|
HC EVENT MONITOR
|
Facility
|
IP
|
$510.24
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$331.66 |
| Max. Negotiated Rate |
$510.24 |
| Rate for Payer: Aetna Commercial |
$459.22
|
| Rate for Payer: ASR ASR |
$494.93
|
| Rate for Payer: ASR Commercial |
$494.93
|
| Rate for Payer: BCBS Trust/PPO |
$415.79
|
| Rate for Payer: BCN Commercial |
$395.59
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cofinity Commercial |
$479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$510.24
|
| Rate for Payer: Healthscope Whirlpool |
$494.93
|
| Rate for Payer: Mclaren Commercial |
$459.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Nomi Health Commercial |
$418.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.01
|
|
|
HC EVENT MONITOR
|
Facility
|
OP
|
$510.24
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$510.24 |
| Rate for Payer: Aetna Commercial |
$459.22
|
| Rate for Payer: Aetna Medicare |
$36.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: ASR ASR |
$494.93
|
| Rate for Payer: ASR Commercial |
$494.93
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$417.84
|
| Rate for Payer: BCN Commercial |
$395.59
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cofinity Commercial |
$479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$510.24
|
| Rate for Payer: Healthscope Whirlpool |
$494.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.54
|
| Rate for Payer: Mclaren Commercial |
$459.22
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Nomi Health Commercial |
$418.40
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$40.19
|
| Rate for Payer: PHP Medicaid |
$19.59
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.07
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$357.68
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$56.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP DNSP |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: VA VA |
$36.54
|
|
|
HC EVEROLIMUS
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.31 |
| Max. Negotiated Rate |
$69.71 |
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: ASR ASR |
$67.62
|
| Rate for Payer: ASR Commercial |
$67.62
|
| Rate for Payer: BCBS Trust/PPO |
$56.81
|
| Rate for Payer: BCN Commercial |
$54.05
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$65.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$69.71
|
| Rate for Payer: Healthscope Whirlpool |
$67.62
|
| Rate for Payer: Mclaren Commercial |
$62.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.34
|
|
|
HC EVEROLIMUS
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$69.71 |
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: ASR ASR |
$67.62
|
| Rate for Payer: ASR Commercial |
$67.62
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$57.09
|
| Rate for Payer: BCN Commercial |
$54.05
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$65.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$69.71
|
| Rate for Payer: Healthscope Whirlpool |
$67.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.73
|
| Rate for Payer: Mclaren Commercial |
$62.74
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.44
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$17.15
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.73
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$13.73
|
| Rate for Payer: UHCCP DNSP |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$286.62 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Trust/PPO |
$233.57
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$472.90 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$234.71
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.14
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$200.92
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$286.62 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Trust/PPO |
$233.57
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$472.90 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$234.71
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.14
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$200.92
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$785.40
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$510.51 |
| Max. Negotiated Rate |
$785.40 |
| Rate for Payer: Aetna Commercial |
$706.86
|
| Rate for Payer: ASR ASR |
$761.84
|
| Rate for Payer: ASR Commercial |
$761.84
|
| Rate for Payer: BCBS Trust/PPO |
$640.02
|
| Rate for Payer: BCN Commercial |
$608.92
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$738.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Healthscope Commercial |
$785.40
|
| Rate for Payer: Healthscope Whirlpool |
$761.84
|
| Rate for Payer: Mclaren Commercial |
$706.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.59
|
| Rate for Payer: Nomi Health Commercial |
$644.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.15
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$785.40
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$785.40 |
| Rate for Payer: Aetna Commercial |
$706.86
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$761.84
|
| Rate for Payer: ASR Commercial |
$761.84
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$643.16
|
| Rate for Payer: BCN Commercial |
$608.92
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$738.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$785.40
|
| Rate for Payer: Healthscope Whirlpool |
$761.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$706.86
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.59
|
| Rate for Payer: Nomi Health Commercial |
$644.03
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.17
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$550.57
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$54.10
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$58.31
|
| Rate for Payer: ASR Commercial |
$58.31
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$49.22
|
| Rate for Payer: BCN Commercial |
$46.60
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$56.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Healthscope Whirlpool |
$58.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$54.10
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: Nomi Health Commercial |
$49.29
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.67
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$42.14
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.07 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$54.10
|
| Rate for Payer: ASR ASR |
$58.31
|
| Rate for Payer: ASR Commercial |
$58.31
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$46.60
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$56.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Healthscope Whirlpool |
$58.31
|
| Rate for Payer: Mclaren Commercial |
$54.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: Nomi Health Commercial |
$49.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.90
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$491.41
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$564.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$525.79
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$420.66
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.05 |
| Max. Negotiated Rate |
$600.08 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Trust/PPO |
$489.01
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$564.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.05 |
| Max. Negotiated Rate |
$600.08 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Trust/PPO |
$489.01
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$564.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$491.41
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$564.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$525.79
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$420.66
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,759.14 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,459.11
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,990.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.09
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,990.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,719.32
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,975.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.09
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,990.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,719.32
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,975.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,759.14 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,459.11
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,990.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,647.94 |
| Max. Negotiated Rate |
$7,150.67 |
| Rate for Payer: Aetna Commercial |
$6,435.60
|
| Rate for Payer: ASR ASR |
$6,936.15
|
| Rate for Payer: ASR Commercial |
$6,936.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,827.08
|
| Rate for Payer: BCN Commercial |
$5,543.91
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$6,721.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Healthscope Commercial |
$7,150.67
|
| Rate for Payer: Healthscope Whirlpool |
$6,936.15
|
| Rate for Payer: Mclaren Commercial |
$6,435.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: Nomi Health Commercial |
$5,863.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,292.59
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$7,150.67 |
| Rate for Payer: Aetna Commercial |
$6,435.60
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$6,936.15
|
| Rate for Payer: ASR Commercial |
$6,936.15
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,855.68
|
| Rate for Payer: BCN Commercial |
$5,543.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$6,721.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$7,150.67
|
| Rate for Payer: Healthscope Whirlpool |
$6,936.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$6,435.60
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: Nomi Health Commercial |
$5,863.55
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,265.42
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$5,012.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,292.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,665.91 |
| Max. Negotiated Rate |
$2,562.94 |
| Rate for Payer: Aetna Commercial |
$2,306.65
|
| Rate for Payer: ASR ASR |
$2,486.05
|
| Rate for Payer: ASR Commercial |
$2,486.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,088.54
|
| Rate for Payer: BCN Commercial |
$1,987.05
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$2,409.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Healthscope Commercial |
$2,562.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,486.05
|
| Rate for Payer: Mclaren Commercial |
$2,306.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: Nomi Health Commercial |
$2,101.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,255.39
|
|
