|
HC GEN ANES INIT 30 MIN
|
Facility
|
IP
|
$601.51
|
|
| Hospital Charge Code |
37000002
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$451.13 |
| Max. Negotiated Rate |
$601.51 |
| Rate for Payer: Aetna Commercial |
$541.36
|
| Rate for Payer: ASR ASR |
$583.46
|
| Rate for Payer: BCBS Trust/PPO |
$493.96
|
| Rate for Payer: BCN Commercial |
$493.96
|
| Rate for Payer: Cash Price |
$481.21
|
| Rate for Payer: Cofinity Commercial |
$565.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.21
|
| Rate for Payer: Healthscope Commercial |
$583.46
|
| Rate for Payer: Healthscope Whirlpool |
$601.51
|
| Rate for Payer: Mclaren Commercial |
$541.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.28
|
| Rate for Payer: Nomi Health Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.33
|
|
|
HC GEN ANES INIT 30 MIN
|
Facility
|
OP
|
$601.51
|
|
| Hospital Charge Code |
37000002
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$222.56 |
| Max. Negotiated Rate |
$601.51 |
| Rate for Payer: Aetna Commercial |
$541.36
|
| Rate for Payer: Aetna Medicare |
$222.56
|
| Rate for Payer: ASR ASR |
$583.46
|
| Rate for Payer: BCBS Complete |
$240.60
|
| Rate for Payer: BCBS Trust/PPO |
$495.94
|
| Rate for Payer: BCN Commercial |
$495.94
|
| Rate for Payer: Cash Price |
$481.21
|
| Rate for Payer: Cofinity Commercial |
$565.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.21
|
| Rate for Payer: Healthscope Commercial |
$583.46
|
| Rate for Payer: Healthscope Whirlpool |
$601.51
|
| Rate for Payer: Mclaren Commercial |
$541.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$481.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.28
|
| Rate for Payer: Nomi Health Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$527.04
|
| Rate for Payer: Priority Health Narrow Network |
$421.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.33
|
|
|
HC GENERAL ANESTHESIA PER MINUTE
|
Facility
|
IP
|
$16.32
|
|
| Hospital Charge Code |
37000024
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$16.32 |
| Rate for Payer: Aetna Commercial |
$14.69
|
| Rate for Payer: ASR ASR |
$15.83
|
| Rate for Payer: BCBS Trust/PPO |
$13.40
|
| Rate for Payer: BCN Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cofinity Commercial |
$15.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$15.83
|
| Rate for Payer: Healthscope Whirlpool |
$16.32
|
| Rate for Payer: Mclaren Commercial |
$14.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.87
|
| Rate for Payer: Nomi Health Commercial |
$13.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.36
|
|
|
HC GENERAL ANESTHESIA PER MINUTE
|
Facility
|
OP
|
$16.32
|
|
| Hospital Charge Code |
37000024
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$16.32 |
| Rate for Payer: Aetna Commercial |
$14.69
|
| Rate for Payer: Aetna Medicare |
$6.04
|
| Rate for Payer: ASR ASR |
$15.83
|
| Rate for Payer: BCBS Complete |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCN Commercial |
$13.46
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cofinity Commercial |
$15.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$15.83
|
| Rate for Payer: Healthscope Whirlpool |
$16.32
|
| Rate for Payer: Mclaren Commercial |
$14.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.87
|
| Rate for Payer: Nomi Health Commercial |
$13.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14.30
|
| Rate for Payer: Priority Health Narrow Network |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.36
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
OP
|
$235.33
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$235.33 |
| Rate for Payer: Aetna Commercial |
$211.80
|
| Rate for Payer: Aetna Medicare |
$87.07
|
| Rate for Payer: ASR ASR |
$228.27
|
| Rate for Payer: BCBS Complete |
$94.13
|
| Rate for Payer: BCBS Trust/PPO |
$194.03
|
| Rate for Payer: BCN Commercial |
$194.03
|
| Rate for Payer: Cash Price |
$188.26
|
| Rate for Payer: Cofinity Commercial |
$221.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.26
|
| Rate for Payer: Healthscope Commercial |
$228.27
|
| Rate for Payer: Healthscope Whirlpool |
$235.33
|
| Rate for Payer: Mclaren Commercial |
$211.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.03
|
| Rate for Payer: Nomi Health Commercial |
$192.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$206.20
|
| Rate for Payer: Priority Health Narrow Network |
$164.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.09
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
IP
|
$235.33
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$176.50 |
| Max. Negotiated Rate |
$235.33 |
| Rate for Payer: Aetna Commercial |
$211.80
|
| Rate for Payer: ASR ASR |
$228.27
|
| Rate for Payer: BCBS Trust/PPO |
$193.25
|
| Rate for Payer: BCN Commercial |
$193.25
|
| Rate for Payer: Cash Price |
$188.26
|
| Rate for Payer: Cofinity Commercial |
$221.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.26
|
| Rate for Payer: Healthscope Commercial |
$228.27
|
| Rate for Payer: Healthscope Whirlpool |
$235.33
|
| Rate for Payer: Mclaren Commercial |
$211.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.03
|
| Rate for Payer: Nomi Health Commercial |
$192.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.09
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
IP
|
