|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
OP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.41 |
| Max. Negotiated Rate |
$303.82 |
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: Aetna Medicare |
$112.41
|
| Rate for Payer: ASR ASR |
$294.71
|
| Rate for Payer: BCBS Complete |
$121.53
|
| Rate for Payer: BCBS Trust/PPO |
$250.50
|
| Rate for Payer: BCN Commercial |
$250.50
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Commercial |
$285.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$294.71
|
| Rate for Payer: Healthscope Whirlpool |
$303.82
|
| Rate for Payer: Mclaren Commercial |
$273.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Nomi Health Commercial |
$249.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$266.21
|
| Rate for Payer: Priority Health Narrow Network |
$212.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.36
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
IP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$227.87 |
| Max. Negotiated Rate |
$303.82 |
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: ASR ASR |
$294.71
|
| Rate for Payer: BCBS Trust/PPO |
$249.50
|
| Rate for Payer: BCN Commercial |
$249.50
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Commercial |
$285.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$294.71
|
| Rate for Payer: Healthscope Whirlpool |
$303.82
|
| Rate for Payer: Mclaren Commercial |
$273.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Nomi Health Commercial |
$249.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.36
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$2,826.77
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,045.90 |
| Max. Negotiated Rate |
$2,826.77 |
| Rate for Payer: Aetna Commercial |
$2,544.09
|
| Rate for Payer: Aetna Medicare |
$1,045.90
|
| Rate for Payer: ASR ASR |
$2,741.97
|
| Rate for Payer: BCBS Complete |
$1,130.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,330.67
|
| Rate for Payer: BCN Commercial |
$2,330.67
|
| Rate for Payer: Cash Price |
$2,261.42
|
| Rate for Payer: Cofinity Commercial |
$2,657.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.42
|
| Rate for Payer: Healthscope Commercial |
$2,741.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,826.77
|
| Rate for Payer: Mclaren Commercial |
$2,544.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,261.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.75
|
| Rate for Payer: Nomi Health Commercial |
$2,317.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,476.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,981.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,487.56
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$2,826.77
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,120.08 |
| Max. Negotiated Rate |
$2,826.77 |
| Rate for Payer: Aetna Commercial |
$2,544.09
|
| Rate for Payer: ASR ASR |
$2,741.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,321.34
|
| Rate for Payer: BCN Commercial |
$2,321.34
|
| Rate for Payer: Cash Price |
$2,261.42
|
| Rate for Payer: Cofinity Commercial |
$2,657.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.42
|
| Rate for Payer: Healthscope Commercial |
$2,741.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,826.77
|
| Rate for Payer: Mclaren Commercial |
$2,544.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.75
|
| Rate for Payer: Nomi Health Commercial |
$2,317.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,487.56
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
OP
|
$8,177.54
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,025.69 |
| Max. Negotiated Rate |
$8,177.54 |
| Rate for Payer: Aetna Commercial |
$7,359.79
|
| Rate for Payer: Aetna Medicare |
$3,025.69
|
| Rate for Payer: ASR ASR |
$7,932.21
|
| Rate for Payer: BCBS Complete |
$3,271.02
|
| Rate for Payer: BCBS Trust/PPO |
$6,742.38
|
| Rate for Payer: BCN Commercial |
$6,742.38
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,686.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,932.21
|
| Rate for Payer: Healthscope Whirlpool |
$8,177.54
|
| Rate for Payer: Mclaren Commercial |
$7,359.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,542.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,165.16
|
| Rate for Payer: Priority Health Narrow Network |
$5,732.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,196.24
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
IP
|
$8,177.54
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,133.15 |
| Max. Negotiated Rate |
$8,177.54 |
| Rate for Payer: Aetna Commercial |
$7,359.79
|
| Rate for Payer: ASR ASR |
$7,932.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,715.40
|
| Rate for Payer: BCN Commercial |
$6,715.40
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,686.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,932.21
|
| Rate for Payer: Healthscope Whirlpool |
$8,177.54
|
| Rate for Payer: Mclaren Commercial |
$7,359.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,196.24
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
IP
|
$8,177.54
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,133.15 |
