|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
OP
|
$510.33
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$188.82 |
| Max. Negotiated Rate |
$510.33 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: Aetna Medicare |
$188.82
|
| Rate for Payer: ASR ASR |
$495.02
|
| Rate for Payer: BCBS Complete |
$204.13
|
| Rate for Payer: BCBS Trust/PPO |
$420.77
|
| Rate for Payer: BCN Commercial |
$420.77
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$479.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$495.02
|
| Rate for Payer: Healthscope Whirlpool |
$510.33
|
| Rate for Payer: Mclaren Commercial |
$459.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$447.15
|
| Rate for Payer: Priority Health Narrow Network |
$357.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.09
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
OP
|
$66.86
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$60.17
|
| Rate for Payer: Aetna Medicare |
$18.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.23
|
| Rate for Payer: ASR ASR |
$64.85
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS MAPPO |
$18.58
|
| Rate for Payer: BCBS Trust/PPO |
$55.13
|
| Rate for Payer: BCN Commercial |
$55.13
|
| Rate for Payer: BCN Medicare Advantage |
$18.58
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$62.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$64.85
|
| Rate for Payer: Healthscope Whirlpool |
$66.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.58
|
| Rate for Payer: Mclaren Commercial |
$60.17
|
| Rate for Payer: Mclaren Medicaid |
$18.58
|
| Rate for Payer: Mclaren Medicare |
$18.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.51
|
| Rate for Payer: Meridian Medicaid |
$10.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Nomi Health Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: PACE Medicare |
$17.65
|
| Rate for Payer: PACE SWMI |
$18.58
|
| Rate for Payer: PHP Commercial |
$20.44
|
| Rate for Payer: PHP Medicaid |
$9.96
|
| Rate for Payer: PHP Medicare Advantage |
$18.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$18.58
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.58
|
| Rate for Payer: UHC Exchange |
$28.80
|
| Rate for Payer: UHC Medicaid |
$9.72
|
| Rate for Payer: UHCCP DNSP |
$18.58
|
| Rate for Payer: UHCCP Medicaid |
$9.72
|
| Rate for Payer: VA VA |
$18.58
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
IP
|
$66.86
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.15 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$60.17
|
| Rate for Payer: ASR ASR |
$64.85
|
| Rate for Payer: BCBS Trust/PPO |
$54.91
|
| Rate for Payer: BCN Commercial |
$54.91
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$62.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Healthscope Commercial |
$64.85
|
| Rate for Payer: Healthscope Whirlpool |
$66.86
|
| Rate for Payer: Mclaren Commercial |
$60.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Nomi Health Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.84
|
|
|
HC FOLLOWUP EVAL OF FOOT PT LOP
|
Facility
|
IP
|
$398.00
|
|
|
Service Code
|
HCPCS G0246
|
| Hospital Charge Code |
51000134
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$298.50 |
| Max. Negotiated Rate |
$398.00 |
| Rate for Payer: Aetna Commercial |
$358.20
|
| Rate for Payer: ASR ASR |
$386.06
|
| Rate for Payer: BCBS Trust/PPO |
$326.84
|
| Rate for Payer: BCN Commercial |
$326.84
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$374.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.40
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Healthscope Whirlpool |
$398.00
|
| Rate for Payer: Mclaren Commercial |
$358.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.30
|
| Rate for Payer: Nomi Health Commercial |
$326.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.24
|
|
|
HC FOLLOWUP EVAL OF FOOT PT LOP
|
Facility
|
OP
|
$398.00
|
|
|
Service Code
|
HCPCS G0246
|
| Hospital Charge Code |
51000134
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$398.00 |
| Rate for Payer: Aetna Commercial |
$358.20
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.82
|
| Rate for Payer: ASR ASR |
$386.06
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$132.66
|
| Rate for Payer: BCBS Trust/PPO |
$328.15
|
| Rate for Payer: BCN Commercial |
$328.15
|
| Rate for Payer: BCN Medicare Advantage |
$132.66
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$374.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.66
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Healthscope Whirlpool |
$398.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.66
|
| Rate for Payer: Mclaren Commercial |
$358.20
|
| Rate for Payer: Mclaren Medicaid |
$132.66
|
| Rate for Payer: Mclaren Medicare |
$132.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.29
|
| Rate for Payer: Meridian Medicaid |
$72.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.30
|
| Rate for Payer: Nomi Health Commercial |
$326.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: PACE Medicare |
$126.03
|
| Rate for Payer: PACE SWMI |
$132.66
|
| Rate for Payer: PHP Commercial |
$145.93
|
| Rate for Payer: PHP Medicaid |
$71.11
|
| Rate for Payer: PHP Medicare Advantage |
$132.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$348.73
|
| Rate for Payer: Priority Health Medicare |
$132.66
|
| Rate for Payer: Priority Health Narrow Network |
$279.00
|
| Rate for Payer: Railroad Medicare Medicare |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.66
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicaid |
$69.38
|
| Rate for Payer: UHCCP DNSP |
$132.66
|
| Rate for Payer: UHCCP Medicaid |
$69.38
|
| Rate for Payer: VA VA |
$132.66
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
IP
|
$663.26
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$497.44 |
| Max. Negotiated Rate |
$663.26 |
| Rate for Payer: Aetna Commercial |
$596.93
|
| Rate for Payer: ASR ASR |
$643.36
|
| Rate for Payer: BCBS Trust/PPO |
$544.67
|
| Rate for Payer: BCN Commercial |
$544.67
|
| Rate for Payer: Cash Price |
$530.61
|
| Rate for Payer: Cofinity Commercial |
$623.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.61
|
| Rate for Payer: Healthscope Commercial |
$643.36
