|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$350.06 |
| Max. Negotiated Rate |
$538.56 |
| Rate for Payer: Aetna Commercial |
$484.70
|
| Rate for Payer: ASR ASR |
$522.40
|
| Rate for Payer: ASR Commercial |
$522.40
|
| Rate for Payer: BCBS Trust/PPO |
$438.87
|
| Rate for Payer: BCN Commercial |
$417.55
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$506.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$538.56
|
| Rate for Payer: Healthscope Whirlpool |
$522.40
|
| Rate for Payer: Mclaren Commercial |
$484.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.93
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$215.42 |
| Max. Negotiated Rate |
$538.56 |
| Rate for Payer: Aetna Commercial |
$484.70
|
| Rate for Payer: Aetna Medicare |
$269.28
|
| Rate for Payer: ASR ASR |
$522.40
|
| Rate for Payer: ASR Commercial |
$522.40
|
| Rate for Payer: BCBS Complete |
$215.42
|
| Rate for Payer: BCBS Trust/PPO |
$441.03
|
| Rate for Payer: BCN Commercial |
$417.55
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$506.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$538.56
|
| Rate for Payer: Healthscope Whirlpool |
$522.40
|
| Rate for Payer: Mclaren Commercial |
$484.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.89
|
| Rate for Payer: Priority Health Narrow Network |
$377.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.93
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.65 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$827.22
|
| Rate for Payer: Aetna Medicare |
$459.56
|
| Rate for Payer: ASR ASR |
$891.56
|
| Rate for Payer: ASR Commercial |
$891.56
|
| Rate for Payer: BCBS Complete |
$367.65
|
| Rate for Payer: BCBS Trust/PPO |
$752.68
|
| Rate for Payer: BCN Commercial |
$712.60
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$863.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Healthscope Whirlpool |
$891.56
|
| Rate for Payer: Mclaren Commercial |
$827.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$805.34
|
| Rate for Payer: Priority Health Narrow Network |
$644.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.83
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$597.43 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$827.22
|
| Rate for Payer: ASR ASR |
$891.56
|
| Rate for Payer: ASR Commercial |
$891.56
|
| Rate for Payer: BCBS Trust/PPO |
$749.00
|
| Rate for Payer: BCN Commercial |
$712.60
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$863.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Healthscope Whirlpool |
$891.56
|
| Rate for Payer: Mclaren Commercial |
$827.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.83
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,783.76 |
| Max. Negotiated Rate |
$4,282.71 |
| Rate for Payer: Aetna Commercial |
$3,854.44
|
| Rate for Payer: ASR ASR |
$4,154.23
|
| Rate for Payer: ASR Commercial |
$4,154.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,489.98
|
| Rate for Payer: BCN Commercial |
$3,320.39
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$4,025.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Healthscope Commercial |
$4,282.71
|
| Rate for Payer: Healthscope Whirlpool |
$4,154.23
|
| Rate for Payer: Mclaren Commercial |
$3,854.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: Nomi Health Commercial |
$3,511.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,768.78
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,282.71 |
| Rate for Payer: Aetna Commercial |
$3,854.44
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$4,154.23
|
| Rate for Payer: ASR Commercial |
$4,154.23
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,507.11
|
| Rate for Payer: BCN Commercial |
$3,320.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$4,025.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,282.71
|
| Rate for Payer: Healthscope Whirlpool |
$4,154.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,854.44
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: Nomi Health Commercial |
$3,511.82
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,752.51
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,002.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,768.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$338.13 |
| Max. Negotiated Rate |
$520.20 |
| Rate for Payer: Aetna Commercial |
$468.18
|
| Rate for Payer: ASR ASR |
$504.59
|
| Rate for Payer: ASR Commercial |
$504.59
|
| Rate for Payer: BCBS Trust/PPO |
$423.91
|
| Rate for Payer: BCN Commercial |
$403.31
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$488.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$520.20
|
| Rate for Payer: Healthscope Whirlpool |
$504.59
|
| Rate for Payer: Mclaren Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.78
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$520.20 |
| Rate for Payer: Aetna Commercial |
$468.18
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$504.59
|
| Rate for Payer: ASR Commercial |
$504.59
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$425.99
|
| Rate for Payer: BCN Commercial |
$403.31
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$488.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$520.20
|
| Rate for Payer: Healthscope Whirlpool |
$504.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.11
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$186.49
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,361.41 |
| Max. Negotiated Rate |
$2,094.48 |
| Rate for Payer: Aetna Commercial |
$1,885.03
|
| Rate for Payer: ASR ASR |