| Max. Negotiated Rate |
$8,177.54 |
| Rate for Payer: Aetna Commercial |
$7,359.79
|
| Rate for Payer: ASR ASR |
$7,932.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,715.40
|
| Rate for Payer: BCN Commercial |
$6,715.40
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,686.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,932.21
|
| Rate for Payer: Healthscope Whirlpool |
$8,177.54
|
| Rate for Payer: Mclaren Commercial |
$7,359.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,196.24
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
OP
|
$8,177.54
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,025.69 |
| Max. Negotiated Rate |
$8,177.54 |
| Rate for Payer: Aetna Commercial |
$7,359.79
|
| Rate for Payer: Aetna Medicare |
$3,025.69
|
| Rate for Payer: ASR ASR |
$7,932.21
|
| Rate for Payer: BCBS Complete |
$3,271.02
|
| Rate for Payer: BCBS Trust/PPO |
$6,742.38
|
| Rate for Payer: BCN Commercial |
$6,742.38
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,686.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,932.21
|
| Rate for Payer: Healthscope Whirlpool |
$8,177.54
|
| Rate for Payer: Mclaren Commercial |
$7,359.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,542.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,165.16
|
| Rate for Payer: Priority Health Narrow Network |
$5,732.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,196.24
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
OP
|
$5,204.08
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,925.51 |
| Max. Negotiated Rate |
$5,204.08 |
| Rate for Payer: Aetna Commercial |
$4,683.67
|
| Rate for Payer: Aetna Medicare |
$1,925.51
|
| Rate for Payer: ASR ASR |
$5,047.96
|
| Rate for Payer: BCBS Complete |
$2,081.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,290.76
|
| Rate for Payer: BCN Commercial |
$4,290.76
|
| Rate for Payer: Cash Price |
$4,163.26
|
| Rate for Payer: Cofinity Commercial |
$4,891.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.26
|
| Rate for Payer: Healthscope Commercial |
$5,047.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,204.08
|
| Rate for Payer: Mclaren Commercial |
$4,683.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,163.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.47
|
| Rate for Payer: Nomi Health Commercial |
$4,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,559.81
|
| Rate for Payer: Priority Health Narrow Network |
$3,648.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,579.59
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
IP
|
$5,204.08
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,903.06 |
| Max. Negotiated Rate |
$5,204.08 |
| Rate for Payer: Aetna Commercial |
$4,683.67
|
| Rate for Payer: ASR ASR |
$5,047.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,273.59
|
| Rate for Payer: BCN Commercial |
$4,273.59
|
| Rate for Payer: Cash Price |
$4,163.26
|
| Rate for Payer: Cofinity Commercial |
$4,891.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.26
|
| Rate for Payer: Healthscope Commercial |
$5,047.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,204.08
|
| Rate for Payer: Mclaren Commercial |
$4,683.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.47
|
| Rate for Payer: Nomi Health Commercial |
$4,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,579.59
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
IP
|
$804.23
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$603.17 |
| Max. Negotiated Rate |
$804.23 |
| Rate for Payer: Aetna Commercial |
$723.81
|
| Rate for Payer: ASR ASR |
$780.10
|
| Rate for Payer: BCBS Trust/PPO |
$660.43
|
| Rate for Payer: BCN Commercial |
$660.43
|
| Rate for Payer: Cash Price |
$643.38
|
| Rate for Payer: Cofinity Commercial |
$755.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$643.38
|
| Rate for Payer: Healthscope Commercial |
$780.10
|
| Rate for Payer: Healthscope Whirlpool |
$804.23
|
| Rate for Payer: Mclaren Commercial |
$723.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$683.60
|
| Rate for Payer: Nomi Health Commercial |
$659.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$707.72
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
OP
|
$804.23
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$297.57 |
| Max. Negotiated Rate |
$804.23 |
| Rate for Payer: Aetna Commercial |
$723.81
|
| Rate for Payer: Aetna Medicare |
$297.57
|
| Rate for Payer: ASR ASR |
$780.10
|
| Rate for Payer: BCBS Complete |
$321.69
|
| Rate for Payer: BCBS Trust/PPO |
$663.09
|
| Rate for Payer: BCN Commercial |
$663.09
|
| Rate for Payer: Cash Price |
$643.38
|
| Rate for Payer: Cofinity Commercial |
$755.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$643.38
|
| Rate for Payer: Healthscope Commercial |
$780.10
|
| Rate for Payer: Healthscope Whirlpool |
$804.23
|
| Rate for Payer: Mclaren Commercial |
$723.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$643.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$683.60
|
| Rate for Payer: Nomi Health Commercial |
$659.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$704.67
|
| Rate for Payer: Priority Health Narrow Network |
