
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.31
|
| Rate for Payer: Nomi Health Commercial |
$233.76
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$216.81
|
| Rate for Payer: PHP Medicaid |
$105.65
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.78
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$199.83
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Exchange |
$305.50
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP DNSP |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: VA VA |
$197.10
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
IP
|
$285.07
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.30 |
| Max. Negotiated Rate |
$285.07 |
| Rate for Payer: Aetna Commercial |
$256.56
|
| Rate for Payer: ASR ASR |
$276.52
|
| Rate for Payer: ASR Commercial |
$276.52
|
| Rate for Payer: BCBS Trust/PPO |
$232.30
|
| Rate for Payer: BCN Commercial |
$221.01
|
| Rate for Payer: Cash Price |
$228.06
|
| Rate for Payer: Cofinity Commercial |
$267.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.06
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Healthscope Whirlpool |
$276.52
|
| Rate for Payer: Mclaren Commercial |
$256.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.31
|
| Rate for Payer: Nomi Health Commercial |
$233.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.86
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
IP
|
$426.04
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.93 |
| Max. Negotiated Rate |
$426.04 |
| Rate for Payer: Aetna Commercial |
$383.44
|
| Rate for Payer: ASR ASR |
$413.26
|
| Rate for Payer: ASR Commercial |
$413.26
|
| Rate for Payer: BCBS Trust/PPO |
$347.18
|
| Rate for Payer: BCN Commercial |
$330.31
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cofinity Commercial |
$400.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$426.04
|
| Rate for Payer: Healthscope Whirlpool |
$413.26
|
| Rate for Payer: Mclaren Commercial |
$383.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.13
|
| Rate for Payer: Nomi Health Commercial |
$349.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.92
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
OP
|
$426.04
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$383.44
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$413.26
|
| Rate for Payer: ASR Commercial |
$413.26
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$348.88
|
| Rate for Payer: BCCCP Commercial |
$146.69
|
| Rate for Payer: BCN Commercial |
$330.31
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cofinity Commercial |
$400.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$426.04
|
| Rate for Payer: Healthscope Whirlpool |
$413.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$383.44
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.13
|
| Rate for Payer: Nomi Health Commercial |
$349.35
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.30
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$298.65
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
IP
|
$426.04
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.93 |
| Max. Negotiated Rate |
$426.04 |
| Rate for Payer: Aetna Commercial |
$383.44
|
| Rate for Payer: ASR ASR |
$413.26
|
| Rate for Payer: ASR Commercial |
$413.26
|
| Rate for Payer: BCBS Trust/PPO |
$347.18
|
| Rate for Payer: BCN Commercial |
$330.31
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cofinity Commercial |
$400.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$426.04
|
| Rate for Payer: Healthscope Whirlpool |
$413.26
|
| Rate for Payer: Mclaren Commercial |
$383.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.13
|
| Rate for Payer: Nomi Health Commercial |
$349.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.92
|
|
