|
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 |
$12.80 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$54.10
|
| Rate for Payer: Aetna Medicare |
$23.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: ASR ASR |
$58.31
|
| Rate for Payer: ASR Commercial |
$58.31
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$49.22
|
| Rate for Payer: BCN Commercial |
$46.60
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| 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 |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Healthscope Whirlpool |
$58.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.88
|
| Rate for Payer: Mclaren Commercial |
$54.10
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: Nomi Health Commercial |
$49.29
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$26.27
|
| Rate for Payer: PHP Medicaid |
$12.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| 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 |
$23.88
|
| Rate for Payer: Priority Health Narrow Network |
$42.14
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$37.01
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP DNSP |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: VA VA |
$23.88
|
|
|
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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$491.41
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| 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 |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$420.66
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$540.07
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$582.08
|
| Rate for Payer: ASR Commercial |
$582.08
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$491.41
|
| Rate for Payer: BCN Commercial |
$465.24
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$600.08
|
| Rate for Payer: Healthscope Whirlpool |
$582.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| 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 |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$420.66
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 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 |
$367.80 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| 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 |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$846.98 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.09
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| 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 |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| 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 |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,975.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
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 |
$846.98 |
| Max. Negotiated Rate |
$4,244.83 |
| Rate for Payer: Aetna Commercial |
$3,820.35
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$4,117.49
|
| Rate for Payer: ASR Commercial |
$4,117.49
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.09
|
| Rate for Payer: BCN Commercial |
$3,291.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,117.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$3,820.35
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| 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 |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| 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 |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,975.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,735.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
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 |
$1,496.14 |
| Max. Negotiated Rate |
$7,150.67 |
| Rate for Payer: Aetna Commercial |
$6,435.60
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$6,936.15
|
| Rate for Payer: ASR Commercial |
$6,936.15
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,855.68
|
| Rate for Payer: BCN Commercial |
$5,543.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| 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 |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,150.67
|
| Rate for Payer: Healthscope Whirlpool |
$6,936.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$6,435.60
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| 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 |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| 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 |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,012.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,292.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
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
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$2,867.66 |
| Rate for Payer: Aetna Commercial |
$2,306.65
|
| Rate for Payer: Aetna Medicare |
$1,850.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: ASR ASR |
$2,486.05
|
| Rate for Payer: ASR Commercial |
$2,486.05
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,098.79
|
| Rate for Payer: BCN Commercial |
$1,987.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$2,050.35
|
| 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: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$2,562.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,486.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,850.10
|
| Rate for Payer: Mclaren Commercial |
$2,306.65
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: Nomi Health Commercial |
$2,101.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$2,035.11
|
| Rate for Payer: PHP Medicaid |
$991.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,245.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,796.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,255.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$2,867.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP DNSP |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$3,900.42
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$4,203.79
|
| Rate for Payer: ASR Commercial |
$4,203.79
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,548.95
|
| Rate for Payer: BCN Commercial |
$3,360.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$4,073.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$4,333.80
|
| Rate for Payer: Healthscope Whirlpool |
$4,203.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$3,900.42
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,797.28
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,037.99
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,813.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,816.97 |
| Max. Negotiated Rate |
$4,333.80 |
| Rate for Payer: Aetna Commercial |
$3,900.42
|
| Rate for Payer: ASR ASR |
$4,203.79
|
| Rate for Payer: ASR Commercial |
$4,203.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,531.61
|
| Rate for Payer: BCN Commercial |
$3,360.00
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$4,073.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Healthscope Commercial |
$4,333.80
|
| Rate for Payer: Healthscope Whirlpool |
$4,203.79
|
| Rate for Payer: Mclaren Commercial |
$3,900.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,813.74
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,302.51 |
| Max. Negotiated Rate |
$3,542.33 |
| Rate for Payer: Aetna Commercial |
$3,188.10
|
| Rate for Payer: ASR ASR |
$3,436.06
|
| Rate for Payer: ASR Commercial |
$3,436.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,886.64
|
| Rate for Payer: BCN Commercial |
$2,746.37
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,329.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Healthscope Commercial |
$3,542.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,436.06
|
| Rate for Payer: Mclaren Commercial |
$3,188.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,117.25
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,542.33 |
| Rate for Payer: Aetna Commercial |
$3,188.10
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$3,436.06
|
| Rate for Payer: ASR Commercial |
$3,436.06
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.81
|
| Rate for Payer: BCN Commercial |
$2,746.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,329.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$3,542.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,436.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$3,188.10
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,103.79
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,483.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,117.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$228.53 |
| Max. Negotiated Rate |
$1,524.05 |
| Rate for Payer: Aetna Commercial |
$1,371.64
|
| Rate for Payer: Aetna Medicare |
$426.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: ASR ASR |
$1,478.33
|
| Rate for Payer: ASR Commercial |
$1,478.33
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.04
|
| Rate for Payer: BCN Commercial |
$1,181.60
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,432.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$1,524.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$426.37
|
| Rate for Payer: Mclaren Commercial |
$1,371.64
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$469.01
|
| Rate for Payer: PHP Medicaid |
$228.53
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.37
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.36
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,341.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$660.87
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP DNSP |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: VA VA |
$426.37
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$990.63 |
| Max. Negotiated Rate |
$1,524.05 |
| Rate for Payer: Aetna Commercial |
$1,371.64
|
| Rate for Payer: ASR ASR |
$1,478.33
|
| Rate for Payer: ASR Commercial |
$1,478.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.95
|
| Rate for Payer: BCN Commercial |
$1,181.60
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,432.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Healthscope Commercial |
$1,524.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.33
|
| Rate for Payer: Mclaren Commercial |
$1,371.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,341.16
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.67 |
| Max. Negotiated Rate |
$550.26 |
| Rate for Payer: Aetna Commercial |
$495.23
|
| Rate for Payer: ASR ASR |
$533.75
|
| Rate for Payer: ASR Commercial |
$533.75
|
| Rate for Payer: BCBS Trust/PPO |
$448.41
|
| Rate for Payer: BCN Commercial |
$426.62
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$517.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$550.26
|
| Rate for Payer: Healthscope Whirlpool |
$533.75
|
| Rate for Payer: Mclaren Commercial |
$495.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.23
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$220.10 |
| Max. Negotiated Rate |
$550.26 |
| Rate for Payer: Aetna Commercial |
$495.23
|
| Rate for Payer: Aetna Medicare |
$275.13
|
| Rate for Payer: ASR ASR |
$533.75
|
| Rate for Payer: ASR Commercial |
$533.75
|
| Rate for Payer: BCBS Complete |
$220.10
|
| Rate for Payer: BCBS Trust/PPO |
$450.61
|
| Rate for Payer: BCN Commercial |
$426.62
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$517.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$550.26
|
| Rate for Payer: Healthscope Whirlpool |
$533.75
|
| Rate for Payer: Mclaren Commercial |
$495.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.14
|
| Rate for Payer: Priority Health Narrow Network |
$385.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.23
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,598.70
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,060.42
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,648.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
