|
HC ENDO BIOPSY
|
Facility
|
IP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$186.87 |
| Max. Negotiated Rate |
$287.49 |
| Rate for Payer: Aetna Commercial |
$258.74
|
| Rate for Payer: ASR ASR |
$278.87
|
| Rate for Payer: ASR Commercial |
$278.87
|
| Rate for Payer: BCBS Trust/PPO |
$234.28
|
| Rate for Payer: BCN Commercial |
$222.89
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$287.49
|
| Rate for Payer: Healthscope Whirlpool |
$278.87
|
| Rate for Payer: Mclaren Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.99
|
|
|
HC ENDO BIOPSY
|
Facility
|
OP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$287.49 |
| Rate for Payer: Aetna Commercial |
$258.74
|
| Rate for Payer: Aetna Medicare |
$143.74
|
| Rate for Payer: ASR ASR |
$278.87
|
| Rate for Payer: ASR Commercial |
$278.87
|
| Rate for Payer: BCBS Complete |
$115.00
|
| Rate for Payer: BCBS Trust/PPO |
$235.43
|
| Rate for Payer: BCN Commercial |
$222.89
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$287.49
|
| Rate for Payer: Healthscope Whirlpool |
$278.87
|
| Rate for Payer: Mclaren Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.90
|
| Rate for Payer: Priority Health Narrow Network |
$201.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.99
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$551.08
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$1,322.35 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$853.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,066.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,066.41
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Complete |
$480.14
|
| Rate for Payer: BCBS MAPPO |
$853.13
|
| Rate for Payer: BCBS Trust/PPO |
$553.79
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: BCN Medicare Advantage |
$853.13
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$853.13
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$457.28
|
| Rate for Payer: Mclaren Medicare |
$853.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.79
|
| Rate for Payer: Meridian Medicaid |
$480.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$981.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Medicare |
$810.47
|
| Rate for Payer: PACE SWMI |
$853.13
|
| Rate for Payer: PHP Commercial |
$938.44
|
| Rate for Payer: PHP Medicaid |
$457.28
|
| Rate for Payer: PHP Medicare Advantage |
$853.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.54
|
| Rate for Payer: Priority Health Medicare |
$853.13
|
| Rate for Payer: Priority Health Narrow Network |
$474.06
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.13
|
| Rate for Payer: UHC Exchange |
$1,322.35
|
| Rate for Payer: UHC Medicare Advantage |
$853.13
|
| Rate for Payer: UHCCP DNSP |
$853.13
|
| Rate for Payer: UHCCP Medicaid |
$457.28
|
| Rate for Payer: VA VA |
$853.13
|
|
|
HC ENDO CLIPPING
|
Facility
|
IP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.17 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: ASR Commercial |
$313.64
|
| Rate for Payer: BCBS Trust/PPO |
$263.49
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
|
HC ENDO CLIPPING
|
Facility
|
OP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$129.34 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: Aetna Medicare |
$161.67
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: ASR Commercial |
$313.64
|
| Rate for Payer: BCBS Complete |
$129.34
|
| Rate for Payer: BCBS Trust/PPO |
$264.78
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.31
|
| Rate for Payer: Priority Health Narrow Network |
$226.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
OP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$722.18 |
| Max. Negotiated Rate |
$1,805.46 |
| Rate for Payer: Aetna Commercial |
$1,624.91
|
| Rate for Payer: Aetna Medicare |
$902.73
|
| Rate for Payer: ASR ASR |
$1,751.30
|
| Rate for Payer: ASR Commercial |
$1,751.30
|
| Rate for Payer: BCBS Complete |
$722.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.49
|
| Rate for Payer: BCN Commercial |
$1,399.77
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,697.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,805.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,751.30
|
| Rate for Payer: Mclaren Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,581.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.80
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
IP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,173.55 |
| Max. Negotiated Rate |
$1,805.46 |
| Rate for Payer: Aetna Commercial |
$1,624.91
|
| Rate for Payer: ASR ASR |
$1,751.30
|
| Rate for Payer: ASR Commercial |
$1,751.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.27
|
| Rate for Payer: BCN Commercial |
$1,399.77
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,697.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,805.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,751.30
|
| Rate for Payer: Mclaren Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.80
|
|
|
HC ENDO DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$864.75 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.13
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
|
HC ENDO DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.16 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: Aetna Medicare |
$665.20
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.46
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.69
|
| Rate for Payer: Priority Health Narrow Network |
$932.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
OP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$429.81 |
| Max. Negotiated Rate |
$1,074.53 |
| Rate for Payer: Aetna Commercial |
$967.08
|
| Rate for Payer: Aetna Medicare |