$2,031.65
|
| Rate for Payer: ASR Commercial |
$2,031.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.79
|
| Rate for Payer: BCN Commercial |
$1,623.85
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,968.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$2,094.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,031.65
|
| Rate for Payer: Mclaren Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: Nomi Health Commercial |
$1,717.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,843.14
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$837.79 |
| Max. Negotiated Rate |
$2,094.48 |
| Rate for Payer: Aetna Commercial |
$1,885.03
|
| Rate for Payer: Aetna Medicare |
$1,047.24
|
| Rate for Payer: ASR ASR |
$2,031.65
|
| Rate for Payer: ASR Commercial |
$2,031.65
|
| Rate for Payer: BCBS Complete |
$837.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,715.17
|
| Rate for Payer: BCN Commercial |
$1,623.85
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,968.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$2,094.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,031.65
|
| Rate for Payer: Mclaren Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: Nomi Health Commercial |
$1,717.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,835.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,468.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,843.14
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,772.67 |
| Max. Negotiated Rate |
$4,265.64 |
| Rate for Payer: Aetna Commercial |
$3,839.08
|
| Rate for Payer: ASR ASR |
$4,137.67
|
| Rate for Payer: ASR Commercial |
$4,137.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.07
|
| Rate for Payer: BCN Commercial |
$3,307.15
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$4,009.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Healthscope Commercial |
$4,265.64
|
| Rate for Payer: Healthscope Whirlpool |
$4,137.67
|
| Rate for Payer: Mclaren Commercial |
$3,839.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: Nomi Health Commercial |
$3,497.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,753.76
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,265.64 |
| Rate for Payer: Aetna Commercial |
$3,839.08
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$4,137.67
|
| Rate for Payer: ASR Commercial |
$4,137.67
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,493.13
|
| Rate for Payer: BCN Commercial |
$3,307.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$4,009.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,265.64
|
| Rate for Payer: Healthscope Whirlpool |
$4,137.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,839.08
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: Nomi Health Commercial |
$3,497.82
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,400.50
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,753.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.05 |
| Max. Negotiated Rate |
$3,153.60 |
| Rate for Payer: Aetna Commercial |
$2,838.24
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$3,058.99
|
| Rate for Payer: ASR Commercial |
$3,058.99
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,582.48
|
| Rate for Payer: BCN Commercial |
$2,444.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,964.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,153.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,058.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$2,838.24
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: Nomi Health Commercial |
$2,585.95
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.56
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$694.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,775.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,049.84 |
| Max. Negotiated Rate |
$3,153.60 |
| Rate for Payer: Aetna Commercial |
$2,838.24
|
| Rate for Payer: ASR ASR |
$3,058.99
|
| Rate for Payer: ASR Commercial |
$3,058.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,569.87
|
| Rate for Payer: BCN Commercial |
$2,444.99
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,964.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Healthscope Commercial |
$3,153.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,058.99
|
| Rate for Payer: Mclaren Commercial |
$2,838.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: Nomi Health Commercial |
$2,585.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,775.17
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,063.53 |
| Max. Negotiated Rate |
$3,174.66 |
| Rate for Payer: Aetna Commercial |
$2,857.19
|
| Rate for Payer: ASR ASR |
$3,079.42
|
| Rate for Payer: ASR Commercial |
$3,079.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,587.03
|
| Rate for Payer: BCN Commercial |
$2,461.31
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,984.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Healthscope Commercial |
$3,174.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,079.42
|
| Rate for Payer: Mclaren Commercial |
$2,857.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: Nomi Health Commercial |
$2,603.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,793.70
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.24 |
| Max. Negotiated Rate |
$3,174.66 |
| Rate for Payer: Aetna Commercial |
$2,857.19
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$3,079.42
|
| Rate for Payer: ASR Commercial |
$3,079.42
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,599.73
|
| Rate for Payer: BCN Commercial |
