|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,357.34 |
| Max. Negotiated Rate |
$48,477.78 |
| Rate for Payer: Aetna Commercial |
$25,446.96
|
| Rate for Payer: Aetna Medicare |
$31,275.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,094.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,094.99
|
| Rate for Payer: ASR ASR |
$27,426.17
|
| Rate for Payer: BCBS Complete |
$17,176.77
|
| Rate for Payer: BCBS MAPPO |
$31,275.99
|
| Rate for Payer: BCBS Trust/PPO |
$23,312.24
|
| Rate for Payer: BCN Commercial |
$23,312.24
|
| Rate for Payer: BCN Medicare Advantage |
$31,275.99
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Commercial |
$26,577.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,275.99
|
| Rate for Payer: Healthscope Commercial |
$27,426.17
|
| Rate for Payer: Healthscope Whirlpool |
$28,274.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,275.99
|
| Rate for Payer: Mclaren Commercial |
$25,446.96
|
| Rate for Payer: Mclaren Medicaid |
$31,275.99
|
| Rate for Payer: Mclaren Medicare |
$31,275.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,839.79
|
| Rate for Payer: Meridian Medicaid |
$17,176.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,967.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,403.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Nomi Health Commercial |
$23,185.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: PACE Medicare |
$29,712.19
|
| Rate for Payer: PACE SWMI |
$31,275.99
|
| Rate for Payer: PHP Commercial |
$34,403.59
|
| Rate for Payer: PHP Medicaid |
$16,763.93
|
| Rate for Payer: PHP Medicare Advantage |
$31,275.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,357.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24,774.03
|
| Rate for Payer: Priority Health Medicare |
$31,275.99
|
| Rate for Payer: Priority Health Narrow Network |
$19,820.35
|
| Rate for Payer: Railroad Medicare Medicare |
$31,275.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,881.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31,275.99
|
| Rate for Payer: UHC Exchange |
$48,477.78
|
| Rate for Payer: UHC Medicaid |
$16,357.34
|
| Rate for Payer: UHCCP DNSP |
$31,275.99
|
| Rate for Payer: UHCCP Medicaid |
$16,357.34
|
| Rate for Payer: VA VA |
$31,275.99
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,205.80 |
| Max. Negotiated Rate |
$28,274.40 |
| Rate for Payer: Aetna Commercial |
$25,446.96
|
| Rate for Payer: ASR ASR |
$27,426.17
|
| Rate for Payer: BCBS Trust/PPO |
$23,218.94
|
| Rate for Payer: BCN Commercial |
$23,218.94
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Commercial |
$26,577.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Healthscope Commercial |
$27,426.17
|
| Rate for Payer: Healthscope Whirlpool |
$28,274.40
|
| Rate for Payer: Mclaren Commercial |
$25,446.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Nomi Health Commercial |
$23,185.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,881.47
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,754.97 |
| Max. Negotiated Rate |
$11,673.29 |
| Rate for Payer: Aetna Commercial |
$10,505.96
|
| Rate for Payer: ASR ASR |
$11,323.09
|
| Rate for Payer: BCBS Trust/PPO |
$9,586.11
|
| Rate for Payer: BCN Commercial |
$9,586.11
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Commercial |
$10,972.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Healthscope Commercial |
$11,323.09
|
| Rate for Payer: Healthscope Whirlpool |
$11,673.29
|
| Rate for Payer: Mclaren Commercial |
$10,505.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Nomi Health Commercial |
$9,572.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,272.50
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,182.98 |
| Max. Negotiated Rate |
$34,353.56 |
| Rate for Payer: Aetna Commercial |
$10,505.96
|
| Rate for Payer: Aetna Medicare |
$22,163.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,704.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,704.49
|
| Rate for Payer: ASR ASR |
$11,323.09
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$9,624.63
|
| Rate for Payer: BCN Commercial |
$9,624.63
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Commercial |
$10,972.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$11,323.09
|
| Rate for Payer: Healthscope Whirlpool |
$11,673.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,163.59
|
| Rate for Payer: Mclaren Commercial |
$10,505.96
|
| Rate for Payer: Mclaren Medicaid |
$22,163.59
|
| Rate for Payer: Mclaren Medicare |
$22,163.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,271.77
|
| Rate for Payer: Meridian Medicaid |
$12,172.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,488.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,379.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Nomi Health Commercial |
$9,572.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: PACE Medicare |
$21,055.41
|
| Rate for Payer: PACE SWMI |
$22,163.59
|
| Rate for Payer: PHP Commercial |
$24,379.95
|
| Rate for Payer: PHP Medicaid |
$11,879.68
|
| Rate for Payer: PHP Medicare Advantage |
$22,163.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,591.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,228.14
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health Narrow Network |
$8,182.98
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,272.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,163.59
|
| Rate for Payer: UHC Exchange |
$34,353.56
|
| Rate for Payer: UHC Medicaid |
$11,591.56
|
| Rate for Payer: UHCCP DNSP |
$22,163.59
|
| Rate for Payer: UHCCP Medicaid |
$11,591.56
|
| Rate for Payer: VA VA |
$22,163.59
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,943.34 |
