|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$152.44 |
| Max. Negotiated Rate |
$381.09 |
| Rate for Payer: Aetna Commercial |
$342.98
|
| Rate for Payer: ASR ASR |
$369.66
|
| Rate for Payer: BCBS Complete |
$152.44
|
| Rate for Payer: BCBS Trust/PPO |
$295.46
|
| Rate for Payer: BCN Commercial |
$295.46
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$358.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$381.09
|
| Rate for Payer: Healthscope Whirlpool |
$369.66
|
| Rate for Payer: Mclaren Commercial |
$342.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.79
|
| Rate for Payer: Priority Health Narrow Network |
$270.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.36
|
|
|
HC IR GUIDEWIRE
|
Facility
|
OP
|
$43.86
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Complete |
$17.54
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.91
|
| Rate for Payer: Priority Health Narrow Network |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC IR GUIDEWIRE
|
Facility
|
IP
|
$43.86
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.70 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
IP
|
$476.47
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$333.53 |
| Max. Negotiated Rate |
$476.47 |
| Rate for Payer: Aetna Commercial |
$428.82
|
| Rate for Payer: ASR ASR |
$462.18
|
| Rate for Payer: BCBS Trust/PPO |
$369.41
|
| Rate for Payer: BCN Commercial |
$369.41
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$447.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Healthscope Commercial |
$476.47
|
| Rate for Payer: Healthscope Whirlpool |
$462.18
|
| Rate for Payer: Mclaren Commercial |
$428.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$419.29
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
OP
|
$476.47
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$476.47 |
| Rate for Payer: Aetna Commercial |
$428.82
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$462.18
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$369.41
|
| Rate for Payer: BCN Commercial |
$369.41
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$447.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$476.47
|
| Rate for Payer: Healthscope Whirlpool |
$462.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$428.82
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$361.21
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$288.97
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$419.29
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
IP
|
$809.50
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$566.65 |
| Max. Negotiated Rate |
$809.50 |
| Rate for Payer: Aetna Commercial |
$728.55
|
| Rate for Payer: ASR ASR |
$785.22
|
| Rate for Payer: BCBS Trust/PPO |
$627.61
|
| Rate for Payer: BCN Commercial |
$627.61
|
| Rate for Payer: Cash Price |
$647.60
|
| Rate for Payer: Cofinity Commercial |
$760.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.60
|
| Rate for Payer: Healthscope Commercial |
$809.50
|
| Rate for Payer: Healthscope Whirlpool |
$785.22
|
| Rate for Payer: Mclaren Commercial |
$728.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$688.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$712.36
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
OP
|
$809.50
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.23 |
| Max. Negotiated Rate |
$809.50 |
| Rate for Payer: Aetna Commercial |
$728.55
|
| Rate for Payer: Aetna Medicare |
$490.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: ASR ASR |
$785.22
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$627.61
|
| Rate for Payer: BCN Commercial |
$627.61
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$647.60
|
| Rate for Payer: Cash Price |
$647.60
|
| Rate for Payer: Cofinity Commercial |
$760.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$809.50
|
| Rate for Payer: Healthscope Whirlpool |
$785.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$490.37
|
| Rate for Payer: Mclaren Commercial |
$728.55
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$688.08
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$539.41
|
| Rate for Payer: PHP Medicaid |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$736.64
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$574.74
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$712.36
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: VA VA |
$490.37
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
IP
|
$1,919.61
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,343.73 |
| Max. Negotiated Rate |
$1,919.61 |
| Rate for Payer: Aetna Commercial |
$1,727.65
|
| Rate for Payer: ASR ASR |
$1,862.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.27
|
| Rate for Payer: BCN Commercial |
$1,488.27
|
| Rate for Payer: Cash Price |
$1,535.69
|
| Rate for Payer: Cofinity Commercial |
$1,804.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,535.69
|
| Rate for Payer: Healthscope Commercial |
$1,919.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,862.02
|
| Rate for Payer: Mclaren Commercial |
$1,727.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,631.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,343.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,689.26
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
OP
|
$1,919.61
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,263.10 |
| Rate for Payer: Aetna Commercial |
$1,727.65
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$1,862.02
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.27
|
| Rate for Payer: BCN Commercial |
$1,488.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$1,535.69
|
| Rate for Payer: Cash Price |
$1,535.69
|
| Rate for Payer: Cofinity Commercial |
$1,804.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,535.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$1,919.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,862.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$1,727.65
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,631.67
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,343.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,746.85
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,362.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,689.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
IP
|
$4,219.50
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,953.65 |
| Max. Negotiated Rate |
$4,219.50 |
| Rate for Payer: Aetna Commercial |
$3,797.55
|
| Rate for Payer: ASR ASR |
$4,092.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,271.38
|
