|
HC GENERAL ANESTHESIA PER MINUTE
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
37000024
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: ASR ASR |
$15.52
|
| Rate for Payer: ASR Commercial |
$15.52
|
| Rate for Payer: BCBS Complete |
$6.40
|
| Rate for Payer: BCBS Trust/PPO |
$13.10
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$15.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$16.00
|
| Rate for Payer: Healthscope Whirlpool |
$15.52
|
| Rate for Payer: Mclaren Commercial |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Nomi Health Commercial |
$13.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.02
|
| Rate for Payer: Priority Health Narrow Network |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.08
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
IP
|
$230.72
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$149.97 |
| Max. Negotiated Rate |
$230.72 |
| Rate for Payer: Aetna Commercial |
$207.65
|
| Rate for Payer: ASR ASR |
$223.80
|
| Rate for Payer: ASR Commercial |
$223.80
|
| Rate for Payer: BCBS Trust/PPO |
$188.01
|
| Rate for Payer: BCN Commercial |
$178.88
|
| Rate for Payer: Cash Price |
$184.58
|
| Rate for Payer: Cofinity Commercial |
$216.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.58
|
| Rate for Payer: Healthscope Commercial |
$230.72
|
| Rate for Payer: Healthscope Whirlpool |
$223.80
|
| Rate for Payer: Mclaren Commercial |
$207.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.11
|
| Rate for Payer: Nomi Health Commercial |
$189.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.03
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
OP
|
$230.72
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.29 |
| Max. Negotiated Rate |
$230.72 |
| Rate for Payer: Aetna Commercial |
$207.65
|
| Rate for Payer: Aetna Medicare |
$115.36
|
| Rate for Payer: ASR ASR |
$223.80
|
| Rate for Payer: ASR Commercial |
$223.80
|
| Rate for Payer: BCBS Complete |
$92.29
|
| Rate for Payer: BCBS Trust/PPO |
$188.94
|
| Rate for Payer: BCN Commercial |
$178.88
|
| Rate for Payer: Cash Price |
$184.58
|
| Rate for Payer: Cofinity Commercial |
$216.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.58
|
| Rate for Payer: Healthscope Commercial |
$230.72
|
| Rate for Payer: Healthscope Whirlpool |
$223.80
|
| Rate for Payer: Mclaren Commercial |
$207.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.11
|
| Rate for Payer: Nomi Health Commercial |
$189.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.16
|
| Rate for Payer: Priority Health Narrow Network |
$161.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.03
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
IP
|
$123.01
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.96 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$110.71
|
| Rate for Payer: ASR ASR |
$119.32
|
| Rate for Payer: ASR Commercial |
$119.32
|
| Rate for Payer: BCBS Trust/PPO |
$100.24
|
| Rate for Payer: BCN Commercial |
$95.37
|
| Rate for Payer: Cash Price |
$98.41
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.41
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Healthscope Whirlpool |
$119.32
|
| Rate for Payer: Mclaren Commercial |
$110.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.56
|
| Rate for Payer: Nomi Health Commercial |
$100.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.25
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
OP
|
$123.01
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$110.71
|
| 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 |
$119.32
|
| Rate for Payer: ASR Commercial |
$119.32
|
| Rate for Payer: BCBS Complete |
$9.22
|
| Rate for Payer: BCBS MAPPO |
$16.38
|
| Rate for Payer: BCBS Trust/PPO |
$100.73
|
| Rate for Payer: BCN Commercial |
$95.37
|
| Rate for Payer: BCN Medicare Advantage |
$16.38
|
| Rate for Payer: Cash Price |
$98.41
|
| Rate for Payer: Cash Price |
$98.41
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.38
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Healthscope Whirlpool |
$119.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.38
|
| Rate for Payer: Mclaren Commercial |
$110.71
|
| Rate for Payer: Mclaren Medicaid |
$8.78
|
| 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 |
$9.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.56
|
| Rate for Payer: Nomi Health Commercial |
$100.87
|
| 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 |
$8.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.12
|
| Rate for Payer: Priority Health Medicare |
$16.38
|
| Rate for Payer: Priority Health Narrow Network |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.38
|
| Rate for Payer: UHC Exchange |
$25.39
|
| Rate for Payer: UHC Medicare Advantage |
$16.38
|
| Rate for Payer: UHCCP DNSP |
$16.38
|
| Rate for Payer: UHCCP Medicaid |
$8.78
|
| Rate for Payer: VA VA |
$16.38
|
|
|
HC GGTP
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.08 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.52
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
|
|
HC GGTP
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| 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 |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Complete |
$4.05
|
| Rate for Payer: BCBS MAPPO |
$7.20
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: BCN Medicare Advantage |
$7.20
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.20
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$3.86
|
| 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 |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| 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 |