| Max. Negotiated Rate |
$5,771.46 |
| Rate for Payer: Aetna Commercial |
$2,495.02
|
| Rate for Payer: Aetna Medicare |
$3,723.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: ASR ASR |
$2,689.07
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,285.71
|
| Rate for Payer: BCN Commercial |
$2,285.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Commercial |
$2,605.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$2,689.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,772.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,723.52
|
| Rate for Payer: Mclaren Commercial |
$2,495.02
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$2,044.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Nomi Health Commercial |
$2,273.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$4,095.87
|
| Rate for Payer: PHP Medicaid |
$1,995.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,429.04
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Exchange |
$5,771.46
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP DNSP |
$3,723.52
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: VA VA |
$3,723.52
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,079.18 |
| Max. Negotiated Rate |
$2,772.24 |
| Rate for Payer: Aetna Commercial |
$2,495.02
|
| Rate for Payer: ASR ASR |
$2,689.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.56
|
| Rate for Payer: BCN Commercial |
$2,276.56
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Commercial |
$2,605.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Healthscope Commercial |
$2,689.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,772.24
|
| Rate for Payer: Mclaren Commercial |
$2,495.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Nomi Health Commercial |
$2,273.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.57
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$3,227.50 |
| Rate for Payer: Aetna Commercial |
$2,904.75
|
| Rate for Payer: Aetna Medicare |
$2,055.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: ASR ASR |
$3,130.68
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.07
|
| Rate for Payer: BCN Commercial |
$2,661.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Commercial |
$3,033.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$3,130.68
|
| Rate for Payer: Healthscope Whirlpool |
$3,227.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,055.86
|
| Rate for Payer: Mclaren Commercial |
$2,904.75
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$1,129.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Nomi Health Commercial |
$2,646.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,261.45
|
| Rate for Payer: PHP Medicaid |
$1,101.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,827.94
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,262.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$3,186.58
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP DNSP |
$2,055.86
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,420.62 |
| Max. Negotiated Rate |
$3,227.50 |
| Rate for Payer: Aetna Commercial |
$2,904.75
|
| Rate for Payer: ASR ASR |
$3,130.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,650.42
|
| Rate for Payer: BCN Commercial |
$2,650.42
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Commercial |
$3,033.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Healthscope Commercial |
$3,130.68
|
| Rate for Payer: Healthscope Whirlpool |
$3,227.50
|
| Rate for Payer: Mclaren Commercial |
$2,904.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Nomi Health Commercial |
$2,646.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.20
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,020.77 |
| Max. Negotiated Rate |
$20,027.70 |
| Rate for Payer: Aetna Commercial |
$18,024.93
|
| Rate for Payer: ASR ASR |
$19,426.87
|
| Rate for Payer: BCBS Trust/PPO |
$16,446.75
|
| Rate for Payer: BCN Commercial |
$16,446.75
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Commercial |
$18,826.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Healthscope Commercial |
$19,426.87
|
| Rate for Payer: Healthscope Whirlpool |
$20,027.70
|
| Rate for Payer: Mclaren Commercial |
$18,024.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Nomi Health Commercial |
$16,422.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,624.38
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,039.42 |
| Max. Negotiated Rate |
$48,477.78 |
| Rate for Payer: Aetna Commercial |
$18,024.93
|
| Rate for Payer: Aetna Medicare |
$31,275.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,094.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,094.99
|
| Rate for Payer: ASR ASR |
$19,426.87
|
| Rate for Payer: BCBS Complete |
$17,176.77
|
| Rate for Payer: BCBS MAPPO |
$31,275.99
|
| Rate for Payer: BCBS Trust/PPO |
$16,512.84
|
| Rate for Payer: BCN Commercial |
$16,512.84
|
| Rate for Payer: BCN Medicare Advantage |
$31,275.99
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Commercial |
$18,826.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,275.99
|
| Rate for Payer: Healthscope Commercial |
$19,426.87
|
| Rate for Payer: Healthscope Whirlpool |
$20,027.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,275.99
|
| Rate for Payer: Mclaren Commercial |
$18,024.93
|
| Rate for Payer: Mclaren Medicaid |
$31,275.99
|
| Rate for Payer: Mclaren Medicare |
$31,275.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,839.79
|
| Rate for Payer: Meridian Medicaid |
$17,176.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,967.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,403.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Nomi Health Commercial |