$125.47
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.10 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$112.92
|
| Rate for Payer: ASR ASR |
$121.71
|
| Rate for Payer: BCBS Trust/PPO |
$103.04
|
| Rate for Payer: BCN Commercial |
$103.04
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Commercial |
$117.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Healthscope Commercial |
$121.71
|
| Rate for Payer: Healthscope Whirlpool |
$125.47
|
| Rate for Payer: Mclaren Commercial |
$112.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.65
|
| Rate for Payer: Nomi Health Commercial |
$102.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.41
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
OP
|
$125.47
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$112.92
|
| Rate for Payer: Aetna Medicare |
$16.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.48
|
| Rate for Payer: ASR ASR |
$121.71
|
| Rate for Payer: BCBS Complete |
$9.00
|
| Rate for Payer: BCBS MAPPO |
$16.38
|
| Rate for Payer: BCBS Trust/PPO |
$103.45
|
| Rate for Payer: BCN Commercial |
$103.45
|
| Rate for Payer: BCN Medicare Advantage |
$16.38
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Commercial |
$117.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.38
|
| Rate for Payer: Healthscope Commercial |
$121.71
|
| Rate for Payer: Healthscope Whirlpool |
$125.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.38
|
| Rate for Payer: Mclaren Commercial |
$112.92
|
| Rate for Payer: Mclaren Medicaid |
$16.38
|
| Rate for Payer: Mclaren Medicare |
$16.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.20
|
| Rate for Payer: Meridian Medicaid |
$9.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.65
|
| Rate for Payer: Nomi Health Commercial |
$102.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.10
|
| Rate for Payer: PACE Medicare |
$15.56
|
| Rate for Payer: PACE SWMI |
$16.38
|
| Rate for Payer: PHP Commercial |
$18.02
|
| Rate for Payer: PHP Medicaid |
$8.78
|
| Rate for Payer: PHP Medicare Advantage |
$16.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$16.38
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.38
|
| Rate for Payer: UHC Exchange |
$25.39
|
| Rate for Payer: UHC Medicaid |
$8.57
|
| Rate for Payer: UHCCP DNSP |
$16.38
|
| Rate for Payer: UHCCP Medicaid |
$8.57
|
| Rate for Payer: VA VA |
$16.38
|
|
|
HC GGTP
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$7.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.00
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.20
|
| Rate for Payer: BCBS Trust/PPO |
$58.33
|
| Rate for Payer: BCN Commercial |
$58.33
|
| Rate for Payer: BCN Medicare Advantage |
$7.20
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.20
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$7.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.56
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$6.84
|
| Rate for Payer: PACE SWMI |
$7.20
|
| Rate for Payer: PHP Commercial |
$7.92
|
| Rate for Payer: PHP Medicaid |
$3.86
|
| Rate for Payer: PHP Medicare Advantage |
$7.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.25
|
| Rate for Payer: Priority Health Medicare |
$7.20
|
| Rate for Payer: Priority Health Narrow Network |
$21.80
|
| Rate for Payer: Railroad Medicare Medicare |
$7.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.20
|
| Rate for Payer: UHC Exchange |
$11.16
|
| Rate for Payer: UHC Medicaid |
$3.77
|
| Rate for Payer: UHCCP DNSP |
$7.20
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$7.20
|
|
|
HC GGTP
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.06 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Trust/PPO |
$58.10
|
| Rate for Payer: BCN Commercial |
$58.10
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$46.70 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Trust/PPO |
$38.35
|
| Rate for Payer: BCN Commercial |
$38.35
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$38.50
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.40
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$54.72
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,886.25
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,414.69 |
| Max. Negotiated Rate |
$1,886.25 |
| Rate for Payer: Aetna Commercial |
$1,697.62
|
| Rate for Payer: ASR ASR |
$1,829.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.99
|
| Rate for Payer: BCN Commercial |
$1,548.99
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cofinity Commercial |
$1,773.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.00
|
| Rate for Payer: Healthscope Commercial |
$1,829.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,886.25
|
| Rate for Payer: Mclaren Commercial |
$1,697.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.31
|
| Rate for Payer: Nomi Health Commercial |
$1,546.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.90
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,886.25
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$999.98 |
| Max. Negotiated Rate |
$2,963.62 |
| Rate for Payer: Aetna Commercial |
$1,697.62
|
| Rate for Payer: Aetna Medicare |
$1,912.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: ASR ASR |
$1,829.66
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,555.21
|