| Rate for Payer: BCN Commercial |
$3,271.38
|
| Rate for Payer: Cash Price |
$3,375.60
|
| Rate for Payer: Cofinity Commercial |
$3,966.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,375.60
|
| Rate for Payer: Healthscope Commercial |
$4,219.50
|
| Rate for Payer: Healthscope Whirlpool |
$4,092.92
|
| Rate for Payer: Mclaren Commercial |
$3,797.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,586.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,713.16
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,219.50
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,219.50 |
| Rate for Payer: Aetna Commercial |
$3,797.55
|
| 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 |
$4,092.92
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,271.38
|
| Rate for Payer: BCN Commercial |
$3,271.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,375.60
|
| Rate for Payer: Cash Price |
$3,375.60
|
| Rate for Payer: Cofinity Commercial |
$3,966.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,375.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,219.50
|
| Rate for Payer: Healthscope Whirlpool |
$4,092.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,797.55
|
| 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 |
$3,586.58
|
| 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 |
$2,953.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,839.74
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,995.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,713.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
IP
|
$3,402.31
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,381.62 |
| Max. Negotiated Rate |
$3,402.31 |
| Rate for Payer: Aetna Commercial |
$3,062.08
|
| Rate for Payer: ASR ASR |
$3,300.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,637.81
|
| Rate for Payer: BCN Commercial |
$2,637.81
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$3,198.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Healthscope Commercial |
$3,402.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,300.24
|
| Rate for Payer: Mclaren Commercial |
$3,062.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,994.03
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,402.31
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$3,062.08
|
| 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 |
$3,300.24
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,637.81
|
| Rate for Payer: BCN Commercial |
$2,637.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$3,198.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,402.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,300.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,062.08
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| 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 |
$2,381.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,096.10
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,415.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,994.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
OP
|
$1,243.18
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,243.18 |
| Rate for Payer: Aetna Commercial |
$1,118.86
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.88
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.84
|
| Rate for Payer: BCN Commercial |
$963.84
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cofinity Commercial |
$1,168.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.86
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.70
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.29
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.66
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,094.00
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
IP
|
$1,243.18
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$870.23 |
| Max. Negotiated Rate |
$1,243.18 |
| Rate for Payer: Aetna Commercial |
$1,118.86
|
| Rate for Payer: ASR ASR |
$1,205.88
|
| Rate for Payer: BCBS Trust/PPO |
$963.84
|
| Rate for Payer: BCN Commercial |
$963.84
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cofinity Commercial |
$1,168.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.54
|
| Rate for Payer: Healthscope Commercial |
$1,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.88
|
| Rate for Payer: Mclaren Commercial |
$1,118.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,094.00
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
IP
|
$1,618.52
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,132.96 |
| Max. Negotiated Rate |
$1,618.52 |
| Rate for Payer: Aetna Commercial |
$1,456.67
|
| Rate for Payer: ASR ASR |
$1,569.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.84
|
| Rate for Payer: BCN Commercial |
$1,254.84
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cofinity Commercial |
$1,521.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.82
|
| Rate for Payer: Healthscope Commercial |
$1,618.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,569.96
|
| Rate for Payer: Mclaren Commercial |
$1,456.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,375.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,424.30
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
OP
|
$1,618.52
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,618.52 |
| Rate for Payer: Aetna Commercial |
$1,456.67
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,569.96
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.84
|
| Rate for Payer: BCN Commercial |
$1,254.84
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cofinity Commercial |
$1,521.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,618.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,569.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,456.67
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,375.74
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,472.85
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.15
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,424.30
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,750.87
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,682.15 |
| Max. Negotiated Rate |
$4,750.87 |
| Rate for Payer: Aetna Commercial |
$4,275.78
|
| 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 |
$4,608.34
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,683.35
|
| Rate for Payer: BCN Commercial |
$3,683.35
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cofinity Commercial |
$4,465.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,800.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$4,750.87
|