$3.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$7.20
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: Railroad Medicare Medicare |
$7.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.20
|
| Rate for Payer: UHC Exchange |
$11.16
|
| Rate for Payer: UHC Medicare Advantage |
$7.20
|
| Rate for Payer: UHCCP DNSP |
$7.20
|
| Rate for Payer: UHCCP Medicaid |
$3.86
|
| Rate for Payer: VA VA |
$7.20
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$62.04 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| 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 |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| 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 |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.04
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$49.63
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.31
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,796.43
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$996.23 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$1,616.79
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$1,742.54
|
| Rate for Payer: ASR Commercial |
$1,742.54
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.10
|
| Rate for Payer: BCN Commercial |
$1,392.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cofinity Commercial |
$1,688.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,437.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,796.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,742.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$1,616.79
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.97
|
| Rate for Payer: Nomi Health Commercial |
$1,473.07
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,574.03
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,259.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,580.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,796.43
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,167.68 |
| Max. Negotiated Rate |
$1,796.43 |
| Rate for Payer: Aetna Commercial |
$1,616.79
|
| Rate for Payer: ASR ASR |
$1,742.54
|
| Rate for Payer: ASR Commercial |
$1,742.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,463.91
|
| Rate for Payer: BCN Commercial |
$1,392.77
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cofinity Commercial |
$1,688.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,437.14
|
| Rate for Payer: Healthscope Commercial |
$1,796.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,742.54
|
| Rate for Payer: Mclaren Commercial |
$1,616.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.97
|
| Rate for Payer: Nomi Health Commercial |
$1,473.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,580.86
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,811.10
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$724.44 |
| Max. Negotiated Rate |
$1,811.10 |
| Rate for Payer: Aetna Commercial |
$1,629.99
|
| Rate for Payer: Aetna Medicare |
$905.55
|
| Rate for Payer: ASR ASR |
$1,756.77
|
| Rate for Payer: ASR Commercial |
$1,756.77
|
| Rate for Payer: BCBS Complete |
$724.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.11
|
| Rate for Payer: BCN Commercial |
$1,404.15
|
| Rate for Payer: Cash Price |
$1,448.88
|
| Rate for Payer: Cofinity Commercial |
$1,702.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.88
|
| Rate for Payer: Healthscope Commercial |
$1,811.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,756.77
|
| Rate for Payer: Mclaren Commercial |
$1,629.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.44
|
| Rate for Payer: Nomi Health Commercial |
$1,485.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.77
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,811.10
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,177.22 |
| Max. Negotiated Rate |
$1,811.10 |
| Rate for Payer: Aetna Commercial |
$1,629.99
|
| Rate for Payer: ASR ASR |
$1,756.77
|
| Rate for Payer: ASR Commercial |
$1,756.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.87
|
| Rate for Payer: BCN Commercial |
$1,404.15
|
| Rate for Payer: Cash Price |
$1,448.88
|
| Rate for Payer: Cofinity Commercial |
$1,702.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.88
|
| Rate for Payer: Healthscope Commercial |
$1,811.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,756.77
|
| Rate for Payer: Mclaren Commercial |
$1,629.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.44
|
| Rate for Payer: Nomi Health Commercial |
$1,485.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.77
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,267.94
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$824.16 |
| Max. Negotiated Rate |
$1,267.94 |
| Rate for Payer: Aetna Commercial |
$1,141.15
|
| Rate for Payer: ASR ASR |
$1,229.90
|
| Rate for Payer: ASR Commercial |
$1,229.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.24
|
| Rate for Payer: BCN Commercial |
$983.03
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cofinity Commercial |
$1,191.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.35
|
| Rate for Payer: Healthscope Commercial |
$1,267.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.90
|
| Rate for Payer: Mclaren Commercial |
$1,141.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.75
|
| Rate for Payer: Nomi Health Commercial |
$1,039.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.79
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,267.94
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$1,342.86 |
| Rate for Payer: Aetna Commercial |
