|
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
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,180.42 |
| Max. Negotiated Rate |
$1,686.32 |
| Rate for Payer: Aetna Commercial |
$1,517.69
|
| Rate for Payer: ASR ASR |
$1,635.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.40
|
| Rate for Payer: BCN Commercial |
$1,307.40
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,585.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,686.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.73
|
| Rate for Payer: Mclaren Commercial |
$1,517.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,483.96
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,517.69
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,635.73
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.40
|
| Rate for Payer: BCN Commercial |
$1,307.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,585.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,686.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,517.69
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,445.88
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,483.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,127.03 |
| Max. Negotiated Rate |
$1,610.04 |
| Rate for Payer: Aetna Commercial |
$1,449.04
|
| Rate for Payer: ASR ASR |
$1,561.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.26
|
| Rate for Payer: BCN Commercial |
$1,248.26
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,513.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Healthscope Commercial |
$1,610.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.74
|
| Rate for Payer: Mclaren Commercial |
$1,449.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.84
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,449.04
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,561.74
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.26
|
| Rate for Payer: BCN Commercial |
$1,248.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,513.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,610.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,449.04
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,465.14
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,143.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,071.00 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.21
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$628.84 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.21
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.05
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$628.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,475.03 |
| Max. Negotiated Rate |
$3,535.76 |
| Rate for Payer: Aetna Commercial |
$3,182.18
|
| Rate for Payer: ASR ASR |
$3,429.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.27
|
| Rate for Payer: BCN Commercial |
$2,741.27
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$3,323.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Healthscope Commercial |
$3,535.76
|
| Rate for Payer: Healthscope Whirlpool |
$3,429.69
|
| Rate for Payer: Mclaren Commercial |
$3,182.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,111.47
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,475.03 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$3,182.18
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$3,429.69
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.27
|
| Rate for Payer: BCN Commercial |
$2,741.27
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$3,323.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$3,535.76
|
| Rate for Payer: Healthscope Whirlpool |
$3,429.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$3,182.18
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,217.54
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,510.39
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,111.47
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,254.74 |
| Max. Negotiated Rate |
$3,221.06 |
| Rate for Payer: Aetna Commercial |
$2,898.95
|
| Rate for Payer: ASR ASR |
$3,124.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,497.29
|
| Rate for Payer: BCN Commercial |
$2,497.29
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$3,027.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.85
|
| Rate for Payer: Healthscope Commercial |
$3,221.06
|
| Rate for Payer: Healthscope Whirlpool |
$3,124.43
|
| Rate for Payer: Mclaren Commercial |
$2,898.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,834.53
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,682.15 |
| Max. Negotiated Rate |
$3,844.02 |
| Rate for Payer: Aetna Commercial |
$2,898.95
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$3,124.43
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,497.29
|
| Rate for Payer: BCN Commercial |
$2,497.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$3,027.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,221.06
|
| Rate for Payer: Healthscope Whirlpool |
$3,124.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$2,898.95
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,931.16
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,286.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,834.53
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,499.33 |
| Max. Negotiated Rate |
$2,141.90 |
| Rate for Payer: Aetna Commercial |
$1,927.71
|
| Rate for Payer: ASR ASR |
$2,077.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,660.62
|
| Rate for Payer: BCN Commercial |
$1,660.62
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$2,013.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.52
|
| Rate for Payer: Healthscope Commercial |
$2,141.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.64
|
| Rate for Payer: Mclaren Commercial |
$1,927.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,884.87
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$2,141.90 |
| Rate for Payer: Aetna Commercial |
