|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$5,627.68 |
| Rate for Payer: Aetna Commercial |
$5,064.91
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$5,458.85
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,640.02
|
| Rate for Payer: BCN Commercial |
$4,640.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Commercial |
$5,290.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$5,458.85
|
| Rate for Payer: Healthscope Whirlpool |
$5,627.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$5,064.91
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Nomi Health Commercial |
$4,614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,202.28
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$3,361.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,952.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.01 |
| Max. Negotiated Rate |
$113.55 |
| Rate for Payer: Aetna Commercial |
$102.19
|
| Rate for Payer: Aetna Medicare |
$42.01
|
| Rate for Payer: ASR ASR |
$110.14
|
| Rate for Payer: BCBS Complete |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$93.62
|
| Rate for Payer: BCN Commercial |
$93.62
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Commercial |
$106.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Healthscope Commercial |
$110.14
|
| Rate for Payer: Healthscope Whirlpool |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$102.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Nomi Health Commercial |
$93.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$99.49
|
| Rate for Payer: Priority Health Narrow Network |
$79.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.92
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.16 |
| Max. Negotiated Rate |
$113.55 |
| Rate for Payer: Aetna Commercial |
$102.19
|
| Rate for Payer: ASR ASR |
$110.14
|
| Rate for Payer: BCBS Trust/PPO |
$93.25
|
| Rate for Payer: BCN Commercial |
$93.25
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Commercial |
$106.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Healthscope Commercial |
$110.14
|
| Rate for Payer: Healthscope Whirlpool |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$102.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Nomi Health Commercial |
$93.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.92
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$317.16 |
| Max. Negotiated Rate |
$1,141.44 |
| Rate for Payer: Aetna Commercial |
$449.85
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$484.84
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$412.11
|
| Rate for Payer: BCN Commercial |
$412.11
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$469.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$484.84
|
| Rate for Payer: Healthscope Whirlpool |
$499.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$449.85
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$396.45
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$317.16
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$374.87 |
| Max. Negotiated Rate |
$499.83 |
| Rate for Payer: Aetna Commercial |
$449.85
|
| Rate for Payer: ASR ASR |
$484.84
|
| Rate for Payer: BCBS Trust/PPO |
$410.46
|
| Rate for Payer: BCN Commercial |
$410.46
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$469.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Healthscope Commercial |
$484.84
|
| Rate for Payer: Healthscope Whirlpool |
$499.83
|
| Rate for Payer: Mclaren Commercial |
$449.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.85
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$756.35 |
| Max. Negotiated Rate |
$2,044.20 |
| Rate for Payer: Aetna Commercial |
$1,839.78
|
| Rate for Payer: Aetna Medicare |
$756.35
|
| Rate for Payer: ASR ASR |
$1,982.87
|
| Rate for Payer: BCBS Complete |
$817.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.44
|
| Rate for Payer: BCN Commercial |
$1,685.44
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Commercial |
$1,921.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Healthscope Commercial |
$1,982.87
|
| Rate for Payer: Healthscope Whirlpool |
$2,044.20
|
| Rate for Payer: Mclaren Commercial |
$1,839.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,635.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Nomi Health Commercial |
$1,676.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,791.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,432.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,798.90
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,533.15 |
| Max. Negotiated Rate |
$2,044.20 |
| Rate for Payer: Aetna Commercial |
$1,839.78
|
| Rate for Payer: ASR ASR |
$1,982.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.70
|
| Rate for Payer: BCN Commercial |
$1,678.70
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Commercial |
$1,921.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Healthscope Commercial |
$1,982.87
|
| Rate for Payer: Healthscope Whirlpool |
$2,044.20
|
| Rate for Payer: Mclaren Commercial |
$1,839.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Nomi Health Commercial |
$1,676.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,798.90
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$640.89 |
| Rate for Payer: Aetna Commercial |
$576.80
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$621.66
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$528.41
|
| Rate for Payer: BCN Commercial |
$528.41
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Commercial |
$602.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$621.66
|
| Rate for Payer: Healthscope Whirlpool |
$640.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$576.80
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$593.18
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$474.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$563.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.67 |
| Max. Negotiated Rate |
$640.89 |
| Rate for Payer: Aetna Commercial |
$576.80
|
| Rate for Payer: ASR ASR |
$621.66
|
| Rate for Payer: BCBS Trust/PPO |
$526.30
|
| Rate for Payer: BCN Commercial |
$526.30
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Commercial |
$602.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Healthscope Commercial |
$621.66
|
| Rate for Payer: Healthscope Whirlpool |
$640.89
|
| Rate for Payer: Mclaren Commercial |
$576.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$563.98
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,097.05 |
| Max. Negotiated Rate |
$8,129.40 |
| Rate for Payer: Aetna Commercial |
$7,316.46
|
| Rate for Payer: ASR ASR |
$7,885.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,675.86
|
| Rate for Payer: BCN Commercial |
$6,675.86
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cofinity Commercial |
$7,641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,503.52
|
| Rate for Payer: Healthscope Commercial |
$7,885.52
|
| Rate for Payer: Healthscope Whirlpool |
$8,129.40
|
| Rate for Payer: Mclaren Commercial |
$7,316.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,909.99
|
| Rate for Payer: Nomi Health Commercial |
$6,666.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,097.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,153.87
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$8,129.40 |
| Rate for Payer: Aetna Commercial |
$7,316.46
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$7,885.52
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,702.69
|
| Rate for Payer: BCN Commercial |
$6,702.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cofinity Commercial |
$7,641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,503.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,885.52
|
| Rate for Payer: Healthscope Whirlpool |
$8,129.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$7,316.46
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,909.99
|
| Rate for Payer: Nomi Health Commercial |
$6,666.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,097.05
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,368.98
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,695.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,153.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
IP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,611.25 |
| Max. Negotiated Rate |
$8,815.00 |
| Rate for Payer: Aetna Commercial |
$7,933.50
|
| Rate for Payer: ASR ASR |
$8,550.55
|
| Rate for Payer: BCBS Trust/PPO |
$7,238.88
|
| Rate for Payer: BCN Commercial |
$7,238.88
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Commercial |
$8,286.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$8,550.55
|
| Rate for Payer: Healthscope Whirlpool |
$8,815.00
|
| Rate for Payer: Mclaren Commercial |
$7,933.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Nomi Health Commercial |