$2,461.31
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,984.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$3,174.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,079.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$2,857.19
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: Nomi Health Commercial |
$2,603.22
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.80
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$146.24
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,793.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,064.42 |
| Rate for Payer: Aetna Commercial |
$3,657.98
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$3,942.49
|
| Rate for Payer: ASR Commercial |
$3,942.49
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,328.35
|
| Rate for Payer: BCN Commercial |
$3,151.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$3,820.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,064.42
|
| Rate for Payer: Healthscope Whirlpool |
$3,942.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,657.98
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: Nomi Health Commercial |
$3,332.82
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,400.50
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,576.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,641.87 |
| Max. Negotiated Rate |
$4,064.42 |
| Rate for Payer: Aetna Commercial |
$3,657.98
|
| Rate for Payer: ASR ASR |
$3,942.49
|
| Rate for Payer: ASR Commercial |
$3,942.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.10
|
| Rate for Payer: BCN Commercial |
$3,151.14
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$3,820.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Healthscope Commercial |
$4,064.42
|
| Rate for Payer: Healthscope Whirlpool |
$3,942.49
|
| Rate for Payer: Mclaren Commercial |
$3,657.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: Nomi Health Commercial |
$3,332.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,576.69
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,661.75 |
| Max. Negotiated Rate |
$4,095.00 |
| Rate for Payer: Aetna Commercial |
$3,685.50
|
| Rate for Payer: ASR ASR |
$3,972.15
|
| Rate for Payer: ASR Commercial |
$3,972.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,337.02
|
| Rate for Payer: BCN Commercial |
$3,174.85
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,849.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$4,095.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,972.15
|
| Rate for Payer: Mclaren Commercial |
$3,685.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: Nomi Health Commercial |
$3,357.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,603.60
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,095.00 |
| Rate for Payer: Aetna Commercial |
$3,685.50
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$3,972.15
|
| Rate for Payer: ASR Commercial |
$3,972.15
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,353.40
|
| Rate for Payer: BCN Commercial |
$3,174.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,849.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,095.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,972.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,685.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: Nomi Health Commercial |
$3,357.90
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,588.04
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,870.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,603.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.49 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$873.62
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$941.57
|
| Rate for Payer: ASR Commercial |
$941.57
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$794.90
|
| Rate for Payer: BCN Commercial |
$752.58
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$970.69
|
| Rate for Payer: Healthscope Whirlpool |
$941.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$873.62
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.11
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$186.49
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$630.95 |
| Max. Negotiated Rate |
$970.69 |
| Rate for Payer: Aetna Commercial |
$873.62
|
| Rate for Payer: ASR ASR |
$941.57
|
| Rate for Payer: ASR Commercial |
$941.57
|
| Rate for Payer: BCBS Trust/PPO |
$791.02
|
| Rate for Payer: BCN Commercial |
$752.58
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$970.69
|
| Rate for Payer: Healthscope Whirlpool |
$941.57
|
| Rate for Payer: Mclaren Commercial |
$873.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.21
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.36
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.09
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$4.87
|
| Rate for Payer: Mclaren Medicare |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Meridian Medicaid |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.45
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$8.64
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Commercial |
$10.00
|
| Rate for Payer: PHP Medicaid |
$4.87
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.63
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: Priority Health Narrow Network |
$10.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Exchange |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UHCCP DNSP |
$9.09
|
| Rate for Payer: UHCCP Medicaid |
$4.87
|
| Rate for Payer: VA VA |
$9.09
|
|
