|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,355.89 |
| Max. Negotiated Rate |
$1,936.98 |
| Rate for Payer: Aetna Commercial |
$1,743.28
|
| Rate for Payer: ASR ASR |
$1,878.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.74
|
| Rate for Payer: BCN Commercial |
$1,501.74
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,820.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Healthscope Commercial |
$1,936.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,878.87
|
| Rate for Payer: Mclaren Commercial |
$1,743.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.54
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,355.89 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$1,743.28
|
| 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 |
$1,878.87
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.74
|
| Rate for Payer: BCN Commercial |
$1,501.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,820.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$1,936.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,878.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$1,743.28
|
| 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 |
$1,646.43
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,762.65
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.54
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,283.01
|
| 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 |
$2,460.58
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.69
|
| Rate for Payer: BCN Commercial |
$1,966.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$2,384.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,536.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,460.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,283.01
|
| 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 |
$2,156.18
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,308.38
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,801.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,775.68 |
| Max. Negotiated Rate |
$2,536.68 |
| Rate for Payer: Aetna Commercial |
$2,283.01
|
| Rate for Payer: ASR ASR |
$2,460.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.69
|
| Rate for Payer: BCN Commercial |
$1,966.69
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$2,384.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Healthscope Commercial |
$2,536.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,460.58
|
| Rate for Payer: Mclaren Commercial |
$2,283.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,156.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.28
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,299.25 |
| Rate for Payer: Aetna Commercial |
$1,169.32
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,260.27
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.31
|
| Rate for Payer: BCN Commercial |
$1,007.31
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,221.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,299.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$1,169.32
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.73
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$534.98
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.34
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$909.48 |
| Max. Negotiated Rate |
$1,299.25 |
| Rate for Payer: Aetna Commercial |
$1,169.32
|
| Rate for Payer: ASR ASR |
$1,260.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.31
|
| Rate for Payer: BCN Commercial |
$1,007.31
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,221.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Healthscope Commercial |
$1,299.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.27
|
| Rate for Payer: Mclaren Commercial |
$1,169.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.34
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$959.13 |
| Rate for Payer: Aetna Commercial |
$863.22
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$930.36
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$743.61
|
| Rate for Payer: BCN Commercial |
$743.61
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$901.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$959.13
|
| Rate for Payer: Healthscope Whirlpool |
$930.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$863.22
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.73
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$534.98
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.03
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$671.39 |
| Max. Negotiated Rate |
$959.13 |
| Rate for Payer: Aetna Commercial |
$863.22
|
| Rate for Payer: ASR ASR |
$930.36
|
| Rate for Payer: BCBS Trust/PPO |
$743.61
|
| Rate for Payer: BCN Commercial |
$743.61
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$901.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Healthscope Commercial |
$959.13
|
| Rate for Payer: Healthscope Whirlpool |
$930.36
|
| Rate for Payer: Mclaren Commercial |
$863.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.03
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,671.93
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,879.75
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,301.72
|
| Rate for Payer: BCN Commercial |
$2,301.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,790.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,968.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,879.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,671.93
|
| 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 |
$2,523.49
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,701.62
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,107.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,612.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,078.17 |
| Max. Negotiated Rate |
$2,968.81 |
| Rate for Payer: Aetna Commercial |
$2,671.93
|
| Rate for Payer: ASR ASR |
$2,879.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,301.72
|
| Rate for Payer: BCN Commercial |
$2,301.72
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,790.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Healthscope Commercial |
$2,968.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,879.75
|
| Rate for Payer: Mclaren Commercial |
$2,671.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,523.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,612.55
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,274.12
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$891.88 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$1,146.71
|
| 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 |
$1,235.90
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$987.83
|
| Rate for Payer: BCN Commercial |
$987.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cofinity Commercial |
$1,197.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,019.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$1,274.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,235.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$1,146.71
|
| 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 |
$1,083.00
|
| 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 |
$891.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.45
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$904.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.23
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,274.12
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$891.88 |
| Max. Negotiated Rate |
$1,274.12 |
| Rate for Payer: Aetna Commercial |
$1,146.71
|
| Rate for Payer: ASR ASR |
$1,235.90
|
| Rate for Payer: BCBS Trust/PPO |
$987.83
|
| Rate for Payer: BCN Commercial |
$987.83
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cofinity Commercial |
$1,197.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,019.30
|
| Rate for Payer: Healthscope Commercial |
$1,274.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,235.90
|
| Rate for Payer: Mclaren Commercial |
$1,146.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.23
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.29 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.07 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.34
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Complete |
$221.64
|
| Rate for Payer: BCBS MAPPO |
$385.87
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: BCN Medicare Advantage |
$385.87
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.87
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$385.87
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Mclaren Medicaid |
$211.07
|
| Rate for Payer: Mclaren Medicare |
$385.87
|
| Rate for Payer: Meridian Medicaid |
$221.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Medicare |
$366.58
|
| Rate for Payer: PACE SWMI |
$385.87
|