$537.26
|
| Rate for Payer: ASR ASR |
$1,042.29
|
| Rate for Payer: ASR Commercial |
$1,042.29
|
| Rate for Payer: BCBS Complete |
$429.81
|
| Rate for Payer: BCBS Trust/PPO |
$879.93
|
| Rate for Payer: BCN Commercial |
$833.08
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$1,010.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Healthscope Commercial |
$1,074.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,042.29
|
| Rate for Payer: Mclaren Commercial |
$967.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: Nomi Health Commercial |
$881.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$941.50
|
| Rate for Payer: Priority Health Narrow Network |
$753.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$945.59
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
IP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$698.44 |
| Max. Negotiated Rate |
$1,074.53 |
| Rate for Payer: Aetna Commercial |
$967.08
|
| Rate for Payer: ASR ASR |
$1,042.29
|
| Rate for Payer: ASR Commercial |
$1,042.29
|
| Rate for Payer: BCBS Trust/PPO |
$875.63
|
| Rate for Payer: BCN Commercial |
$833.08
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$1,010.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Healthscope Commercial |
$1,074.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,042.29
|
| Rate for Payer: Mclaren Commercial |
$967.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: Nomi Health Commercial |
$881.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$945.59
|
|
|
HC ENDOFORM 2X2
|
Facility
|
OP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: Aetna Medicare |
$19.51
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Complete |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.19
|
| Rate for Payer: Priority Health Narrow Network |
$27.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
|
|
HC ENDOFORM 2X2
|
Facility
|
IP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Trust/PPO |
$31.80
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
|
|
HC ENDOFORM 4X4
|
Facility
|
IP
|
$135.72
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.22 |
| Max. Negotiated Rate |
$135.72 |
| Rate for Payer: Aetna Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$131.65
|
| Rate for Payer: ASR Commercial |
$131.65
|
| Rate for Payer: BCBS Trust/PPO |
$110.60
|
| Rate for Payer: BCN Commercial |
$105.22
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$127.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$135.72
|
| Rate for Payer: Healthscope Whirlpool |
$131.65
|
| Rate for Payer: Mclaren Commercial |
$122.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.36
|
| Rate for Payer: Nomi Health Commercial |
$111.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.43
|
|
|
HC ENDOFORM 4X4
|
Facility
|
OP
|
$135.72
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.29 |
| Max. Negotiated Rate |
$135.72 |
| Rate for Payer: Aetna Commercial |
$122.15
|
| Rate for Payer: Aetna Medicare |
$67.86
|
| Rate for Payer: ASR ASR |
$131.65
|
| Rate for Payer: ASR Commercial |
$131.65
|
| Rate for Payer: BCBS Complete |
$54.29
|
| Rate for Payer: BCBS Trust/PPO |
$111.14
|
| Rate for Payer: BCN Commercial |
$105.22
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$127.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$135.72
|
| Rate for Payer: Healthscope Whirlpool |
$131.65
|
| Rate for Payer: Mclaren Commercial |
$122.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.36
|
| Rate for Payer: Nomi Health Commercial |
$111.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.92
|
| Rate for Payer: Priority Health Narrow Network |
$95.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.43
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
OP
|
$125.46
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$50.18 |
| Max. Negotiated Rate |
$125.46 |
| Rate for Payer: Aetna Commercial |
$112.91
|
| Rate for Payer: Aetna Medicare |
$62.73
|
| Rate for Payer: ASR ASR |
$121.70
|
| Rate for Payer: ASR Commercial |
$121.70
|
| Rate for Payer: BCBS Complete |
$50.18
|
| Rate for Payer: BCBS Trust/PPO |
$102.74
|
| Rate for Payer: BCN Commercial |
$97.27
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$117.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Healthscope Commercial |
$125.46
|
| Rate for Payer: Healthscope Whirlpool |
$121.70
|
| Rate for Payer: Mclaren Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: Nomi Health Commercial |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.93
|
| Rate for Payer: Priority Health Narrow Network |
$87.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.40
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
IP
|
$125.46
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$81.55 |
| Max. Negotiated Rate |
$125.46 |
| Rate for Payer: Aetna Commercial |
$112.91
|
| Rate for Payer: ASR ASR |
$121.70
|
| Rate for Payer: ASR Commercial |
$121.70
|
| Rate for Payer: BCBS Trust/PPO |
$102.24
|
| Rate for Payer: BCN Commercial |
$97.27
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$117.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Healthscope Commercial |
$125.46
|
| Rate for Payer: Healthscope Whirlpool |
$121.70
|
| Rate for Payer: Mclaren Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: Nomi Health Commercial |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.40
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$430.57 |
| Max. Negotiated Rate |
$662.41 |
| Rate for Payer: Aetna Commercial |
$596.17
|
| Rate for Payer: ASR ASR |
$642.54
|
| Rate for Payer: ASR Commercial |
$642.54
|
| Rate for Payer: BCBS Trust/PPO |
$539.80
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$662.41
|
