|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,514.14
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,514.14 |
| Rate for Payer: Aetna Commercial |
$1,362.73
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$1,468.72
|
| Rate for Payer: ASR Commercial |
$1,468.72
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.93
|
| Rate for Payer: BCN Commercial |
$1,173.91
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cofinity Commercial |
$1,423.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,514.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$1,362.73
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,287.02
|
| Rate for Payer: Nomi Health Commercial |
$1,241.59
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$680.22
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$544.18
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,332.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,825.90 |
| Rate for Payer: Aetna Commercial |
$1,643.31
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,771.12
|
| Rate for Payer: ASR Commercial |
$1,771.12
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,495.23
|
| Rate for Payer: BCN Commercial |
$1,415.62
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,716.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,825.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,771.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,643.31
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: Nomi Health Commercial |
$1,497.24
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$951.42
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$761.14
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,606.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,186.84 |
| Max. Negotiated Rate |
$1,825.90 |
| Rate for Payer: Aetna Commercial |
$1,643.31
|
| Rate for Payer: ASR ASR |
$1,771.12
|
| Rate for Payer: ASR Commercial |
$1,771.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.93
|
| Rate for Payer: BCN Commercial |
$1,415.62
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,716.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Healthscope Commercial |
$1,825.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,771.12
|
| Rate for Payer: Mclaren Commercial |
$1,643.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: Nomi Health Commercial |
$1,497.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,606.79
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,344.20 |
| Max. Negotiated Rate |
$2,068.00 |
| Rate for Payer: Aetna Commercial |
$1,861.20
|
| Rate for Payer: ASR ASR |
$2,005.96
|
| Rate for Payer: ASR Commercial |
$2,005.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.21
|
| Rate for Payer: BCN Commercial |
$1,603.32
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Healthscope Commercial |
$2,068.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,005.96
|
| Rate for Payer: Mclaren Commercial |
$1,861.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: Nomi Health Commercial |
$1,695.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,819.84
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$2,068.00 |
| Rate for Payer: Aetna Commercial |
$1,861.20
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$2,005.96
|
| Rate for Payer: ASR Commercial |
$2,005.96
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.49
|
| Rate for Payer: BCN Commercial |
$1,603.32
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$2,068.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,005.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,861.20
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: Nomi Health Commercial |
$1,695.76
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$917.39
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$733.91
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,819.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$505.03 |
| Rate for Payer: Aetna Commercial |
$454.53
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$489.88
|
| Rate for Payer: ASR Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$413.57
|
| Rate for Payer: BCN Commercial |
$391.55
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$474.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$505.03
|
| Rate for Payer: Healthscope Whirlpool |
$489.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$454.53
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: Nomi Health Commercial |
$414.12
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.51
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$354.03
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$328.27 |
| Max. Negotiated Rate |
$505.03 |
| Rate for Payer: Aetna Commercial |
$454.53
|
| Rate for Payer: ASR ASR |
$489.88
|
| Rate for Payer: ASR Commercial |
$489.88
|
| Rate for Payer: BCBS Trust/PPO |
$411.55
|
| Rate for Payer: BCN Commercial |
$391.55
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$474.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Healthscope Commercial |
$505.03
|
| Rate for Payer: Healthscope Whirlpool |
$489.88
|
| Rate for Payer: Mclaren Commercial |
$454.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: Nomi Health Commercial |
$414.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.43
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,129.15 |
| Max. Negotiated Rate |
$1,737.15 |
| Rate for Payer: Aetna Commercial |
$1,563.44
|
| Rate for Payer: ASR ASR |
$1,685.04
|
| Rate for Payer: ASR Commercial |
$1,685.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,415.60
|
| Rate for Payer: BCN Commercial |
$1,346.81
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,632.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Healthscope Commercial |
$1,737.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,685.04
|
| Rate for Payer: Mclaren Commercial |
$1,563.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: Nomi Health Commercial |
$1,424.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,528.69
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,737.15 |
| Rate for Payer: Aetna Commercial |
$1,563.44
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,685.04
|
| Rate for Payer: ASR Commercial |
$1,685.04
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.55
|
| Rate for Payer: BCN Commercial |
$1,346.81
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,632.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,737.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,685.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,563.44
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: Nomi Health Commercial |
$1,424.46
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,066.72
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$853.38
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,528.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$984.16 |
| Max. Negotiated Rate |
$1,514.09 |
| Rate for Payer: Aetna Commercial |
$1,362.68
|
| Rate for Payer: ASR ASR |
$1,468.67
|
| Rate for Payer: ASR Commercial |
$1,468.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.83
|
| Rate for Payer: BCN Commercial |
$1,173.87
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,423.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Commercial |
$1,514.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.67
|
| Rate for Payer: Mclaren Commercial |
$1,362.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$1,241.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,332.40
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,514.09 |
| Rate for Payer: Aetna Commercial |
$1,362.68
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$1,468.67
|
| Rate for Payer: ASR Commercial |
$1,468.67
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.89
|
| Rate for Payer: BCN Commercial |
$1,173.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,423.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,514.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$1,362.68
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$1,241.55
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$823.50
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$658.80
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,332.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$2,055.93 |
| Rate for Payer: Aetna Commercial |