$1,141.15
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$1,229.90
|
| Rate for Payer: ASR Commercial |
$1,229.90
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.32
|
| Rate for Payer: BCN Commercial |
$983.03
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cofinity Commercial |
$1,191.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$1,267.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$1,141.15
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.75
|
| Rate for Payer: Nomi Health Commercial |
$1,039.71
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.86
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,074.29
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,226.51
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$492.37 |
| Max. Negotiated Rate |
$1,423.83 |
| Rate for Payer: Aetna Commercial |
$1,103.86
|
| Rate for Payer: Aetna Medicare |
$918.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: ASR ASR |
$1,189.71
|
| Rate for Payer: ASR Commercial |
$1,189.71
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.39
|
| Rate for Payer: BCN Commercial |
$950.91
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,152.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$1,226.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,189.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$918.60
|
| Rate for Payer: Mclaren Commercial |
$1,103.86
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: Nomi Health Commercial |
$1,005.74
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,010.46
|
| Rate for Payer: PHP Medicaid |
$492.37
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.67
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$859.78
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,079.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,423.83
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP DNSP |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: VA VA |
$918.60
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,226.51
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$797.23 |
| Max. Negotiated Rate |
$1,226.51 |
| Rate for Payer: Aetna Commercial |
$1,103.86
|
| Rate for Payer: ASR ASR |
$1,189.71
|
| Rate for Payer: ASR Commercial |
$1,189.71
|
| Rate for Payer: BCBS Trust/PPO |
$999.48
|
| Rate for Payer: BCN Commercial |
$950.91
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,152.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Healthscope Commercial |
$1,226.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,189.71
|
| Rate for Payer: Mclaren Commercial |
$1,103.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: Nomi Health Commercial |
$1,005.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,079.33
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,349.16
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$492.37 |
| Max. Negotiated Rate |
$1,423.83 |
| Rate for Payer: Aetna Commercial |
$1,214.24
|
| Rate for Payer: Aetna Medicare |
$918.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: ASR ASR |
$1,308.69
|
| Rate for Payer: ASR Commercial |
$1,308.69
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.83
|
| Rate for Payer: BCN Commercial |
$1,046.00
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cofinity Commercial |
$1,268.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$1,349.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$918.60
|
| Rate for Payer: Mclaren Commercial |
$1,214.24
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.79
|
| Rate for Payer: Nomi Health Commercial |
$1,106.31
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,010.46
|
| Rate for Payer: PHP Medicaid |
$492.37
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,182.13
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$945.76
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,187.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,423.83
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP DNSP |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: VA VA |
$918.60
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,349.16
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$876.95 |
| Max. Negotiated Rate |
$1,349.16 |
| Rate for Payer: Aetna Commercial |
$1,214.24
|
| Rate for Payer: ASR ASR |
$1,308.69
|
| Rate for Payer: ASR Commercial |
$1,308.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.43
|
| Rate for Payer: BCN Commercial |
$1,046.00
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cofinity Commercial |
$1,268.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.33
|
| Rate for Payer: Healthscope Commercial |
$1,349.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.69
|
| Rate for Payer: Mclaren Commercial |
$1,214.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.79
|
| Rate for Payer: Nomi Health Commercial |
$1,106.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,187.26
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,276.51
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$829.73 |
| Max. Negotiated Rate |
$1,276.51 |
| Rate for Payer: Aetna Commercial |
$1,148.86
|
| Rate for Payer: ASR ASR |
$1,238.21
|
| Rate for Payer: ASR Commercial |
$1,238.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.23
|
| Rate for Payer: BCN Commercial |
$989.68
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cofinity Commercial |
$1,199.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,021.21
|
| Rate for Payer: Healthscope Commercial |
$1,276.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,238.21
|
| Rate for Payer: Mclaren Commercial |