| Rate for Payer: Healthscope Whirlpool |
$4,608.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$4,275.78
|
| 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 |
$4,038.24
|
| 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 |
$3,325.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,323.29
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$3,373.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,180.77
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,750.87
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,325.61 |
| Max. Negotiated Rate |
$4,750.87 |
| Rate for Payer: Aetna Commercial |
$4,275.78
|
| Rate for Payer: ASR ASR |
$4,608.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,683.35
|
| Rate for Payer: BCN Commercial |
$3,683.35
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cofinity Commercial |
$4,465.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,800.70
|
| Rate for Payer: Healthscope Commercial |
$4,750.87
|
| Rate for Payer: Healthscope Whirlpool |
$4,608.34
|
| Rate for Payer: Mclaren Commercial |
$4,275.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,038.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,325.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,180.77
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,765.57
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,335.90 |
| Max. Negotiated Rate |
$4,765.57 |
| Rate for Payer: Aetna Commercial |
$4,289.01
|
| Rate for Payer: ASR ASR |
$4,622.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,694.75
|
| Rate for Payer: BCN Commercial |
$3,694.75
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cofinity Commercial |
$4,479.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,812.46
|
| Rate for Payer: Healthscope Commercial |
$4,765.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,622.60
|
| Rate for Payer: Mclaren Commercial |
$4,289.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,050.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,335.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,193.70
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,765.57
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,765.57 |
| Rate for Payer: Aetna Commercial |
$4,289.01
|
| 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 |
$4,622.60
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,694.75
|
| Rate for Payer: BCN Commercial |
$3,694.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cofinity Commercial |
$4,479.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,812.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,765.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,622.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$4,289.01
|
| 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 |
$4,050.73
|
| 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 |
$3,335.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,336.67
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,383.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,193.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,484.14
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,484.14 |
| Rate for Payer: Aetna Commercial |
$4,035.73
|
| 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 |
$4,349.62
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.55
|
| Rate for Payer: BCN Commercial |
$3,476.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cofinity Commercial |
$4,215.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,587.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,484.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,349.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$4,035.73
|
| 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 |
$3,811.52
|
| 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 |
$3,138.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,080.57
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,183.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,484.14
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,138.90 |
| Max. Negotiated Rate |
$4,484.14 |
| Rate for Payer: Aetna Commercial |
$4,035.73
|
| Rate for Payer: ASR ASR |
$4,349.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.55
|
| Rate for Payer: BCN Commercial |
$3,476.55
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cofinity Commercial |
$4,215.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,587.31
|
| Rate for Payer: Healthscope Commercial |
$4,484.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,349.62
|
| Rate for Payer: Mclaren Commercial |
$4,035.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,811.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,138.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.04
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,770.51
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,671.93 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$4,293.46
|
| 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 |
$4,627.39
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,698.58
|
| Rate for Payer: BCN Commercial |
$3,698.58
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cofinity Commercial |
$4,484.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,816.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$4,770.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,627.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$4,293.46
|
| 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 |
$4,054.93
|
| 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 |
$3,339.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,341.16
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,387.06
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,198.05
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,770.51
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,339.36 |
| Max. Negotiated Rate |
$4,770.51 |
| Rate for Payer: Aetna Commercial |
$4,293.46
|
| Rate for Payer: ASR ASR |
$4,627.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,698.58
|
| Rate for Payer: BCN Commercial |
$3,698.58
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cofinity Commercial |
$4,484.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,816.41
|
| Rate for Payer: Healthscope Commercial |
$4,770.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,627.39
|
| Rate for Payer: Mclaren Commercial |
$4,293.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,054.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,339.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,198.05
|
|