$563.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$707.72
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
OP
|
$3,056.70
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,130.98 |
| Max. Negotiated Rate |
$3,056.70 |
| Rate for Payer: Aetna Commercial |
$2,751.03
|
| Rate for Payer: Aetna Medicare |
$1,130.98
|
| Rate for Payer: ASR ASR |
$2,965.00
|
| Rate for Payer: BCBS Complete |
$1,222.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,520.25
|
| Rate for Payer: BCN Commercial |
$2,520.25
|
| Rate for Payer: Cash Price |
$2,445.36
|
| Rate for Payer: Cofinity Commercial |
$2,873.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,445.36
|
| Rate for Payer: Healthscope Commercial |
$2,965.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,056.70
|
| Rate for Payer: Mclaren Commercial |
$2,751.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,445.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,598.20
|
| Rate for Payer: Nomi Health Commercial |
$2,506.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,678.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,142.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,689.90
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
IP
|
$3,056.70
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,292.53 |
| Max. Negotiated Rate |
$3,056.70 |
| Rate for Payer: Aetna Commercial |
$2,751.03
|
| Rate for Payer: ASR ASR |
$2,965.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,510.16
|
| Rate for Payer: BCN Commercial |
$2,510.16
|
| Rate for Payer: Cash Price |
$2,445.36
|
| Rate for Payer: Cofinity Commercial |
$2,873.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,445.36
|
| Rate for Payer: Healthscope Commercial |
$2,965.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,056.70
|
| Rate for Payer: Mclaren Commercial |
$2,751.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,598.20
|
| Rate for Payer: Nomi Health Commercial |
$2,506.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,689.90
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
IP
|
$4,160.46
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,120.34 |
| Max. Negotiated Rate |
$4,160.46 |
| Rate for Payer: Aetna Commercial |
$3,744.41
|
| Rate for Payer: ASR ASR |
$4,035.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,416.57
|
| Rate for Payer: BCN Commercial |
$3,416.57
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cofinity Commercial |
$3,910.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.37
|
| Rate for Payer: Healthscope Commercial |
$4,035.65
|
| Rate for Payer: Healthscope Whirlpool |
$4,160.46
|
| Rate for Payer: Mclaren Commercial |
$3,744.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,536.39
|
| Rate for Payer: Nomi Health Commercial |
$3,411.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,120.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,661.20
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
OP
|
$4,160.46
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,744.41
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,035.65
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,430.30
|
| Rate for Payer: BCN Commercial |
$3,430.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cash Price |
$3,328.37
|
| Rate for Payer: Cofinity Commercial |
$3,910.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,035.65
|
| Rate for Payer: Healthscope Whirlpool |
$4,160.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,744.41
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,536.39
|
| Rate for Payer: Nomi Health Commercial |
$3,411.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,120.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,645.40
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,916.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,661.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
OP
|
$266.76
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.70 |
| Max. Negotiated Rate |
$266.76 |
| Rate for Payer: Aetna Commercial |
$240.08
|
| Rate for Payer: Aetna Medicare |
$98.70
|
| Rate for Payer: ASR ASR |
$258.76
|
| Rate for Payer: BCBS Complete |
$106.70
|
| Rate for Payer: BCBS Trust/PPO |
$219.94
|
| Rate for Payer: BCN Commercial |
$219.94
|
| Rate for Payer: Cash Price |
$213.41
|
| Rate for Payer: Cofinity Commercial |
$250.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.41
|
| Rate for Payer: Healthscope Commercial |
$258.76
|
| Rate for Payer: Healthscope Whirlpool |
$266.76
|
| Rate for Payer: Mclaren Commercial |
$240.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.75
|
| Rate for Payer: Nomi Health Commercial |
$218.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$233.74
|
| Rate for Payer: Priority Health Narrow Network |
$187.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.75
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
IP
|
$266.76
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.07 |
| Max. Negotiated Rate |
$266.76 |
| Rate for Payer: Aetna Commercial |
$240.08
|
| Rate for Payer: ASR ASR |
$258.76
|
| Rate for Payer: BCBS Trust/PPO |
$219.06
|
| Rate for Payer: BCN Commercial |
$219.06
|