| Rate for Payer: BCN Commercial |
$1,555.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cofinity Commercial |
$1,773.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,829.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,886.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,912.01
|
| Rate for Payer: Mclaren Commercial |
$1,697.62
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$1,050.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.31
|
| Rate for Payer: Nomi Health Commercial |
$1,546.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.69
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,103.21
|
| Rate for Payer: PHP Medicaid |
$1,024.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,652.73
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,322.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Exchange |
$2,963.62
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP DNSP |
$1,912.01
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,847.32
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,385.49 |
| Max. Negotiated Rate |
$1,847.32 |
| Rate for Payer: Aetna Commercial |
$1,662.59
|
| Rate for Payer: ASR ASR |
$1,791.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.02
|
| Rate for Payer: BCN Commercial |
$1,517.02
|
| Rate for Payer: Cash Price |
$1,477.86
|
| Rate for Payer: Cofinity Commercial |
$1,736.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.86
|
| Rate for Payer: Healthscope Commercial |
$1,791.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.32
|
| Rate for Payer: Mclaren Commercial |
$1,662.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,570.22
|
| Rate for Payer: Nomi Health Commercial |
$1,514.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,625.64
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,847.32
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.51 |
| Max. Negotiated Rate |
$1,847.32 |
| Rate for Payer: Aetna Commercial |
$1,662.59
|
| Rate for Payer: Aetna Medicare |
$683.51
|
| Rate for Payer: ASR ASR |
$1,791.90
|
| Rate for Payer: BCBS Complete |
$738.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.12
|
| Rate for Payer: BCN Commercial |
$1,523.12
|
| Rate for Payer: Cash Price |
$1,477.86
|
| Rate for Payer: Cofinity Commercial |
$1,736.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.86
|
| Rate for Payer: Healthscope Commercial |
$1,791.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.32
|
| Rate for Payer: Mclaren Commercial |
$1,662.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,477.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,570.22
|
| Rate for Payer: Nomi Health Commercial |
$1,514.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,618.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,294.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,625.64
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,293.30
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$1,480.50 |
| Rate for Payer: Aetna Commercial |
$1,163.97
|
| 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 |
$1,254.50
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,066.33
|
| Rate for Payer: BCN Commercial |
$1,066.33
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cofinity Commercial |
$1,215.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$1,254.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,293.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$248.95
|
| Rate for Payer: Mclaren Commercial |
$1,163.97
|
| 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 |
$1,099.31
|
| Rate for Payer: Nomi Health Commercial |
$1,060.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.98
|
| 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 |
$1,480.50
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.40
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,138.10
|
| 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 GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,293.30
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.98 |
| Max. Negotiated Rate |
$1,293.30 |
| Rate for Payer: Aetna Commercial |
$1,163.97
|
| Rate for Payer: ASR ASR |
$1,254.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.06
|
| Rate for Payer: BCN Commercial |
$1,062.06
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cofinity Commercial |
$1,215.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.64
|
| Rate for Payer: Healthscope Commercial |
$1,254.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,293.30
|
| Rate for Payer: Mclaren Commercial |
$1,163.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.31
|
| Rate for Payer: Nomi Health Commercial |
$1,060.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,138.10
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,251.04
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$938.28 |
| Max. Negotiated Rate |
$1,251.04 |
| Rate for Payer: Aetna Commercial |
$1,125.94
|
| Rate for Payer: ASR ASR |
$1,213.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,027.35
|
| Rate for Payer: BCN Commercial |
$1,027.35
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Commercial |
$1,175.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Healthscope Commercial |
$1,213.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,251.04
