|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$290.46 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$373.45
|
| Rate for Payer: ASR ASR |
$402.49
|
| Rate for Payer: BCBS Trust/PPO |
$321.70
|
| Rate for Payer: BCN Commercial |
$321.70
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$390.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Healthscope Whirlpool |
$402.49
|
| Rate for Payer: Mclaren Commercial |
$373.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.15
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$373.45
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$402.49
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$321.70
|
| Rate for Payer: BCN Commercial |
$321.70
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$390.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Healthscope Whirlpool |
$402.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$373.45
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.90
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$184.72
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.15
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$565.01 |
| Rate for Payer: Aetna Commercial |
$508.51
|
| 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 |
$548.06
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$438.05
|
| Rate for Payer: BCN Commercial |
$438.05
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$531.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$565.01
|
| Rate for Payer: Healthscope Whirlpool |
$548.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.12
|
| Rate for Payer: Mclaren Commercial |
$508.51
|
| 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 |
$480.26
|
| 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 |
$395.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.73
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$320.58
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.21
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$395.51 |
| Max. Negotiated Rate |
$565.01 |
| Rate for Payer: Aetna Commercial |
$508.51
|
| Rate for Payer: ASR ASR |
$548.06
|
| Rate for Payer: BCBS Trust/PPO |
$438.05
|
| Rate for Payer: BCN Commercial |
$438.05
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$531.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Healthscope Commercial |
$565.01
|
| Rate for Payer: Healthscope Whirlpool |
$548.06
|
| Rate for Payer: Mclaren Commercial |
$508.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.21
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.74 |
| Max. Negotiated Rate |
$195.34 |
| Rate for Payer: Aetna Commercial |
$175.81
|
| Rate for Payer: ASR ASR |
$189.48
|
| Rate for Payer: BCBS Trust/PPO |
$151.45
|
| Rate for Payer: BCN Commercial |
$151.45
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$183.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Healthscope Commercial |
$195.34
|
| Rate for Payer: Healthscope Whirlpool |
$189.48
|
| Rate for Payer: Mclaren Commercial |
$175.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.90
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$195.34 |
| Rate for Payer: Aetna Commercial |
$175.81
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$189.48
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$151.45
|
| Rate for Payer: BCN Commercial |
$151.45
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$183.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$195.34
|
| Rate for Payer: Healthscope Whirlpool |
$189.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$175.81
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.17
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$68.14
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.90
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$736.68 |
| Max. Negotiated Rate |
$1,052.40 |
| Rate for Payer: Aetna Commercial |
$947.16
|
| Rate for Payer: ASR ASR |
$1,020.83
|
| Rate for Payer: BCBS Trust/PPO |
$815.93
|
| Rate for Payer: BCN Commercial |
$815.93
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$989.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Healthscope Commercial |
$1,052.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,020.83
|
| Rate for Payer: Mclaren Commercial |
$947.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$926.11
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$420.96 |
| Max. Negotiated Rate |
$1,052.40 |
| Rate for Payer: Aetna Commercial |
$947.16
|
| Rate for Payer: ASR ASR |
$1,020.83
|
| Rate for Payer: BCBS Complete |
$420.96
|
| Rate for Payer: BCBS Trust/PPO |
$815.93
|
| Rate for Payer: BCN Commercial |
$815.93
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$989.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Healthscope Commercial |
$1,052.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,020.83
|
| Rate for Payer: Mclaren Commercial |
$947.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.68
|
| Rate for Payer: Priority Health Narrow Network |
$747.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$926.11
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,008.92 |
| Max. Negotiated Rate |
$1,441.32 |
| Rate for Payer: Aetna Commercial |
$1,297.19
|
| Rate for Payer: ASR ASR |
$1,398.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.46
|
| Rate for Payer: BCN Commercial |
$1,117.46
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Healthscope Commercial |
$1,441.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.08
|
| Rate for Payer: Mclaren Commercial |
$1,297.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.36
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$1,441.32 |
| Rate for Payer: Aetna Commercial |
$1,297.19
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: ASR ASR |
$1,398.08
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.46
|
| Rate for Payer: BCN Commercial |
$1,117.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,441.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$1,297.19
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,311.60
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,044.06 |
| Max. Negotiated Rate |
$1,491.52 |
| Rate for Payer: Aetna Commercial |
$1,342.37
|
| Rate for Payer: ASR ASR |
$1,446.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.38
|
| Rate for Payer: BCN Commercial |
$1,156.38
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,402.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Healthscope Commercial |
$1,491.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,446.77
|
| Rate for Payer: Mclaren Commercial |
$1,342.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,312.54
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.18 |