$16,422.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: PACE Medicare |
$29,712.19
|
| Rate for Payer: PACE SWMI |
$31,275.99
|
| Rate for Payer: PHP Commercial |
$34,403.59
|
| Rate for Payer: PHP Medicaid |
$16,763.93
|
| Rate for Payer: PHP Medicare Advantage |
$31,275.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,357.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,548.27
|
| Rate for Payer: Priority Health Medicare |
$31,275.99
|
| Rate for Payer: Priority Health Narrow Network |
$14,039.42
|
| Rate for Payer: Railroad Medicare Medicare |
$31,275.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,624.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31,275.99
|
| Rate for Payer: UHC Exchange |
$48,477.78
|
| Rate for Payer: UHC Medicaid |
$16,357.34
|
| Rate for Payer: UHCCP DNSP |
$31,275.99
|
| Rate for Payer: UHCCP Medicaid |
$16,357.34
|
| Rate for Payer: VA VA |
$31,275.99
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,527.43 |
| Max. Negotiated Rate |
$2,036.58 |
| Rate for Payer: Aetna Commercial |
$1,832.92
|
| Rate for Payer: ASR ASR |
$1,975.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.44
|
| Rate for Payer: BCN Commercial |
$1,672.44
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Commercial |
$1,914.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Healthscope Commercial |
$1,975.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,036.58
|
| Rate for Payer: Mclaren Commercial |
$1,832.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Nomi Health Commercial |
$1,670.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,792.19
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$753.53 |
| Max. Negotiated Rate |
$2,036.58 |
| Rate for Payer: Aetna Commercial |
$1,832.92
|
| Rate for Payer: Aetna Medicare |
$753.53
|
| Rate for Payer: ASR ASR |
$1,975.48
|
| Rate for Payer: BCBS Complete |
$814.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,679.16
|
| Rate for Payer: BCN Commercial |
$1,679.16
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Commercial |
$1,914.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Healthscope Commercial |
$1,975.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,036.58
|
| Rate for Payer: Mclaren Commercial |
$1,832.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,629.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Nomi Health Commercial |
$1,670.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,784.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,427.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,792.19
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.18 |
| Max. Negotiated Rate |
$264.24 |
| Rate for Payer: Aetna Commercial |
$237.82
|
| Rate for Payer: ASR ASR |
$256.31
|
| Rate for Payer: BCBS Trust/PPO |
$216.99
|
| Rate for Payer: BCN Commercial |
$216.99
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Commercial |
$248.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Healthscope Commercial |
$256.31
|
| Rate for Payer: Healthscope Whirlpool |
$264.24
|
| Rate for Payer: Mclaren Commercial |
$237.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Nomi Health Commercial |
$216.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.53
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$237.82
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$256.31
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$217.87
|
| Rate for Payer: BCN Commercial |
$217.87
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Commercial |
$248.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$256.31
|
| Rate for Payer: Healthscope Whirlpool |
$264.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$237.82
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Nomi Health Commercial |
$216.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.38
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$217.90
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.84 |
| Max. Negotiated Rate |
$30.46 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: ASR ASR |
$29.55
|
| Rate for Payer: BCBS Trust/PPO |
$25.01
|
| Rate for Payer: BCN Commercial |
$25.01
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$29.55
|
| Rate for Payer: Healthscope Whirlpool |
$30.46
|
| Rate for Payer: Mclaren Commercial |
$27.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Nomi Health Commercial |
$24.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.80
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$30.46 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: ASR ASR |
$29.55
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$25.11
|
| Rate for Payer: BCN Commercial |
$25.11
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$29.55
|
| Rate for Payer: Healthscope Whirlpool |
$30.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$27.41
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Nomi Health Commercial |
$24.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$21.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$202.10 |
| Max. Negotiated Rate |
$546.22 |
| Rate for Payer: Aetna Commercial |
$491.60
|
| Rate for Payer: Aetna Medicare |
$202.10
|
| Rate for Payer: ASR ASR |
$529.83
|
| Rate for Payer: BCBS Complete |
$218.49
|
| Rate for Payer: BCBS Trust/PPO |
$450.36
|
| Rate for Payer: BCN Commercial |
$450.36
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Commercial |
$513.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Healthscope Commercial |
$529.83
|
| Rate for Payer: Healthscope Whirlpool |
$546.22
|
| Rate for Payer: Mclaren Commercial |
$491.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Nomi Health Commercial |
$447.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$478.60