|
| Rate for Payer: Healthscope Whirlpool |
$663.26
|
| Rate for Payer: Mclaren Commercial |
$596.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.77
|
| Rate for Payer: Nomi Health Commercial |
$543.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.67
|
|
|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
OP
|
$663.26
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$245.41 |
| Max. Negotiated Rate |
$663.26 |
| Rate for Payer: Aetna Commercial |
$596.93
|
| Rate for Payer: Aetna Medicare |
$245.41
|
| Rate for Payer: ASR ASR |
$643.36
|
| Rate for Payer: BCBS Complete |
$265.30
|
| Rate for Payer: BCBS Trust/PPO |
$546.86
|
| Rate for Payer: BCN Commercial |
$546.86
|
| Rate for Payer: Cash Price |
$530.61
|
| Rate for Payer: Cofinity Commercial |
$623.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.61
|
| Rate for Payer: Healthscope Commercial |
$643.36
|
| Rate for Payer: Healthscope Whirlpool |
$663.26
|
| Rate for Payer: Mclaren Commercial |
$596.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.77
|
| Rate for Payer: Nomi Health Commercial |
$543.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.15
|
| Rate for Payer: Priority Health Narrow Network |
$464.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.67
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.41 |
| Max. Negotiated Rate |
$287.22 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Trust/PPO |
$235.87
|
| Rate for Payer: BCN Commercial |
$235.87
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$236.81
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$455.16
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$364.13
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$468.74
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$173.43 |
| Max. Negotiated Rate |
$468.74 |
| Rate for Payer: Aetna Commercial |
$421.87
|
| Rate for Payer: Aetna Medicare |
$173.43
|
| Rate for Payer: ASR ASR |
$454.68
|
| Rate for Payer: BCBS Complete |
$187.50
|
| Rate for Payer: BCBS Trust/PPO |
$386.48
|
| Rate for Payer: BCN Commercial |
$386.48
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$440.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Healthscope Commercial |
$454.68
|
| Rate for Payer: Healthscope Whirlpool |
$468.74
|
| Rate for Payer: Mclaren Commercial |
$421.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$410.71
|
| Rate for Payer: Priority Health Narrow Network |
$328.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.49
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$468.74
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$351.56 |
| Max. Negotiated Rate |
$468.74 |
| Rate for Payer: Aetna Commercial |
$421.87
|
| Rate for Payer: ASR ASR |
$454.68
|
| Rate for Payer: BCBS Trust/PPO |
$384.93
|
| Rate for Payer: BCN Commercial |
$384.93
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$440.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Healthscope Commercial |
$454.68
|
| Rate for Payer: Healthscope Whirlpool |
$468.74
|
| Rate for Payer: Mclaren Commercial |
$421.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.49
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$221.09
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.82 |
| Max. Negotiated Rate |
$221.09 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Commercial |
$298.47
|
| Rate for Payer: ASR ASR |
$214.46
|
| Rate for Payer: ASR ASR |
$321.68
|
| Rate for Payer: BCBS Trust/PPO |
$181.56
|
| Rate for Payer: BCBS Trust/PPO |
$272.33
|
| Rate for Payer: BCN Commercial |
$181.56
|
| Rate for Payer: BCN Commercial |
$272.33
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cash Price |
$176.87
|
| Rate for Payer: Cofinity Commercial |
$311.73
|
| Rate for Payer: Cofinity Commercial |
$207.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.30
|
| Rate for Payer: Healthscope Commercial |
$214.46
|
| Rate for Payer: Healthscope Commercial |
$321.68
|
| Rate for Payer: Healthscope Whirlpool |
$331.63
|
| Rate for Payer: Healthscope Whirlpool |
$221.09
|
| Rate for Payer: Mclaren Commercial |
$298.47
|
| Rate for Payer: Mclaren Commercial |
$198.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.93
|
| Rate for Payer: Nomi Health Commercial |
$271.94
|
| Rate for Payer: Nomi Health Commercial |
$181.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.56
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
OP
|
$221.09
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$221.09 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Commercial |
$298.47
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$214.46
|
| Rate for Payer: ASR ASR |
$321.68
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$273.43
|
| Rate for Payer: BCBS Trust/PPO |
$182.29
|
| Rate for Payer: BCN Commercial |
$273.43
|
| Rate for Payer: BCN Commercial |
$182.29
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$176.87
|
| Rate for Payer: Cash Price |
$176.87
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cofinity Commercial |
$207.82
|
| Rate for Payer: Cofinity Commercial |
$311.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$214.46
|
| Rate for Payer: Healthscope Commercial |
$321.68
|
| Rate for Payer: Healthscope Whirlpool |
$221.09
|
| Rate for Payer: Healthscope Whirlpool |
$331.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$298.47
|
| Rate for Payer: Mclaren Commercial |
$198.98
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.89
|
| Rate for Payer: Nomi Health Commercial |
$271.94
|
| Rate for Payer: Nomi Health Commercial |
$181.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.72
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,199.57 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Trust/PPO |
$985.09
|
| Rate for Payer: BCN Commercial |
$985.09
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$678.88 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$989.05
|
| Rate for Payer: BCN Commercial |
$989.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$236.28
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$236.28 |
| Rate for Payer: Aetna Commercial |
$212.65
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$229.19
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$194.81