$7,228.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,757.20
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
OP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$8,815.00 |
| Rate for Payer: Aetna Commercial |
$7,933.50
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$8,550.55
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$7,267.97
|
| Rate for Payer: BCN Commercial |
$7,267.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Commercial |
$8,286.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$8,550.55
|
| Rate for Payer: Healthscope Whirlpool |
$8,815.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$7,933.50
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Nomi Health Commercial |
$7,228.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,368.98
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,695.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,757.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$557.58
|
| Rate for Payer: BCN Commercial |
$557.58
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$655.97
|
| Rate for Payer: Healthscope Whirlpool |
$676.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$593.18
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$474.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$507.19 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$555.34
|
| Rate for Payer: BCN Commercial |
$555.34
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$655.97
|
| Rate for Payer: Healthscope Whirlpool |
$676.26
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,423.70 |
| Max. Negotiated Rate |
$1,898.27 |
| Rate for Payer: Aetna Commercial |
$1,708.44
|
| Rate for Payer: ASR ASR |
$1,841.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.86
|
| Rate for Payer: BCN Commercial |
$1,558.86
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Commercial |
$1,784.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Healthscope Commercial |
$1,841.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,898.27
|
| Rate for Payer: Mclaren Commercial |
$1,708.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Nomi Health Commercial |
$1,556.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,670.48
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,708.44
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,841.32
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.12
|
| Rate for Payer: BCN Commercial |
$1,565.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Commercial |
$1,784.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,841.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,898.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,708.44
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Nomi Health Commercial |
$1,556.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,170.54
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,736.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,670.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$742.58 |
| Max. Negotiated Rate |
$990.10 |
| Rate for Payer: Aetna Commercial |
$891.09
|
| Rate for Payer: ASR ASR |
$960.40
|
| Rate for Payer: BCBS Trust/PPO |
$813.07
|
| Rate for Payer: BCN Commercial |
$813.07
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Commercial |
$930.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Healthscope Commercial |
$960.40
|
| Rate for Payer: Healthscope Whirlpool |
$990.10
|
| Rate for Payer: Mclaren Commercial |
$891.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$811.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$871.29
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$891.09
|
| 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 |
$960.40
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$816.34
|
| Rate for Payer: BCN Commercial |
$816.34
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Commercial |
$930.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$960.40
|
| Rate for Payer: Healthscope Whirlpool |
$990.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$891.09
|
| 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 |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$811.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| 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 |
$867.53
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$694.06
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$871.29
|
| 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 INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.92 |
| Max. Negotiated Rate |
$303.89 |
| Rate for Payer: Aetna Commercial |
$273.50
|
| Rate for Payer: ASR ASR |
$294.77
|
| Rate for Payer: BCBS Trust/PPO |
$249.55
|
| Rate for Payer: BCN Commercial |
$249.55
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Commercial |
$285.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Healthscope Commercial |
$294.77
|
| Rate for Payer: Healthscope Whirlpool |
$303.89
|
| Rate for Payer: Mclaren Commercial |
$273.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$249.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.42
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$385.87 |
| Rate for Payer: Aetna Commercial |
$273.50
|
| Rate for Payer: Aetna Medicare |
$248.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: ASR ASR |
$294.77
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$250.56
|
| Rate for Payer: BCN Commercial |
$250.56
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Commercial |
$285.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$294.77
|
| Rate for Payer: Healthscope Whirlpool |
$303.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$248.95
|
| Rate for Payer: Mclaren Commercial |
$273.50
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$136.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$249.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$273.85
|
| Rate for Payer: PHP Medicaid |
$133.44
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$382.05
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Narrow Network |
$305.64
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$385.87
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP DNSP |
$248.95
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,264.09
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$1,362.40
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.04
|
| Rate for Payer: BCN Commercial |
$1,158.04
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,320.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,362.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,404.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$1,264.09
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,230.66
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$984.58
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,053.40 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,264.09
|
| Rate for Payer: ASR ASR |
$1,362.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.41
|
| Rate for Payer: BCN Commercial |
$1,153.41
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,320.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,362.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,404.54
|
| Rate for Payer: Mclaren Commercial |
$1,264.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.00
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Aetna Commercial |
$2,568.23
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$2,767.98
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,352.78
|
| Rate for Payer: BCN Commercial |
$2,352.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Commercial |
$2,682.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,767.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,853.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$2,568.23
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Nomi Health Commercial |
$2,339.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,500.32
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,000.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,511.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,140.19 |
| Max. Negotiated Rate |
$2,853.59 |
| Rate for Payer: Aetna Commercial |
$2,568.23
|
| Rate for Payer: ASR ASR |
$2,767.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,343.37
|
| Rate for Payer: BCN Commercial |
$2,343.37
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Commercial |
$2,682.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Healthscope Commercial |
$2,767.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,853.59
|
| Rate for Payer: Mclaren Commercial |
$2,568.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Nomi Health Commercial |
$2,339.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,511.16
|
|