| Rate for Payer: PHP Commercial |
$424.46
|
| Rate for Payer: PHP Medicaid |
$211.07
|
| Rate for Payer: PHP Medicare Advantage |
$385.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.37
|
| Rate for Payer: Priority Health Medicare |
$385.87
|
| Rate for Payer: Priority Health Narrow Network |
$406.01
|
| Rate for Payer: Railroad Medicare Medicare |
$385.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
| Rate for Payer: UHC Medicare Advantage |
$397.45
|
| Rate for Payer: VA VA |
$385.87
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,602.41
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,521.69 |
| Max. Negotiated Rate |
$3,602.41 |
| Rate for Payer: Aetna Commercial |
$3,242.17
|
| Rate for Payer: ASR ASR |
$3,494.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.95
|
| Rate for Payer: BCN Commercial |
$2,792.95
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cofinity Commercial |
$3,386.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,881.93
|
| Rate for Payer: Healthscope Commercial |
$3,602.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,494.34
|
| Rate for Payer: Mclaren Commercial |
$3,242.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,062.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,170.12
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,602.41
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,521.69 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$3,242.17
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$3,494.34
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.95
|
| Rate for Payer: BCN Commercial |
$2,792.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cofinity Commercial |
$3,386.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,881.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$3,602.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,494.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$3,242.17
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,062.05
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,278.19
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,557.71
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,170.12
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$900.70
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$630.49 |
| Max. Negotiated Rate |
$900.70 |
| Rate for Payer: Aetna Commercial |
$810.63
|
| Rate for Payer: ASR ASR |
$873.68
|
| Rate for Payer: BCBS Trust/PPO |
$698.31
|
| Rate for Payer: BCN Commercial |
$698.31
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$846.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Healthscope Commercial |
$900.70
|
| Rate for Payer: Healthscope Whirlpool |
$873.68
|
| Rate for Payer: Mclaren Commercial |
$810.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.62
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$900.70
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$389.31 |
| Max. Negotiated Rate |
$1,024.13 |
| Rate for Payer: Aetna Commercial |
$810.63
|
| Rate for Payer: Aetna Medicare |
$711.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: ASR ASR |
$873.68
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$698.31
|
| Rate for Payer: BCN Commercial |
$698.31
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$846.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$900.70
|
| Rate for Payer: Healthscope Whirlpool |
$873.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$711.71
|
| Rate for Payer: Mclaren Commercial |
$810.63
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$782.88
|
| Rate for Payer: PHP Medicaid |
$389.31
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,024.13
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$819.30
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.62
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: VA VA |
$711.71
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$993.28
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$389.31 |
| Max. Negotiated Rate |
$1,024.13 |
| Rate for Payer: Aetna Commercial |
$893.95
|
| Rate for Payer: Aetna Medicare |
$711.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: ASR ASR |
$963.48
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$770.09
|
| Rate for Payer: BCN Commercial |
$770.09
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cofinity Commercial |
$933.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$993.28
|
| Rate for Payer: Healthscope Whirlpool |
$963.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$711.71
|
| Rate for Payer: Mclaren Commercial |
$893.95
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$844.29
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$782.88
|
| Rate for Payer: PHP Medicaid |
$389.31
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,024.13
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$819.30
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$874.09
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: VA VA |
$711.71
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$993.28
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$695.30 |
| Max. Negotiated Rate |
$993.28 |
| Rate for Payer: Aetna Commercial |
$893.95
|
| Rate for Payer: ASR ASR |
$963.48
|
| Rate for Payer: BCBS Trust/PPO |
$770.09
|
| Rate for Payer: BCN Commercial |
$770.09
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cofinity Commercial |
$933.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.62
|
| Rate for Payer: Healthscope Commercial |
$993.28
|
| Rate for Payer: Healthscope Whirlpool |
$963.48
|
| Rate for Payer: Mclaren Commercial |
$893.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$844.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$874.09
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,334.17
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$389.31 |
| Max. Negotiated Rate |
$1,334.17 |
| Rate for Payer: Aetna Commercial |
$1,200.75
|
| Rate for Payer: Aetna Medicare |
$711.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: ASR ASR |
$1,294.14
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.38
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cofinity Commercial |
$1,254.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$1,334.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$711.71
|
| Rate for Payer: Mclaren Commercial |
$1,200.75
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.04
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$782.88
|
| Rate for Payer: PHP Medicaid |
$389.31
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,024.13
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$819.30
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.07
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: VA VA |
$711.71
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,334.17
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$933.92 |
| Max. Negotiated Rate |
$1,334.17 |
| Rate for Payer: Aetna Commercial |
$1,200.75
|
| Rate for Payer: ASR ASR |
$1,294.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.38
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cofinity Commercial |
$1,254.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.34
|
| Rate for Payer: Healthscope Commercial |
$1,334.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.14
|
| Rate for Payer: Mclaren Commercial |
$1,200.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.07
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$45.03
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$48.74 |
| Rate for Payer: Aetna Commercial |
$40.53
|
| Rate for Payer: Aetna Medicare |
$8.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.92
|
| Rate for Payer: ASR ASR |
$43.68
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$45.03
|
| Rate for Payer: Healthscope Whirlpool |
$43.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.74
|
| Rate for Payer: Mclaren Commercial |
$40.53
|
| Rate for Payer: Mclaren Medicaid |
$4.78
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Medicaid |
$5.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Medicaid |
$4.78
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health Narrow Network |
$38.99
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.00
|
| Rate for Payer: VA VA |
$8.74
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.03
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$45.03 |
| Rate for Payer: Aetna Commercial |
$40.53
|
| Rate for Payer: ASR ASR |
$43.68
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Healthscope Commercial |
$45.03
|
| Rate for Payer: Healthscope Whirlpool |
$43.68
|
| Rate for Payer: Mclaren Commercial |
$40.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.63
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$48.74 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$38.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: VA VA |
$6.47
|
|