|
| Rate for Payer: BCN Commercial |
$194.81
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$189.02
|
| Rate for Payer: Cash Price |
$189.02
|
| Rate for Payer: Cofinity Commercial |
$222.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$229.19
|
| Rate for Payer: Healthscope Whirlpool |
$236.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$212.65
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.84
|
| Rate for Payer: Nomi Health Commercial |
$193.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.21
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$236.28
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.21 |
| Max. Negotiated Rate |
$236.28 |
| Rate for Payer: Aetna Commercial |
$212.65
|
| Rate for Payer: ASR ASR |
$229.19
|
| Rate for Payer: BCBS Trust/PPO |
$194.03
|
| Rate for Payer: BCN Commercial |
$194.03
|
| Rate for Payer: Cash Price |
$189.02
|
| Rate for Payer: Cofinity Commercial |
$222.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.02
|
| Rate for Payer: Healthscope Commercial |
$229.19
|
| Rate for Payer: Healthscope Whirlpool |
$236.28
|
| Rate for Payer: Mclaren Commercial |
$212.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.84
|
| Rate for Payer: Nomi Health Commercial |
$193.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.93
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$4,091.87
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,682.68
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,969.11
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,373.75
|
| Rate for Payer: BCN Commercial |
$3,373.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,273.50
|
| Rate for Payer: Cash Price |
$3,273.50
|
| Rate for Payer: Cofinity Commercial |
$3,846.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,273.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,969.11
|
| Rate for Payer: Healthscope Whirlpool |
$4,091.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,682.68
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,478.09
|
| Rate for Payer: Nomi Health Commercial |
$3,355.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,068.90
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,812.30
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,249.84
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,600.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$4,091.87
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,068.90 |
| Max. Negotiated Rate |
$4,091.87 |
| Rate for Payer: Aetna Commercial |
$3,682.68
|
| Rate for Payer: ASR ASR |
$3,969.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,360.24
|
| Rate for Payer: BCN Commercial |
$3,360.24
|
| Rate for Payer: Cash Price |
$3,273.50
|
| Rate for Payer: Cofinity Commercial |
$3,846.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,273.50
|
| Rate for Payer: Healthscope Commercial |
$3,969.11
|
| Rate for Payer: Healthscope Whirlpool |
$4,091.87
|
| Rate for Payer: Mclaren Commercial |
$3,682.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,478.09
|
| Rate for Payer: Nomi Health Commercial |
$3,355.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,068.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,600.85
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$373.92
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.44 |
| Max. Negotiated Rate |
$373.92 |
| Rate for Payer: Aetna Commercial |
$336.53
|
| Rate for Payer: ASR ASR |
$362.70
|
| Rate for Payer: BCBS Trust/PPO |
$307.06
|
| Rate for Payer: BCN Commercial |
$307.06
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$351.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Healthscope Commercial |
$362.70
|
| Rate for Payer: Healthscope Whirlpool |
$373.92
|
| Rate for Payer: Mclaren Commercial |
$336.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.05
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
OP
|
$373.92
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$608.61 |
| Rate for Payer: Aetna Commercial |
$336.53
|
| Rate for Payer: Aetna Medicare |
$248.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: ASR ASR |
$362.70
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$308.30
|
| Rate for Payer: BCN Commercial |
$308.30
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$351.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$362.70
|
| Rate for Payer: Healthscope Whirlpool |
$373.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$248.95
|
| Rate for Payer: Mclaren Commercial |
$336.53
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$136.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$273.85
|
| Rate for Payer: PHP Medicaid |
$133.44
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$608.61
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Narrow Network |
$486.89
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$385.87
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP DNSP |
$248.95
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$24.61
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$24.61 |
| Rate for Payer: Aetna Commercial |
$22.15
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$23.87
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.29
|
| Rate for Payer: BCN Commercial |
$20.29
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Healthscope Whirlpool |
$24.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.15
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.92
|
| Rate for Payer: Nomi Health Commercial |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.46
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.56
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$24.61
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$24.61 |
| Rate for Payer: Aetna Commercial |
$22.15
|
| Rate for Payer: ASR ASR |
$23.87
|
| Rate for Payer: BCBS Trust/PPO |
$20.21
|
| Rate for Payer: BCN Commercial |
$20.21
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Healthscope Whirlpool |
$24.61
|
| Rate for Payer: Mclaren Commercial |
$22.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.92
|
| Rate for Payer: Nomi Health Commercial |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.66
|
|
