|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92626
|
| Hospital Charge Code |
47100017
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$446.76 |
| Rate for Payer: Aetna Commercial |
$402.08
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$433.36
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$368.35
|
| Rate for Payer: BCN Commercial |
$368.35
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Commercial |
$419.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$433.36
|
| Rate for Payer: Healthscope Whirlpool |
$446.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$402.08
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$366.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$391.45
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$313.18
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92626
|
| Hospital Charge Code |
47100017
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$335.07 |
| Max. Negotiated Rate |
$446.76 |
| Rate for Payer: Aetna Commercial |
$402.08
|
| Rate for Payer: ASR ASR |
$433.36
|
| Rate for Payer: BCBS Trust/PPO |
$366.88
|
| Rate for Payer: BCN Commercial |
$366.88
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Commercial |
$419.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$433.36
|
| Rate for Payer: Healthscope Whirlpool |
$446.76
|
| Rate for Payer: Mclaren Commercial |
$402.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$366.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.15
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 92627
|
| Hospital Charge Code |
47100018
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$28.30 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$28.30
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$63.07
|
| Rate for Payer: BCN Commercial |
$63.07
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$74.20
|
| Rate for Payer: Healthscope Whirlpool |
$76.50
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 92627
|
| Hospital Charge Code |
47100018
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$57.38 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.82
|
| Rate for Payer: BCN Commercial |
$62.82
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$74.20
|
| Rate for Payer: Healthscope Whirlpool |
$76.50
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Medicare |
$15.01
|
| Rate for Payer: ASR ASR |
$39.36
|
| Rate for Payer: BCBS Complete |
$16.23
|
| Rate for Payer: BCBS Trust/PPO |
$33.46
|
| Rate for Payer: BCN Commercial |
$33.46
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$38.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$39.36
|
| Rate for Payer: Healthscope Whirlpool |
$40.58
|
| Rate for Payer: Mclaren Commercial |
$36.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$35.56
|
| Rate for Payer: Priority Health Narrow Network |
$28.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.71
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: ASR ASR |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$33.32
|
| Rate for Payer: BCN Commercial |
$33.32
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$38.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$39.36
|
| Rate for Payer: Healthscope Whirlpool |
$40.58
|
| Rate for Payer: Mclaren Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.71
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
OP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$119.02 |
| Rate for Payer: Aetna Commercial |
$107.12
|
| Rate for Payer: Aetna Medicare |
$44.04
|
| Rate for Payer: ASR ASR |
$115.45
|
| Rate for Payer: BCBS Complete |
$47.61
|
| Rate for Payer: BCBS Trust/PPO |
$98.13
|
| Rate for Payer: BCN Commercial |
$98.13
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Commercial |
$111.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$115.45
|
| Rate for Payer: Healthscope Whirlpool |
$119.02
|
| Rate for Payer: Mclaren Commercial |
$107.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$104.29
|
| Rate for Payer: Priority Health Narrow Network |
$83.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.74
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
IP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$119.02 |
| Rate for Payer: Aetna Commercial |
$107.12
|
| Rate for Payer: ASR ASR |
$115.45
|
| Rate for Payer: BCBS Trust/PPO |
$97.74
|
| Rate for Payer: BCN Commercial |
$97.74
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Commercial |
$111.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$115.45
|
| Rate for Payer: Healthscope Whirlpool |
$119.02
|
| Rate for Payer: Mclaren Commercial |
$107.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.74
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
IP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$231.76 |
| Max. Negotiated Rate |
$309.02 |
| Rate for Payer: Aetna Commercial |
$278.12
|
| Rate for Payer: ASR ASR |
$299.75
|
| Rate for Payer: BCBS Trust/PPO |
$253.77
|
| Rate for Payer: BCN Commercial |
$253.77
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Commercial |
$290.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Healthscope Commercial |
$299.75
|
| Rate for Payer: Healthscope Whirlpool |
$309.02
|
| Rate for Payer: Mclaren Commercial |
$278.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$253.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.94
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
OP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$114.34 |
| Max. Negotiated Rate |
$309.02 |
| Rate for Payer: Aetna Commercial |
$278.12
|
| Rate for Payer: Aetna Medicare |
$114.34
|
| Rate for Payer: ASR ASR |
$299.75
|
| Rate for Payer: BCBS Complete |
$123.61
|
| Rate for Payer: BCBS Trust/PPO |
$254.79
|
| Rate for Payer: BCN Commercial |
$254.79
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Commercial |
$290.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Healthscope Commercial |
$299.75
|
| Rate for Payer: Healthscope Whirlpool |
$309.02
|
| Rate for Payer: Mclaren Commercial |
$278.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$253.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$270.76
|
| Rate for Payer: Priority Health Narrow Network |
$216.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.94
|
|
|
HC EVENT MONITOR
|
Facility
|
OP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$520.44 |
| Rate for Payer: Aetna Commercial |
$468.40
|
| Rate for Payer: Aetna Medicare |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.49
|
| Rate for Payer: ASR ASR |
$504.83
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS MAPPO |
$37.19
|
| Rate for Payer: BCBS Trust/PPO |
$429.10
|
| Rate for Payer: BCN Commercial |
$429.10
|
| Rate for Payer: BCN Medicare Advantage |
$37.19
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Commercial |
$489.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.19
|
| Rate for Payer: Healthscope Commercial |
$504.83
|
| Rate for Payer: Healthscope Whirlpool |
$520.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.19
|