|
| Rate for Payer: Priority Health Narrow Network |
$382.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$480.67
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.67 |
| Max. Negotiated Rate |
$546.22 |
| Rate for Payer: Aetna Commercial |
$491.60
|
| Rate for Payer: ASR ASR |
$529.83
|
| Rate for Payer: BCBS Trust/PPO |
$448.56
|
| Rate for Payer: BCN Commercial |
$448.56
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Commercial |
$513.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Healthscope Commercial |
$529.83
|
| Rate for Payer: Healthscope Whirlpool |
$546.22
|
| Rate for Payer: Mclaren Commercial |
$491.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Nomi Health Commercial |
$447.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$480.67
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$205.61 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$855.49
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$922.02
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$783.72
|
| Rate for Payer: BCN Commercial |
$783.72
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$893.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$922.02
|
| Rate for Payer: Healthscope Whirlpool |
$950.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$855.49
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Nomi Health Commercial |
$779.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.01
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$205.61
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$836.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$712.90 |
| Max. Negotiated Rate |
$950.54 |
| Rate for Payer: Aetna Commercial |
$855.49
|
| Rate for Payer: ASR ASR |
$922.02
|
| Rate for Payer: BCBS Trust/PPO |
$780.58
|
| Rate for Payer: BCN Commercial |
$780.58
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$893.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Healthscope Commercial |
$922.02
|
| Rate for Payer: Healthscope Whirlpool |
$950.54
|
| Rate for Payer: Mclaren Commercial |
$855.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Nomi Health Commercial |
$779.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$836.48
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$184.98 |
| Max. Negotiated Rate |
$499.95 |
| Rate for Payer: Aetna Commercial |
$449.95
|
| Rate for Payer: Aetna Medicare |
$184.98
|
| Rate for Payer: ASR ASR |
$484.95
|
| Rate for Payer: BCBS Complete |
$199.98
|
| Rate for Payer: BCBS Trust/PPO |
$412.21
|
| Rate for Payer: BCN Commercial |
$412.21
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Commercial |
$469.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Healthscope Commercial |
$484.95
|
| Rate for Payer: Healthscope Whirlpool |
$499.95
|
| Rate for Payer: Mclaren Commercial |
$449.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Nomi Health Commercial |
$409.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$438.06
|
| Rate for Payer: Priority Health Narrow Network |
$350.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.96
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.96 |
| Max. Negotiated Rate |
$499.95 |
| Rate for Payer: Aetna Commercial |
$449.95
|
| Rate for Payer: ASR ASR |
$484.95
|
| Rate for Payer: BCBS Trust/PPO |
$410.56
|
| Rate for Payer: BCN Commercial |
$410.56
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Commercial |
$469.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Healthscope Commercial |
$484.95
|
| Rate for Payer: Healthscope Whirlpool |
$499.95
|
| Rate for Payer: Mclaren Commercial |
$449.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Nomi Health Commercial |
$409.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.96
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$866.26 |
| Rate for Payer: Aetna Commercial |
$779.63
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$840.27
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$714.23
|
| Rate for Payer: BCN Commercial |
$714.23
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Commercial |
$814.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$840.27
|
| Rate for Payer: Healthscope Whirlpool |
$866.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$779.63
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$710.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$517.30
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$413.84
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$649.70 |
| Max. Negotiated Rate |
$866.26 |
| Rate for Payer: Aetna Commercial |
$779.63
|
| Rate for Payer: ASR ASR |
$840.27
|
| Rate for Payer: BCBS Trust/PPO |
$711.37
|
| Rate for Payer: BCN Commercial |
$711.37
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Commercial |
$814.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Healthscope Commercial |
$840.27
|
| Rate for Payer: Healthscope Whirlpool |
$866.26
|
| Rate for Payer: Mclaren Commercial |
$779.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$710.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.31
|
|
|
HC IFR MEASUREMENT
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,967.11 |
| Max. Negotiated Rate |
$3,956.14 |
| Rate for Payer: Aetna Commercial |
$3,560.53
|
| Rate for Payer: ASR ASR |
$3,837.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,248.78
|
| Rate for Payer: BCN Commercial |
$3,248.78
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,718.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Healthscope Commercial |
$3,837.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,956.14
|
| Rate for Payer: Mclaren Commercial |
$3,560.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,481.40
|
|