$1,927.71
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$2,077.64
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,660.62
|
| Rate for Payer: BCN Commercial |
$1,660.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$2,013.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$2,141.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,927.71
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.18
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$936.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,884.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
IP
|
$1,947.18
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,363.03 |
| Max. Negotiated Rate |
$1,947.18 |
| Rate for Payer: Aetna Commercial |
$1,752.46
|
| Rate for Payer: ASR ASR |
$1,888.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.65
|
| Rate for Payer: BCN Commercial |
$1,509.65
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cofinity Commercial |
$1,830.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.74
|
| Rate for Payer: Healthscope Commercial |
$1,947.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,888.76
|
| Rate for Payer: Mclaren Commercial |
$1,752.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,655.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,713.52
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,947.18
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,947.18 |
| Rate for Payer: Aetna Commercial |
$1,752.46
|
| Rate for Payer: Aetna Medicare |
$558.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: ASR ASR |
$1,888.76
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.65
|
| Rate for Payer: BCN Commercial |
$1,509.65
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cofinity Commercial |
$1,830.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$1,947.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,888.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$1,752.46
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,655.10
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$614.24
|
| Rate for Payer: PHP Medicaid |
$305.44
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.41
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$530.73
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,713.52
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$83,233.86
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$58,263.70 |
| Max. Negotiated Rate |
$83,233.86 |
| Rate for Payer: Aetna Commercial |
$74,910.47
|
| Rate for Payer: ASR ASR |
$80,736.84
|
| Rate for Payer: BCBS Trust/PPO |
$64,531.21
|
| Rate for Payer: BCN Commercial |
$64,531.21
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cofinity Commercial |
$78,239.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66,587.09
|
| Rate for Payer: Healthscope Commercial |
$83,233.86
|
| Rate for Payer: Healthscope Whirlpool |
$80,736.84
|
| Rate for Payer: Mclaren Commercial |
$74,910.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70,748.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58,263.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73,245.80
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$83,233.86
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,996.08 |
| Max. Negotiated Rate |
$83,233.86 |
| Rate for Payer: Aetna Commercial |
$74,910.47
|
| Rate for Payer: Aetna Medicare |
$29,243.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,554.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,554.11
|
| Rate for Payer: ASR ASR |
$80,736.84
|
| Rate for Payer: BCBS Complete |
$16,797.35
|
| Rate for Payer: BCBS MAPPO |
$29,243.29
|
| Rate for Payer: BCBS Trust/PPO |
$64,531.21
|
| Rate for Payer: BCN Commercial |
$64,531.21
|
| Rate for Payer: BCN Medicare Advantage |
$29,243.29
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cofinity Commercial |
$78,239.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66,587.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,243.29
|
| Rate for Payer: Healthscope Commercial |
$83,233.86
|
| Rate for Payer: Healthscope Whirlpool |
$80,736.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,243.29
|
| Rate for Payer: Mclaren Commercial |
$74,910.47
|
| Rate for Payer: Mclaren Medicaid |
$15,996.08
|
| Rate for Payer: Mclaren Medicare |
$29,243.29
|
| Rate for Payer: Meridian Medicaid |
$16,797.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,705.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,629.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70,748.78
|
| Rate for Payer: PACE Medicare |
$27,781.13
|
| Rate for Payer: PACE SWMI |
$29,243.29
|
| Rate for Payer: PHP Commercial |
$32,167.62
|
| Rate for Payer: PHP Medicaid |
$15,996.08
|
| Rate for Payer: PHP Medicare Advantage |
$29,243.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,996.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58,263.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75,742.81
|
| Rate for Payer: Priority Health Medicare |
$29,243.29
|
| Rate for Payer: Priority Health Narrow Network |
$59,096.04
|
| Rate for Payer: Railroad Medicare Medicare |
$29,243.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73,245.80
|
| Rate for Payer: UHC Medicare Advantage |
$30,120.59
|
| Rate for Payer: VA VA |
$29,243.29
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$181.67
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.17 |
| Max. Negotiated Rate |
$181.67 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| Rate for Payer: ASR ASR |
$176.22
|
| Rate for Payer: BCBS Trust/PPO |
$140.85
|
| Rate for Payer: BCN Commercial |
$140.85
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cofinity Commercial |
$170.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.34
|
| Rate for Payer: Healthscope Commercial |
$181.67
|
| Rate for Payer: Healthscope Whirlpool |
$176.22
|
| Rate for Payer: Mclaren Commercial |
$163.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.87