| Max. Negotiated Rate |
$2,114.21 |
| Rate for Payer: Aetna Commercial |
$1,342.37
|
| Rate for Payer: Aetna Medicare |
$1,691.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: ASR ASR |
$1,446.77
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.38
|
| Rate for Payer: BCN Commercial |
$1,156.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,402.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,491.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,446.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,691.37
|
| Rate for Payer: Mclaren Commercial |
$1,342.37
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,860.51
|
| Rate for Payer: PHP Medicaid |
$925.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,357.28
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,058.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,312.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: VA VA |
$1,691.37
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$146.64
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$158.04
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$126.32
|
| Rate for Payer: BCN Commercial |
$126.32
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$153.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: Healthscope Whirlpool |
$158.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$146.64
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.27
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$115.68
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.38
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.05 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$146.64
|
| Rate for Payer: ASR ASR |
$158.04
|
| Rate for Payer: BCBS Trust/PPO |
$126.32
|
| Rate for Payer: BCN Commercial |
$126.32
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$153.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: Healthscope Whirlpool |
$158.04
|
| Rate for Payer: Mclaren Commercial |
$146.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.38
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.18 |
| Max. Negotiated Rate |
$2,114.21 |
| Rate for Payer: Aetna Commercial |
$1,275.54
|
| Rate for Payer: Aetna Medicare |
$1,691.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: ASR ASR |
$1,374.75
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.81
|
| Rate for Payer: BCN Commercial |
$1,098.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,332.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,417.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,374.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,691.37
|
| Rate for Payer: Mclaren Commercial |
$1,275.54
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,860.51
|
| Rate for Payer: PHP Medicaid |
$925.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.72
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,247.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: VA VA |
$1,691.37
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$992.09 |
| Max. Negotiated Rate |
$1,417.27 |
| Rate for Payer: Aetna Commercial |
$1,275.54
|
| Rate for Payer: ASR ASR |
$1,374.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.81
|
| Rate for Payer: BCN Commercial |
$1,098.81
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,332.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Healthscope Commercial |
$1,417.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,374.75
|
| Rate for Payer: Mclaren Commercial |
$1,275.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,247.20
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.99 |
| Max. Negotiated Rate |
$372.48 |
| Rate for Payer: Aetna Commercial |
$335.23
|
| Rate for Payer: ASR ASR |
$361.31
|
| Rate for Payer: BCBS Complete |
$148.99
|
| Rate for Payer: BCBS Trust/PPO |
$288.78
|
| Rate for Payer: BCN Commercial |
$288.78
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$350.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$372.48
|
| Rate for Payer: Healthscope Whirlpool |
$361.31
|
| Rate for Payer: Mclaren Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.96
|
| Rate for Payer: Priority Health Narrow Network |
$264.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.78
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.74 |
| Max. Negotiated Rate |
$372.48 |
| Rate for Payer: Aetna Commercial |
$335.23
|
| Rate for Payer: ASR ASR |
$361.31
|
| Rate for Payer: BCBS Trust/PPO |
$288.78
|
| Rate for Payer: BCN Commercial |
$288.78
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$350.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$372.48
|
| Rate for Payer: Healthscope Whirlpool |
$361.31
|
| Rate for Payer: Mclaren Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.78
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,271.64 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.55
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,271.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,746.94 |
| Max. Negotiated Rate |
$2,495.63 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,746.94 |
| Max. Negotiated Rate |
$2,495.63 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,271.02
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,614.03
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,817.35
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.84
|
| Rate for Payer: BCN Commercial |
$2,251.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,904.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,817.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,614.03
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,643.08
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,062.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.14 |
| Max. Negotiated Rate |
$2,904.48 |
| Rate for Payer: Aetna Commercial |
$2,614.03
|
| Rate for Payer: ASR ASR |
$2,817.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.84
|
| Rate for Payer: BCN Commercial |
$2,251.84
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,904.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,817.35
|
| Rate for Payer: Mclaren Commercial |
$2,614.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.94
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.14 |
| Max. Negotiated Rate |
$2,904.48 |
| Rate for Payer: Aetna Commercial |
$2,614.03
|
| Rate for Payer: ASR ASR |
$2,817.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.84
|
| Rate for Payer: BCN Commercial |
$2,251.84
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,904.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,817.35
|
| Rate for Payer: Mclaren Commercial |
$2,614.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.94
|
|
