|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
IP
|
$1,242.36
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.65 |
| Max. Negotiated Rate |
$1,242.36 |
| Rate for Payer: Aetna Commercial |
$1,118.12
|
| Rate for Payer: ASR ASR |
$1,205.09
|
| Rate for Payer: BCBS Trust/PPO |
$963.20
|
| Rate for Payer: BCN Commercial |
$963.20
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,167.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Healthscope Commercial |
$1,242.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.09
|
| Rate for Payer: Mclaren Commercial |
$1,118.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.28
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
OP
|
$1,818.84
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,818.84 |
| Rate for Payer: Aetna Commercial |
$1,636.96
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,764.27
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.15
|
| Rate for Payer: BCN Commercial |
$1,410.15
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cofinity Commercial |
$1,709.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,818.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,764.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,636.96
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.01
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.58
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
IP
|
$1,818.84
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,273.19 |
| Max. Negotiated Rate |
$1,818.84 |
| Rate for Payer: Aetna Commercial |
$1,636.96
|
| Rate for Payer: ASR ASR |
$1,764.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.15
|
| Rate for Payer: BCN Commercial |
$1,410.15
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cofinity Commercial |
$1,709.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.07
|
| Rate for Payer: Healthscope Commercial |
$1,818.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,764.27
|
| Rate for Payer: Mclaren Commercial |
$1,636.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.58
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
IP
|
$1,242.36
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.65 |
| Max. Negotiated Rate |
$1,242.36 |
| Rate for Payer: Aetna Commercial |
$1,118.12
|
| Rate for Payer: ASR ASR |
$1,205.09
|
| Rate for Payer: BCBS Trust/PPO |
$963.20
|
| Rate for Payer: BCN Commercial |
$963.20
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,167.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Healthscope Commercial |
$1,242.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.09
|
| Rate for Payer: Mclaren Commercial |
$1,118.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.28
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
OP
|
$1,242.36
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,242.36 |
| Rate for Payer: Aetna Commercial |
$1,118.12
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.09
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.20
|
| Rate for Payer: BCN Commercial |
$963.20
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,167.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,242.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.12
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.55
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.08
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.28
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
OP
|
$1,873.76
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,873.76 |
| Rate for Payer: Aetna Commercial |
$1,686.38
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,817.55
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.73
|
| Rate for Payer: BCN Commercial |
$1,452.73
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cofinity Commercial |
$1,761.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,873.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,817.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,686.38
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,592.70
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.10
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$504.88
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,648.91
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
IP
|
$1,873.76
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,311.63 |
| Max. Negotiated Rate |
$1,873.76 |
| Rate for Payer: Aetna Commercial |
$1,686.38
|
| Rate for Payer: ASR ASR |
$1,817.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.73
|
| Rate for Payer: BCN Commercial |
$1,452.73
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cofinity Commercial |
$1,761.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.01
|
| Rate for Payer: Healthscope Commercial |
$1,873.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,817.55
|
| Rate for Payer: Mclaren Commercial |
$1,686.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,592.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,648.91
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
OP
|
$3,109.92
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$3,109.92 |
| Rate for Payer: Aetna Commercial |
$2,798.93
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$3,016.62
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.12
|
| Rate for Payer: BCN Commercial |
$2,411.12
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,923.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$3,109.92
|
| Rate for Payer: Healthscope Whirlpool |
$3,016.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$2,798.93
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.21
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$445.77
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,736.73
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
IP
|
$3,109.92
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,176.94 |
| Max. Negotiated Rate |
$3,109.92 |
| Rate for Payer: Aetna Commercial |
$2,798.93
|
| Rate for Payer: ASR ASR |
$3,016.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.12
|
| Rate for Payer: BCN Commercial |
$2,411.12