| Rate for Payer: Healthscope Whirlpool |
$642.54
|
| Rate for Payer: Mclaren Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.92
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.96 |
| Max. Negotiated Rate |
$662.41 |
| Rate for Payer: Aetna Commercial |
$596.17
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: ASR ASR |
$642.54
|
| Rate for Payer: ASR Commercial |
$642.54
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: BCBS Trust/PPO |
$542.45
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$662.41
|
| Rate for Payer: Healthscope Whirlpool |
$642.54
|
| Rate for Payer: Mclaren Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.40
|
| Rate for Payer: Priority Health Narrow Network |
$464.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.92
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
OP
|
$5,097.96
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,039.18 |
| Max. Negotiated Rate |
$5,097.96 |
| Rate for Payer: Aetna Commercial |
$4,588.16
|
| Rate for Payer: Aetna Medicare |
$2,548.98
|
| Rate for Payer: ASR ASR |
$4,945.02
|
| Rate for Payer: ASR Commercial |
$4,945.02
|
| Rate for Payer: BCBS Complete |
$2,039.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,174.72
|
| Rate for Payer: BCN Commercial |
$3,952.45
|
| Rate for Payer: Cash Price |
$4,078.37
|
| Rate for Payer: Cofinity Commercial |
$4,792.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,078.37
|
| Rate for Payer: Healthscope Commercial |
$5,097.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,945.02
|
| Rate for Payer: Mclaren Commercial |
$4,588.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,333.27
|
| Rate for Payer: Nomi Health Commercial |
$4,180.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,313.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,466.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,573.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,486.20
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
IP
|
$5,097.96
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,313.67 |
| Max. Negotiated Rate |
$5,097.96 |
| Rate for Payer: Aetna Commercial |
$4,588.16
|
| Rate for Payer: ASR ASR |
$4,945.02
|
| Rate for Payer: ASR Commercial |
$4,945.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.33
|
| Rate for Payer: BCN Commercial |
$3,952.45
|
| Rate for Payer: Cash Price |
$4,078.37
|
| Rate for Payer: Cofinity Commercial |
$4,792.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,078.37
|
| Rate for Payer: Healthscope Commercial |
$5,097.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,945.02
|
| Rate for Payer: Mclaren Commercial |
$4,588.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,333.27
|
| Rate for Payer: Nomi Health Commercial |
$4,180.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,313.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,486.20
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,592.43 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: Aetna Medicare |
$4,836.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,045.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,045.79
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Complete |
$2,722.06
|
| Rate for Payer: BCBS MAPPO |
$4,836.63
|
| Rate for Payer: BCBS Trust/PPO |
$10,935.21
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: BCN Medicare Advantage |
$4,836.63
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,836.63
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,836.63
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$2,592.43
|
| Rate for Payer: Mclaren Medicare |
$4,836.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,078.46
|
| Rate for Payer: Meridian Medicaid |
$2,722.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,562.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PACE Medicare |
$4,594.80
|
| Rate for Payer: PACE SWMI |
$4,836.63
|
| Rate for Payer: PHP Commercial |
$5,320.29
|
| Rate for Payer: PHP Medicaid |
$2,592.43
|
| Rate for Payer: PHP Medicare Advantage |
$4,836.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,592.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,700.36
|
| Rate for Payer: Priority Health Medicare |
$4,836.63
|
| Rate for Payer: Priority Health Narrow Network |
$9,360.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,836.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,836.63
|
| Rate for Payer: UHC Exchange |
$7,496.78
|
| Rate for Payer: UHC Medicare Advantage |
$4,836.63
|
| Rate for Payer: UHCCP DNSP |
$4,836.63
|
| Rate for Payer: UHCCP Medicaid |
$2,592.43
|
| Rate for Payer: VA VA |
$4,836.63
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,881.79
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
OP
|
$723.08
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$289.23 |
| Max. Negotiated Rate |
$723.08 |
| Rate for Payer: Aetna Commercial |
$650.77
|
| Rate for Payer: Aetna Medicare |
$361.54
|
| Rate for Payer: ASR ASR |
$701.39
|
| Rate for Payer: ASR Commercial |
$701.39
|
| Rate for Payer: BCBS Complete |
$289.23
|
| Rate for Payer: BCBS Trust/PPO |
$592.13
|
| Rate for Payer: BCN Commercial |
$560.60
|
| Rate for Payer: Cash Price |
$578.46
|
| Rate for Payer: Cofinity Commercial |
$679.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.46
|
| Rate for Payer: Healthscope Commercial |
$723.08
|
| Rate for Payer: Healthscope Whirlpool |
$701.39
|
| Rate for Payer: Mclaren Commercial |
$650.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.62
|
| Rate for Payer: Nomi Health Commercial |
$592.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.56
|
| Rate for Payer: Priority Health Narrow Network |
$506.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.31
|
|