$1,850.34
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,994.25
|
| Rate for Payer: ASR Commercial |
$1,994.25
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,683.60
|
| Rate for Payer: BCN Commercial |
$1,593.96
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,932.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$2,055.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,994.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,850.34
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,145.77
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$916.62
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,336.35 |
| Max. Negotiated Rate |
$2,055.93 |
| Rate for Payer: Aetna Commercial |
$1,850.34
|
| Rate for Payer: ASR ASR |
$1,994.25
|
| Rate for Payer: ASR Commercial |
$1,994.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,675.38
|
| Rate for Payer: BCN Commercial |
$1,593.96
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,932.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Healthscope Commercial |
$2,055.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,994.25
|
| Rate for Payer: Mclaren Commercial |
$1,850.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.22
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,380.41 |
| Rate for Payer: Aetna Commercial |
$1,242.37
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$1,339.00
|
| Rate for Payer: ASR Commercial |
$1,339.00
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.42
|
| Rate for Payer: BCN Commercial |
$1,070.23
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,297.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,380.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,339.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,242.37
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.52
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$967.67
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$897.27 |
| Max. Negotiated Rate |
$1,380.41 |
| Rate for Payer: Aetna Commercial |
$1,242.37
|
| Rate for Payer: ASR ASR |
$1,339.00
|
| Rate for Payer: ASR Commercial |
$1,339.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.90
|
| Rate for Payer: BCN Commercial |
$1,070.23
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,297.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Healthscope Commercial |
$1,380.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,339.00
|
| Rate for Payer: Mclaren Commercial |
$1,242.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.76
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$438.63 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS Trust/PPO |
$897.99
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.82
|
| Rate for Payer: Priority Health Narrow Network |
$768.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$712.78 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Trust/PPO |
$893.60
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,591.71 |
| Rate for Payer: Aetna Commercial |
$1,432.54
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,543.96
|
| Rate for Payer: ASR Commercial |
$1,543.96
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.45
|
| Rate for Payer: BCN Commercial |
$1,234.05
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,496.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,591.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,543.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,432.54
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: Nomi Health Commercial |
$1,305.20
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.00
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$730.40
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,034.61 |
| Max. Negotiated Rate |
$1,591.71 |
| Rate for Payer: Aetna Commercial |
$1,432.54
|
| Rate for Payer: ASR ASR |
$1,543.96
|
| Rate for Payer: ASR Commercial |
$1,543.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,297.08
|
| Rate for Payer: BCN Commercial |
$1,234.05
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,496.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Healthscope Commercial |
$1,591.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,543.96
|
| Rate for Payer: Mclaren Commercial |
$1,432.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: Nomi Health Commercial |
$1,305.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.70
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$917.07 |
| Max. Negotiated Rate |
$1,410.88 |
| Rate for Payer: Aetna Commercial |
$1,269.79
|
| Rate for Payer: ASR ASR |
$1,368.55
|
| Rate for Payer: ASR Commercial |
$1,368.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.73
|
| Rate for Payer: BCN Commercial |
$1,093.86
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,326.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Healthscope Commercial |
$1,410.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,368.55
|
| Rate for Payer: Mclaren Commercial |
$1,269.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.57
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,410.88 |
| Rate for Payer: Aetna Commercial |
$1,269.79
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$1,368.55
|
| Rate for Payer: ASR Commercial |
$1,368.55
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.37
|
| Rate for Payer: BCN Commercial |
$1,093.86
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,326.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,410.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,368.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$1,269.79
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.86
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$702.29
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,498.69 |
| Rate for Payer: Aetna Commercial |
$1,348.82
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,453.73
|
| Rate for Payer: ASR Commercial |
$1,453.73
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.28
|
| Rate for Payer: BCN Commercial |
$1,161.93
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,408.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,498.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,453.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,348.82
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$978.33
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$782.66
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,318.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$974.15 |
| Max. Negotiated Rate |
$1,498.69 |
| Rate for Payer: Aetna Commercial |
$1,348.82
|
| Rate for Payer: ASR ASR |
$1,453.73
|
| Rate for Payer: ASR Commercial |
$1,453.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,221.28
|
| Rate for Payer: BCN Commercial |
$1,161.93
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,408.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,498.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,453.73
|
| Rate for Payer: Mclaren Commercial |
$1,348.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,318.85
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$941.56 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.70
|
| Rate for Payer: ASR ASR |
$1,405.09
|
| Rate for Payer: ASR Commercial |
$1,405.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.42
|
| Rate for Payer: BCN Commercial |
$1,123.06
|
| 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 |
$1,448.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.09
|
| Rate for Payer: Mclaren Commercial |
$1,303.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
OP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$527.05 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.70
|
| Rate for Payer: Aetna Medicare |
$724.28
|
| Rate for Payer: ASR ASR |
$1,405.09
|
| Rate for Payer: ASR Commercial |
$1,405.09
|
| Rate for Payer: BCBS Complete |
$579.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.22
|
| Rate for Payer: BCN Commercial |
$1,123.06
|
| 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: Healthscope Commercial |
$1,448.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.09
|
| Rate for Payer: Mclaren Commercial |
$1,303.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$658.81
|
| Rate for Payer: Priority Health Narrow Network |
$527.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
|