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,923.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Healthscope Commercial |
$3,109.92
|
| Rate for Payer: Healthscope Whirlpool |
$3,016.62
|
| Rate for Payer: Mclaren Commercial |
$2,798.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,736.73
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
IP
|
$2,549.64
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,784.75 |
| Max. Negotiated Rate |
$2,549.64 |
| Rate for Payer: Aetna Commercial |
$2,294.68
|
| Rate for Payer: ASR ASR |
$2,473.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.74
|
| Rate for Payer: BCN Commercial |
$1,976.74
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cofinity Commercial |
$2,396.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,039.71
|
| Rate for Payer: Healthscope Commercial |
$2,549.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,473.15
|
| Rate for Payer: Mclaren Commercial |
$2,294.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,167.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,784.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,243.68
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
OP
|
$2,549.64
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$2,549.64 |
| Rate for Payer: Aetna Commercial |
$2,294.68
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$2,473.15
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.74
|
| Rate for Payer: BCN Commercial |
$1,976.74
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cofinity Commercial |
$2,396.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,039.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$2,549.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,473.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$2,294.68
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,167.19
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,784.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,243.68
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$669.43 |
| Max. Negotiated Rate |
$956.33 |
| Rate for Payer: Aetna Commercial |
$860.70
|
| Rate for Payer: ASR ASR |
$927.64
|
| Rate for Payer: BCBS Trust/PPO |
$741.44
|
| Rate for Payer: BCN Commercial |
$741.44
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$898.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$956.33
|
| Rate for Payer: Healthscope Whirlpool |
$927.64
|
| Rate for Payer: Mclaren Commercial |
$860.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.57
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$956.33 |
| Rate for Payer: Aetna Commercial |
$860.70
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$927.64
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$741.44
|
| Rate for Payer: BCN Commercial |
$741.44
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$898.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$956.33
|
| Rate for Payer: Healthscope Whirlpool |
$927.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$860.70
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$549.01
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$439.21
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.57
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
OP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,504.19 |
| Rate for Payer: Aetna Commercial |
$1,353.77
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,459.06
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.20
|
| Rate for Payer: BCN Commercial |
$1,166.20
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,413.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,504.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,459.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$1,353.77
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.21
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$445.77
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,323.69
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
IP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,052.93 |
| Max. Negotiated Rate |
$1,504.19 |
| Rate for Payer: Aetna Commercial |
$1,353.77
|
| Rate for Payer: ASR ASR |
$1,459.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.20
|
| Rate for Payer: BCN Commercial |
$1,166.20
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,413.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Healthscope Commercial |
$1,504.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,459.06
|
| Rate for Payer: Mclaren Commercial |
$1,353.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,323.69
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
IP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$611.01 |
| Max. Negotiated Rate |
$872.87 |
| Rate for Payer: Aetna Commercial |
$785.58
|
| Rate for Payer: ASR ASR |
$846.68
|
| Rate for Payer: BCBS Trust/PPO |
$676.74
|
| Rate for Payer: BCN Commercial |
$676.74
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$820.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Healthscope Commercial |
$872.87
|
| Rate for Payer: Healthscope Whirlpool |
$846.68
|
| Rate for Payer: Mclaren Commercial |
$785.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$768.13
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
OP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$872.87 |
| Rate for Payer: Aetna Commercial |
$785.58
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$846.68
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$676.74
|
| Rate for Payer: BCN Commercial |
$676.74
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$820.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$872.87
|
| Rate for Payer: Healthscope Whirlpool |
$846.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$785.58
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.21
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$445.77
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$768.13
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
OP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$3,109.92 |
| Rate for Payer: Aetna Commercial |
$2,798.93
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$3,016.62