| Rate for Payer: Mclaren Commercial |
$468.40
|
| Rate for Payer: Mclaren Medicaid |
$37.19
|
| Rate for Payer: Mclaren Medicare |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.05
|
| Rate for Payer: Meridian Medicaid |
$20.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Nomi Health Commercial |
$426.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: PACE Medicare |
$35.33
|
| Rate for Payer: PACE SWMI |
$37.19
|
| Rate for Payer: PHP Commercial |
$40.91
|
| Rate for Payer: PHP Medicaid |
$19.93
|
| Rate for Payer: PHP Medicare Advantage |
$37.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$456.01
|
| Rate for Payer: Priority Health Medicare |
$37.19
|
| Rate for Payer: Priority Health Narrow Network |
$364.83
|
| Rate for Payer: Railroad Medicare Medicare |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.19
|
| Rate for Payer: UHC Exchange |
$57.64
|
| Rate for Payer: UHC Medicaid |
$19.45
|
| Rate for Payer: UHCCP DNSP |
$37.19
|
| Rate for Payer: UHCCP Medicaid |
$19.45
|
| Rate for Payer: VA VA |
$37.19
|
|
|
HC EVENT MONITOR
|
Facility
|
IP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$390.33 |
| Max. Negotiated Rate |
$520.44 |
| Rate for Payer: Aetna Commercial |
$468.40
|
| Rate for Payer: ASR ASR |
$504.83
|
| Rate for Payer: BCBS Trust/PPO |
$427.39
|
| Rate for Payer: BCN Commercial |
$427.39
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Commercial |
$489.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Healthscope Commercial |
$504.83
|
| Rate for Payer: Healthscope Whirlpool |
$520.44
|
| Rate for Payer: Mclaren Commercial |
$468.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Nomi Health Commercial |
$426.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.99
|
|
|
HC EVEROLIMUS
|
Facility
|
IP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.33 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$68.97
|
| Rate for Payer: BCBS Trust/PPO |
$58.39
|
| Rate for Payer: BCN Commercial |
$58.39
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Healthscope Whirlpool |
$71.10
|
| Rate for Payer: Mclaren Commercial |
$63.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.57
|
|
|
HC EVEROLIMUS
|
Facility
|
OP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$63.99
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: ASR ASR |
$68.97
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Healthscope Whirlpool |
$71.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.73
|
| Rate for Payer: Mclaren Commercial |
$63.99
|
| Rate for Payer: Mclaren Medicaid |
$13.73
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$7.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.64
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.73
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP DNSP |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$576.32 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$241.04
|
| Rate for Payer: BCN Commercial |
$241.04
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$256.16
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$204.94
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$219.26 |
| Max. Negotiated Rate |
$292.35 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Trust/PPO |
$240.08
|
| Rate for Payer: BCN Commercial |
$240.08
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$241.04
|
| Rate for Payer: BCN Commercial |
$241.04
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$256.16
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$204.94
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$219.26 |
| Max. Negotiated Rate |
$292.35 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Trust/PPO |
$240.08
|
| Rate for Payer: BCN Commercial |
$240.08
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$801.11 |
| Rate for Payer: Aetna Commercial |
$721.00
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$777.08
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$660.52
|
| Rate for Payer: BCN Commercial |
$660.52
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Commercial |
$753.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$777.08
|
| Rate for Payer: Healthscope Whirlpool |
$801.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$721.00
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Nomi Health Commercial |
$656.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$701.93
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$561.58
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$600.83 |
| Max. Negotiated Rate |
$801.11 |
| Rate for Payer: Aetna Commercial |
$721.00
|
| Rate for Payer: ASR ASR |
$777.08
|
| Rate for Payer: BCBS Trust/PPO |
$657.87
|
| Rate for Payer: BCN Commercial |
$657.87
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Commercial |
$753.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Healthscope Commercial |
$777.08
|
| Rate for Payer: Healthscope Whirlpool |
$801.11
|
| Rate for Payer: Mclaren Commercial |
$721.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Nomi Health Commercial |
$656.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.98
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$66.73 |
| Rate for Payer: Aetna Commercial |
$60.06
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$64.73
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$55.02
|
| Rate for Payer: BCN Commercial |
$55.02
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$62.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$64.73
|
| Rate for Payer: Healthscope Whirlpool |
$66.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$60.06
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Nomi Health Commercial |
$54.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.47
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$46.78
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.05 |
| Max. Negotiated Rate |
$66.73 |
| Rate for Payer: Aetna Commercial |
$60.06
|
| Rate for Payer: ASR ASR |
$64.73
|
| Rate for Payer: BCBS Trust/PPO |
$54.80
|
| Rate for Payer: BCN Commercial |
$54.80
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$62.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Healthscope Commercial |
$64.73
|
| Rate for Payer: Healthscope Whirlpool |
$66.73
|
| Rate for Payer: Mclaren Commercial |
$60.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Nomi Health Commercial |
$54.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.72
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$593.72
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$575.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$459.06 |
| Max. Negotiated Rate |
$612.08 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| Rate for Payer: ASR ASR |
$593.72
|
| Rate for Payer: BCBS Trust/PPO |
$502.64
|
| Rate for Payer: BCN Commercial |
$502.64
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$575.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$593.72
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$575.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