| Rate for Payer: Cash Price |
$213.41
|
| Rate for Payer: Cofinity Commercial |
$250.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.41
|
| Rate for Payer: Healthscope Commercial |
$258.76
|
| Rate for Payer: Healthscope Whirlpool |
$266.76
|
| Rate for Payer: Mclaren Commercial |
$240.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.75
|
| Rate for Payer: Nomi Health Commercial |
$218.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.75
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
OP
|
$4,204.81
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,784.33
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,078.67
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,466.87
|
| Rate for Payer: BCN Commercial |
$3,466.87
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cofinity Commercial |
$3,952.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,363.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,078.67
|
| Rate for Payer: Healthscope Whirlpool |
$4,204.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,784.33
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,574.09
|
| Rate for Payer: Nomi Health Commercial |
$3,447.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,153.61
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,684.25
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,947.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,700.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
IP
|
$4,204.81
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,153.61 |
| Max. Negotiated Rate |
$4,204.81 |
| Rate for Payer: Aetna Commercial |
$3,784.33
|
| Rate for Payer: ASR ASR |
$4,078.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,452.99
|
| Rate for Payer: BCN Commercial |
$3,452.99
|
| Rate for Payer: Cash Price |
$3,363.85
|
| Rate for Payer: Cofinity Commercial |
$3,952.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,363.85
|
| Rate for Payer: Healthscope Commercial |
$4,078.67
|
| Rate for Payer: Healthscope Whirlpool |
$4,204.81
|
| Rate for Payer: Mclaren Commercial |
$3,784.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,574.09
|
| Rate for Payer: Nomi Health Commercial |
$3,447.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,153.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,700.23
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,901.65
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,813.61 |
| Max. Negotiated Rate |
$4,901.65 |
| Rate for Payer: Aetna Commercial |
$4,411.48
|
| Rate for Payer: Aetna Medicare |
$1,813.61
|
| Rate for Payer: ASR ASR |
$4,754.60
|
| Rate for Payer: BCBS Complete |
$1,960.66
|
| Rate for Payer: BCBS Trust/PPO |
$4,041.41
|
| Rate for Payer: BCN Commercial |
$4,041.41
|
| Rate for Payer: Cash Price |
$3,921.32
|
| Rate for Payer: Cofinity Commercial |
$4,607.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,921.32
|
| Rate for Payer: Healthscope Commercial |
$4,754.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,901.65
|
| Rate for Payer: Mclaren Commercial |
$4,411.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,921.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,166.40
|
| Rate for Payer: Nomi Health Commercial |
$4,019.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,676.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,294.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,436.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,313.45
|
|
|
HC ENDOVENT
|
Facility
|
IP
|
$4,901.65
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,676.24 |
| Max. Negotiated Rate |
$4,901.65 |
| Rate for Payer: Aetna Commercial |
$4,411.48
|
| Rate for Payer: ASR ASR |
$4,754.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,025.23
|
| Rate for Payer: BCN Commercial |
$4,025.23
|
| Rate for Payer: Cash Price |
$3,921.32
|
| Rate for Payer: Cofinity Commercial |
$4,607.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,921.32
|
| Rate for Payer: Healthscope Commercial |
$4,754.60
|
| Rate for Payer: Healthscope Whirlpool |
$4,901.65
|
| Rate for Payer: Mclaren Commercial |
$4,411.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,166.40
|
| Rate for Payer: Nomi Health Commercial |
$4,019.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,676.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,313.45
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,897.16
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,672.87 |
| Max. Negotiated Rate |
$4,897.16 |
| Rate for Payer: Aetna Commercial |
$4,407.44
|
| Rate for Payer: ASR ASR |
$4,750.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,021.55
|
| Rate for Payer: BCN Commercial |
$4,021.55
|
| Rate for Payer: Cash Price |
$3,917.73
|
| Rate for Payer: Cofinity Commercial |
$4,603.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,917.73
|
| Rate for Payer: Healthscope Commercial |
$4,750.25
|
| Rate for Payer: Healthscope Whirlpool |
$4,897.16
|
| Rate for Payer: Mclaren Commercial |
$4,407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,162.59
|
| Rate for Payer: Nomi Health Commercial |
$4,015.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,309.50
|
|