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.12
|
| Rate for Payer: BCN Commercial |
$2,411.12
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,923.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$3,109.92
|
| Rate for Payer: Healthscope Whirlpool |
$3,016.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$2,798.93
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,736.73
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
IP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,176.94 |
| Max. Negotiated Rate |
$3,109.92 |
| Rate for Payer: Aetna Commercial |
$2,798.93
|
| Rate for Payer: ASR ASR |
$3,016.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.12
|
| Rate for Payer: BCN Commercial |
$2,411.12
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,923.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Healthscope Commercial |
$3,109.92
|
| Rate for Payer: Healthscope Whirlpool |
$3,016.62
|
| Rate for Payer: Mclaren Commercial |
$2,798.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,736.73
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
IP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,182.74 |
| Max. Negotiated Rate |
$3,118.20 |
| Rate for Payer: Aetna Commercial |
$2,806.38
|
| Rate for Payer: ASR ASR |
$3,024.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,417.54
|
| Rate for Payer: BCN Commercial |
$2,417.54
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,931.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Healthscope Commercial |
$3,118.20
|
| Rate for Payer: Healthscope Whirlpool |
$3,024.65
|
| Rate for Payer: Mclaren Commercial |
$2,806.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,744.02
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
OP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$3,118.20 |
| Rate for Payer: Aetna Commercial |
$2,806.38
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$3,024.65
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,417.54
|
| Rate for Payer: BCN Commercial |
$2,417.54
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,931.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$3,118.20
|
| Rate for Payer: Healthscope Whirlpool |
$3,024.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$2,806.38
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,947.69
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,558.15
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,744.02
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$956.33 |
| Rate for Payer: Aetna Commercial |
$860.70
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$927.64
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$741.44
|
| Rate for Payer: BCN Commercial |
$741.44
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$898.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$956.33
|
| Rate for Payer: Healthscope Whirlpool |
$927.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$860.70
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.26
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$678.99
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.57
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$669.43 |
| Max. Negotiated Rate |
$956.33 |
| Rate for Payer: Aetna Commercial |
$860.70
|
| Rate for Payer: ASR ASR |
$927.64
|
| Rate for Payer: BCBS Trust/PPO |
$741.44
|
| Rate for Payer: BCN Commercial |
$741.44
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$898.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$956.33
|
| Rate for Payer: Healthscope Whirlpool |
$927.64
|
| Rate for Payer: Mclaren Commercial |
$860.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.57
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
IP
|
$475.49
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$332.84 |
| Max. Negotiated Rate |
$475.49 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: ASR ASR |
$461.23
|
| Rate for Payer: BCBS Trust/PPO |
$368.65
|
| Rate for Payer: BCN Commercial |
$368.65
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cofinity Commercial |
$446.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.39
|
| Rate for Payer: Healthscope Commercial |
$475.49
|
| Rate for Payer: Healthscope Whirlpool |
$461.23
|
| Rate for Payer: Mclaren Commercial |
$427.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$418.43
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
OP
|
$475.49
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$178.86 |
| Max. Negotiated Rate |
$475.49 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: Aetna Medicare |
$326.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$408.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$408.74
|
| Rate for Payer: ASR ASR |
$461.23
|
| Rate for Payer: BCBS Complete |
$187.82
|
| Rate for Payer: BCBS MAPPO |
$326.99
|
| Rate for Payer: BCBS Trust/PPO |
$368.65
|
| Rate for Payer: BCN Commercial |
$368.65
|
| Rate for Payer: BCN Medicare Advantage |
$326.99
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cofinity Commercial |
$446.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.99
|
| Rate for Payer: Healthscope Commercial |
$475.49
|
| Rate for Payer: Healthscope Whirlpool |
$461.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$326.99
|
| Rate for Payer: Mclaren Commercial |
$427.94
|
| Rate for Payer: Mclaren Medicaid |
$178.86
|
| Rate for Payer: Mclaren Medicare |
$326.99
|
| Rate for Payer: Meridian Medicaid |
$187.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$343.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.17
|
| Rate for Payer: PACE Medicare |
$310.64
|
| Rate for Payer: PACE SWMI |
$326.99
|
| Rate for Payer: PHP Commercial |
$359.69
|
| Rate for Payer: PHP Medicaid |
$178.86
|
| Rate for Payer: PHP Medicare Advantage |
$326.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.70
|
| Rate for Payer: Priority Health Medicare |
$326.99
|
| Rate for Payer: Priority Health Narrow Network |
$337.60
|
| Rate for Payer: Railroad Medicare Medicare |
$326.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$418.43
|
| Rate for Payer: UHC Medicare Advantage |
$336.80
|
| Rate for Payer: VA VA |
$326.99
|
|