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$181.67
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$181.67 |
| Rate for Payer: Aetna Commercial |
$163.50
|
| 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 |
$176.22
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$140.85
|
| Rate for Payer: BCN Commercial |
$140.85
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cofinity Commercial |
$170.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$181.67
|
| Rate for Payer: Healthscope Whirlpool |
$176.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$163.50
|
| 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 |
$154.42
|
| 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 |
$127.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.78
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$87.02
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.87
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$3,997.05
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,997.05 |
| Rate for Payer: Aetna Commercial |
$3,597.34
|
| 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 |
$3,877.14
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,098.91
|
| Rate for Payer: BCN Commercial |
$3,098.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cofinity Commercial |
$3,757.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,197.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,997.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,597.34
|
| 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 |
$3,397.49
|
| 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 |
$2,797.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,637.32
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,837.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,517.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$3,997.05
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,797.94 |
| Max. Negotiated Rate |
$3,997.05 |
| Rate for Payer: Aetna Commercial |
$3,597.34
|
| Rate for Payer: ASR ASR |
$3,877.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,098.91
|
| Rate for Payer: BCN Commercial |
$3,098.91
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cofinity Commercial |
$3,757.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,197.64
|
| Rate for Payer: Healthscope Commercial |
$3,997.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.14
|
| Rate for Payer: Mclaren Commercial |
$3,597.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,397.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,517.40
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,058.39
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,840.87 |
| Max. Negotiated Rate |
$4,058.39 |
| Rate for Payer: Aetna Commercial |
$3,652.55
|
| Rate for Payer: ASR ASR |
$3,936.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,146.47
|
| Rate for Payer: BCN Commercial |
$3,146.47
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cofinity Commercial |
$3,814.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.71
|
| Rate for Payer: Healthscope Commercial |
$4,058.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,936.64
|
| Rate for Payer: Mclaren Commercial |
$3,652.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,449.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,840.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,571.38
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,058.39
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,671.93 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$3,652.55
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$3,936.64
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,146.47
|
| Rate for Payer: BCN Commercial |
$3,146.47
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cofinity Commercial |
$3,814.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$4,058.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,936.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$3,652.55
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,449.63
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,840.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,693.13
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,881.46
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,571.38
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$259.90
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$103.96 |
| Max. Negotiated Rate |
$259.90 |
| Rate for Payer: Aetna Commercial |
$233.91
|
| Rate for Payer: ASR ASR |
$252.10
|
| Rate for Payer: BCBS Complete |
$103.96
|
| Rate for Payer: BCBS Trust/PPO |
$201.50
|
| Rate for Payer: BCCCP Commercial |
$137.47
|
| Rate for Payer: BCN Commercial |
$201.50
|
| Rate for Payer: Cash Price |
$207.92
|
| Rate for Payer: Cash Price |
$207.92
|
| Rate for Payer: Cofinity Commercial |
$244.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.92
|
| Rate for Payer: Healthscope Commercial |
$259.90
|
| Rate for Payer: Healthscope Whirlpool |
$252.10
|
| Rate for Payer: Mclaren Commercial |
$233.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.51
|
| Rate for Payer: Priority Health Narrow Network |
$184.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.71
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$259.90
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$181.93 |
| Max. Negotiated Rate |
$259.90 |
| Rate for Payer: Aetna Commercial |
$233.91
|
| Rate for Payer: ASR ASR |
$252.10
|
| Rate for Payer: BCBS Trust/PPO |
$201.50
|
| Rate for Payer: BCN Commercial |
$201.50
|
| Rate for Payer: Cash Price |
$207.92
|
| Rate for Payer: Cofinity Commercial |
$244.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.92
|
| Rate for Payer: Healthscope Commercial |
$259.90
|
| Rate for Payer: Healthscope Whirlpool |
$252.10
|
| Rate for Payer: Mclaren Commercial |
$233.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.71
|
|
