|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.73 |
| Max. Negotiated Rate |
$532.68 |
| Rate for Payer: Aetna Commercial |
$479.41
|
| Rate for Payer: Aetna Medicare |
$354.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: ASR ASR |
$516.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$412.99
|
| Rate for Payer: BCN Commercial |
$412.99
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$532.68
|
| Rate for Payer: Healthscope Whirlpool |
$516.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.16
|
| Rate for Payer: Mclaren Commercial |
$479.41
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$389.58
|
| Rate for Payer: PHP Medicaid |
$193.73
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.74
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$378.20
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.76
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: VA VA |
$354.16
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.88 |
| Max. Negotiated Rate |
$532.68 |
| Rate for Payer: Aetna Commercial |
$479.41
|
| Rate for Payer: ASR ASR |
$516.70
|
| Rate for Payer: BCBS Trust/PPO |
$412.99
|
| Rate for Payer: BCN Commercial |
$412.99
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Healthscope Commercial |
$532.68
|
| Rate for Payer: Healthscope Whirlpool |
$516.70
|
| Rate for Payer: Mclaren Commercial |
$479.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.76
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,327.00
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$5,128.90 |
| Max. Negotiated Rate |
$7,327.00 |
| Rate for Payer: Aetna Commercial |
$6,594.30
|
| Rate for Payer: Aetna Commercial |
$6,287.38
|
| Rate for Payer: ASR ASR |
$6,776.40
|
| Rate for Payer: ASR ASR |
$7,107.19
|
| Rate for Payer: BCBS Trust/PPO |
$5,680.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,416.23
|
| Rate for Payer: BCN Commercial |
$5,416.23
|
| Rate for Payer: BCN Commercial |
$5,680.62
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cofinity Commercial |
$6,887.38
|
| Rate for Payer: Cofinity Commercial |
$6,566.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Healthscope Commercial |
$7,327.00
|
| Rate for Payer: Healthscope Commercial |
$6,985.98
|
| Rate for Payer: Healthscope Whirlpool |
$7,107.19
|
| Rate for Payer: Healthscope Whirlpool |
$6,776.40
|
| Rate for Payer: Mclaren Commercial |
$6,594.30
|
| Rate for Payer: Mclaren Commercial |
$6,287.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,447.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,147.66
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,327.00
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$673.71 |
| Max. Negotiated Rate |
$7,327.00 |
| Rate for Payer: Aetna Commercial |
$6,594.30
|
| Rate for Payer: Aetna Commercial |
$6,287.38
|
| Rate for Payer: Aetna Medicare |
$1,231.65
|
| Rate for Payer: Aetna Medicare |
$1,231.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: ASR ASR |
$6,776.40
|
| Rate for Payer: ASR ASR |
$7,107.19
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS Trust/PPO |
$5,416.23
|
| Rate for Payer: BCBS Trust/PPO |
$5,680.62
|
| Rate for Payer: BCN Commercial |
$5,416.23
|
| Rate for Payer: BCN Commercial |
$5,680.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cofinity Commercial |
$6,887.38
|
| Rate for Payer: Cofinity Commercial |
$6,566.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Healthscope Commercial |
$7,327.00
|
| Rate for Payer: Healthscope Commercial |
$6,985.98
|
| Rate for Payer: Healthscope Whirlpool |
$6,776.40
|
| Rate for Payer: Healthscope Whirlpool |
$7,107.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,231.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,231.65
|
| Rate for Payer: Mclaren Commercial |
$6,594.30
|
| Rate for Payer: Mclaren Commercial |
$6,287.38
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PHP Commercial |
$1,354.82
|
| Rate for Payer: PHP Commercial |
$1,354.82
|
| Rate for Payer: PHP Medicaid |
$673.71
|
| Rate for Payer: PHP Medicaid |
$673.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,667.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,357.24
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Narrow Network |
$5,202.17
|
| Rate for Payer: Priority Health Narrow Network |
$4,960.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,147.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,447.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: VA VA |
$1,231.65
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$538.06 |
| Max. Negotiated Rate |
$768.66 |
| Rate for Payer: Aetna Commercial |
$691.79
|
| Rate for Payer: ASR ASR |
$745.60
|
| Rate for Payer: BCBS Trust/PPO |
$595.94
|
| Rate for Payer: BCN Commercial |
$595.94
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$722.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Healthscope Commercial |
$768.66
|
| Rate for Payer: Healthscope Whirlpool |
$745.60
|
| Rate for Payer: Mclaren Commercial |
$691.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.42
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$307.46 |
| Max. Negotiated Rate |
$768.66 |
| Rate for Payer: Aetna Commercial |
$691.79
|
| Rate for Payer: ASR ASR |
$745.60
|
| Rate for Payer: BCBS Complete |
$307.46
|
| Rate for Payer: BCBS Trust/PPO |
$595.94
|
| Rate for Payer: BCN Commercial |
$595.94
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$722.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Healthscope Commercial |
$768.66
|
| Rate for Payer: Healthscope Whirlpool |
$745.60
|
| Rate for Payer: Mclaren Commercial |
$691.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$699.48
|
| Rate for Payer: Priority Health Narrow Network |
$545.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.42
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,713.79 |
| Max. Negotiated Rate |