$1,148.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.03
|
| Rate for Payer: Nomi Health Commercial |
$1,046.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,123.33
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,276.51
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$492.37 |
| Max. Negotiated Rate |
$1,423.83 |
| Rate for Payer: Aetna Commercial |
$1,148.86
|
| Rate for Payer: Aetna Medicare |
$918.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: ASR ASR |
$1,238.21
|
| Rate for Payer: ASR Commercial |
$1,238.21
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,045.33
|
| Rate for Payer: BCN Commercial |
$989.68
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cofinity Commercial |
$1,199.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,021.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$1,276.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,238.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$918.60
|
| Rate for Payer: Mclaren Commercial |
$1,148.86
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.03
|
| Rate for Payer: Nomi Health Commercial |
$1,046.74
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,010.46
|
| Rate for Payer: PHP Medicaid |
$492.37
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.48
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$894.83
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,123.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,423.83
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP DNSP |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: VA VA |
$918.60
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$887.36
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$492.37 |
| Max. Negotiated Rate |
$1,423.83 |
| Rate for Payer: Aetna Commercial |
$798.62
|
| Rate for Payer: Aetna Medicare |
$918.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: ASR ASR |
$860.74
|
| Rate for Payer: ASR Commercial |
$860.74
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$726.66
|
| Rate for Payer: BCN Commercial |
$687.97
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$834.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$887.36
|
| Rate for Payer: Healthscope Whirlpool |
$860.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$918.60
|
| Rate for Payer: Mclaren Commercial |
$798.62
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: Nomi Health Commercial |
$727.64
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,010.46
|
| Rate for Payer: PHP Medicaid |
$492.37
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.50
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$622.04
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$780.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,423.83
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP DNSP |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: VA VA |
$918.60
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$887.36
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$576.78 |
| Max. Negotiated Rate |
$887.36 |
| Rate for Payer: Aetna Commercial |
$798.62
|
| Rate for Payer: ASR ASR |
$860.74
|
| Rate for Payer: ASR Commercial |
$860.74
|
| Rate for Payer: BCBS Trust/PPO |
$723.11
|
| Rate for Payer: BCN Commercial |
$687.97
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$834.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Healthscope Commercial |
$887.36
|
| Rate for Payer: Healthscope Whirlpool |
$860.74
|
| Rate for Payer: Mclaren Commercial |
$798.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: Nomi Health Commercial |
$727.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$780.88
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$718.71
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$467.16 |
| Max. Negotiated Rate |
$718.71 |
| Rate for Payer: Aetna Commercial |
$646.84
|
| Rate for Payer: ASR ASR |
$697.15
|
| Rate for Payer: ASR Commercial |
$697.15
|
| Rate for Payer: BCBS Trust/PPO |
$585.68
|
| Rate for Payer: BCN Commercial |
$557.22
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cofinity Commercial |
$675.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.97
|
| Rate for Payer: Healthscope Commercial |
$718.71
|
| Rate for Payer: Healthscope Whirlpool |
$697.15
|
| Rate for Payer: Mclaren Commercial |
$646.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.90
|
| Rate for Payer: Nomi Health Commercial |
$589.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.46
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$718.71
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$718.71 |
| Rate for Payer: Aetna Commercial |
$646.84
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$697.15
|
| Rate for Payer: ASR Commercial |
$697.15
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$588.55
|
| Rate for Payer: BCN Commercial |
$557.22
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cofinity Commercial |
$675.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$718.71
|
| Rate for Payer: Healthscope Whirlpool |
$697.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$646.84
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.90
|
| Rate for Payer: Nomi Health Commercial |
$589.34
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$223.39
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.73
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$503.82
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$646.01
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP DNSP |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: VA VA |
$416.78
|
|