|
| Rate for Payer: Mclaren Commercial |
$1,125.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$1,025.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,100.92
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,251.04
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$1,125.94
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$1,213.51
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.48
|
| Rate for Payer: BCN Commercial |
$1,031.48
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Commercial |
$1,175.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,213.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,251.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$1,125.94
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$1,025.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,096.16
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$876.98
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,100.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Exchange |
$1,400.77
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,376.14
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,032.11 |
| Max. Negotiated Rate |
$1,376.14 |
| Rate for Payer: Aetna Commercial |
$1,238.53
|
| Rate for Payer: ASR ASR |
$1,334.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.09
|
| Rate for Payer: BCN Commercial |
$1,130.09
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cofinity Commercial |
$1,293.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.91
|
| Rate for Payer: Healthscope Commercial |
$1,334.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,376.14
|
| Rate for Payer: Mclaren Commercial |
$1,238.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.72
|
| Rate for Payer: Nomi Health Commercial |
$1,128.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.00
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,376.14
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$1,238.53
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$1,334.86
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.63
|
| Rate for Payer: BCN Commercial |
$1,134.63
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cofinity Commercial |
$1,293.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,334.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,376.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$1,238.53
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.72
|
| Rate for Payer: Nomi Health Commercial |
$1,128.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.11
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,205.77
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$964.67
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Exchange |
$1,400.77
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,302.04
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$1,171.84
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$1,262.98
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.53
|
| Rate for Payer: BCN Commercial |
$1,073.53
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cofinity Commercial |
$1,223.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,041.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,262.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$1,171.84
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.73
|
| Rate for Payer: Nomi Health Commercial |
$1,067.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$976.53
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,140.85
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$912.73
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,145.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Exchange |
$1,400.77
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,302.04
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$976.53 |
| Max. Negotiated Rate |
$1,302.04 |
| Rate for Payer: Aetna Commercial |
$1,171.84
|
| Rate for Payer: ASR ASR |
$1,262.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.24
|
| Rate for Payer: BCN Commercial |
$1,069.24
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cofinity Commercial |
$1,223.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,041.63
|
| Rate for Payer: Healthscope Commercial |
$1,262.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.04
|
| Rate for Payer: Mclaren Commercial |
$1,171.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.73
|
| Rate for Payer: Nomi Health Commercial |
$1,067.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$976.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,145.80
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$905.11
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$678.83 |
| Max. Negotiated Rate |
$905.11 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| Rate for Payer: ASR ASR |
$877.96
|
| Rate for Payer: BCBS Trust/PPO |
$743.28
|
| Rate for Payer: BCN Commercial |
$743.28
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Commercial |
$850.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Healthscope Commercial |
$877.96
|
| Rate for Payer: Healthscope Whirlpool |
$905.11
|
| Rate for Payer: Mclaren Commercial |
$814.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$742.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.50
|
|