$5,305.42 |
| Rate for Payer: Aetna Commercial |
$4,774.88
|
| Rate for Payer: ASR ASR |
$5,146.26
|
| Rate for Payer: BCBS Trust/PPO |
$4,113.29
|
| Rate for Payer: BCN Commercial |
$4,113.29
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$4,987.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Healthscope Commercial |
$5,305.42
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.26
|
| Rate for Payer: Mclaren Commercial |
$4,774.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,668.77
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,122.17 |
| Max. Negotiated Rate |
$5,305.42 |
| Rate for Payer: Aetna Commercial |
$4,774.88
|
| Rate for Payer: ASR ASR |
$5,146.26
|
| Rate for Payer: BCBS Complete |
$2,122.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,113.29
|
| Rate for Payer: BCN Commercial |
$4,113.29
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$4,987.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Healthscope Commercial |
$5,305.42
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.26
|
| Rate for Payer: Mclaren Commercial |
$4,774.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,827.93
|
| Rate for Payer: Priority Health Narrow Network |
$3,766.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,668.77
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$5,409.15 |
| Rate for Payer: Aetna Commercial |
$4,868.24
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$5,246.88
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,193.71
|
| Rate for Payer: BCN Commercial |
$4,193.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$5,084.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$5,409.15
|
| Rate for Payer: Healthscope Whirlpool |
$5,246.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$4,868.24
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,562.23
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,849.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,760.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,786.40 |
| Max. Negotiated Rate |
$5,409.15 |
| Rate for Payer: Aetna Commercial |
$4,868.24
|
| Rate for Payer: ASR ASR |
$5,246.88
|
| Rate for Payer: BCBS Trust/PPO |
$4,193.71
|
| Rate for Payer: BCN Commercial |
$4,193.71
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$5,084.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Healthscope Commercial |
$5,409.15
|
| Rate for Payer: Healthscope Whirlpool |
$5,246.88
|
| Rate for Payer: Mclaren Commercial |
$4,868.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,760.05
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$109.14 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: ASR ASR |
$105.87
|
| Rate for Payer: BCBS Trust/PPO |
$84.62
|
| Rate for Payer: BCN Commercial |
$84.62
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$102.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Healthscope Commercial |
$109.14
|
| Rate for Payer: Healthscope Whirlpool |
$105.87
|
| Rate for Payer: Mclaren Commercial |
$98.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.04
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$109.14 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: ASR ASR |
$105.87
|
| Rate for Payer: BCBS Complete |
$43.66
|
| Rate for Payer: BCBS Trust/PPO |
$84.62
|
| Rate for Payer: BCN Commercial |
$84.62
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$102.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Healthscope Commercial |
$109.14
|
| Rate for Payer: Healthscope Whirlpool |
$105.87
|
| Rate for Payer: Mclaren Commercial |
$98.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.32
|
| Rate for Payer: Priority Health Narrow Network |
$77.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.04
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$336.29 |
| Max. Negotiated Rate |
$480.42 |
| Rate for Payer: Aetna Commercial |
$432.38
|
| Rate for Payer: ASR ASR |
$466.01
|
| Rate for Payer: BCBS Trust/PPO |
$372.47
|
| Rate for Payer: BCN Commercial |
$372.47
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$451.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Healthscope Commercial |
$480.42
|
| Rate for Payer: Healthscope Whirlpool |
$466.01
|
| Rate for Payer: Mclaren Commercial |
$432.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.77
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.86 |
| Max. Negotiated Rate |
$697.82 |
| Rate for Payer: Aetna Commercial |
$432.38
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$466.01
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$372.47
|
| Rate for Payer: BCN Commercial |
$372.47
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$451.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$480.42
|
| Rate for Payer: Healthscope Whirlpool |
$466.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$432.38
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.07
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$268.86
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.77
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,375.37 |
| Max. Negotiated Rate |
$1,964.82 |
| Rate for Payer: Aetna Commercial |
$1,768.34
|
| Rate for Payer: ASR ASR |
$1,905.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.32
|
| Rate for Payer: BCN Commercial |
$1,523.32
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,846.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Healthscope Commercial |
$1,964.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,905.88
|
| Rate for Payer: Mclaren Commercial |
$1,768.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,729.04
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$785.93 |
| Max. Negotiated Rate |
$1,964.82 |
| Rate for Payer: Aetna Commercial |
$1,768.34
|
| Rate for Payer: ASR ASR |
$1,905.88
|
| Rate for Payer: BCBS Complete |
$785.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.32
|
| Rate for Payer: BCN Commercial |
$1,523.32
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,846.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Healthscope Commercial |
$1,964.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,905.88
|
| Rate for Payer: Mclaren Commercial |
$1,768.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,787.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,395.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,729.04
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$431.20 |
| Max. Negotiated Rate |
$616.00 |
| Rate for Payer: Aetna Commercial |
$554.40
|
| Rate for Payer: ASR ASR |
$597.52
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: BCN Commercial |
$477.58
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$579.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$616.00
|
| Rate for Payer: Healthscope Whirlpool |
$597.52
|
| Rate for Payer: Mclaren Commercial |
$554.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.08
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$616.00 |
| Rate for Payer: Aetna Commercial |
$554.40
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: ASR ASR |
$597.52
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: BCN Commercial |
$477.58
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$579.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$616.00
|
| Rate for Payer: Healthscope Whirlpool |
$597.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.12
|
| Rate for Payer: Mclaren Commercial |
$554.40
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$238.83
|
| Rate for Payer: PHP Medicaid |
$118.76
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.83
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$402.26
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.08
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$503.94
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.12
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$238.83
|
| Rate for Payer: PHP Medicaid |
$118.76
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.83
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$402.26
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.00 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: BCBS Trust/PPO |
$503.94
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,839.94 |
| Rate for Payer: Aetna Commercial |
$1,595.19
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$1,719.26
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,374.16
|
| Rate for Payer: BCN Commercial |
$1,374.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,666.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,772.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,719.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,595.19
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,839.94
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,559.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,240.70 |
| Max. Negotiated Rate |
$1,772.43 |
| Rate for Payer: Aetna Commercial |
$1,595.19
|
| Rate for Payer: ASR ASR |
$1,719.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,374.16
|
| Rate for Payer: BCN Commercial |
$1,374.16
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,666.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Healthscope Commercial |
$1,772.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,719.26
|
| Rate for Payer: Mclaren Commercial |
$1,595.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,559.74
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$951.66 |
| Rate for Payer: Aetna Commercial |
$856.49
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$923.11
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$737.82
|
| Rate for Payer: BCN Commercial |
$737.82
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$894.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$951.66
|
| Rate for Payer: Healthscope Whirlpool |
$923.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$856.49
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.01
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$675.68
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.46
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.16 |
| Max. Negotiated Rate |
$951.66 |
| Rate for Payer: Aetna Commercial |
$856.49
|
| Rate for Payer: ASR ASR |
$923.11
|
| Rate for Payer: BCBS Trust/PPO |
$737.82
|
| Rate for Payer: BCN Commercial |
$737.82
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$894.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Healthscope Commercial |
$951.66
|
| Rate for Payer: Healthscope Whirlpool |
$923.11
|
| Rate for Payer: Mclaren Commercial |
$856.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.46
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$292.09
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$323.86 |
| Rate for Payer: Aetna Commercial |
$262.88
|
| Rate for Payer: Aetna Medicare |
$219.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: ASR ASR |
$283.33
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$226.46
|
| Rate for Payer: BCN Commercial |
$226.46
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$233.67
|
| Rate for Payer: Cash Price |
$233.67
|
| Rate for Payer: Cofinity Commercial |
$274.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$292.09
|
| Rate for Payer: Healthscope Whirlpool |
$283.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$219.68
|
| Rate for Payer: Mclaren Commercial |
$262.88
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$248.28
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$241.65
|
| Rate for Payer: PHP Medicaid |
$120.16
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.86
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$259.09
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
