|
HC INITIAT MED TX IN ER
|
Facility
|
OP
|
$161.26
|
|
|
Service Code
|
HCPCS G2213
|
| Hospital Charge Code |
45000106
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$161.26 |
| Rate for Payer: Aetna Commercial |
$145.13
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: ASR ASR |
$156.42
|
| Rate for Payer: BCBS Complete |
$64.50
|
| Rate for Payer: BCBS Trust/PPO |
$132.96
|
| Rate for Payer: BCN Commercial |
$132.96
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$151.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$156.42
|
| Rate for Payer: Healthscope Whirlpool |
$161.26
|
| Rate for Payer: Mclaren Commercial |
$145.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$141.30
|
| Rate for Payer: Priority Health Narrow Network |
$113.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.91
|
|
|
HC INITIAT MED TX IN ER
|
Facility
|
IP
|
$161.26
|
|
|
Service Code
|
HCPCS G2213
|
| Hospital Charge Code |
45000106
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.94 |
| Max. Negotiated Rate |
$161.26 |
| Rate for Payer: Aetna Commercial |
$145.13
|
| Rate for Payer: ASR ASR |
$156.42
|
| Rate for Payer: BCBS Trust/PPO |
$132.43
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$151.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$156.42
|
| Rate for Payer: Healthscope Whirlpool |
$161.26
|
| Rate for Payer: Mclaren Commercial |
$145.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.91
|
|
|
HC INIT SUB PSYCH 1ST 30 MIN
|
Facility
|
IP
|
$129.47
|
|
|
Service Code
|
HCPCS G2214
|
| Hospital Charge Code |
76100344
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$97.10 |
| Max. Negotiated Rate |
$129.47 |
| Rate for Payer: Aetna Commercial |
$116.52
|
| Rate for Payer: ASR ASR |
$125.59
|
| Rate for Payer: BCBS Trust/PPO |
$106.32
|
| Rate for Payer: BCN Commercial |
$106.32
|
| Rate for Payer: Cash Price |
$103.58
|
| Rate for Payer: Cofinity Commercial |
$121.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.58
|
| Rate for Payer: Healthscope Commercial |
$125.59
|
| Rate for Payer: Healthscope Whirlpool |
$129.47
|
| Rate for Payer: Mclaren Commercial |
$116.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.05
|
| Rate for Payer: Nomi Health Commercial |
$106.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.93
|
|
|
HC INIT SUB PSYCH 1ST 30 MIN
|
Facility
|
OP
|
$129.47
|
|
|
Service Code
|
HCPCS G2214
|
| Hospital Charge Code |
76100344
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$156.89 |
| Rate for Payer: Aetna Commercial |
$116.52
|
| Rate for Payer: Aetna Medicare |
$101.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: ASR ASR |
$125.59
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$106.75
|
| Rate for Payer: BCN Commercial |
$106.75
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$103.58
|
| Rate for Payer: Cash Price |
$103.58
|
| Rate for Payer: Cofinity Commercial |
$121.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$125.59
|
| Rate for Payer: Healthscope Whirlpool |
$129.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$101.22
|
| Rate for Payer: Mclaren Commercial |
$116.52
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$55.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.05
|
| Rate for Payer: Nomi Health Commercial |
$106.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.10
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: PHP Medicaid |
$54.25
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.44
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health Narrow Network |
$90.76
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$156.89
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP DNSP |
$101.22
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC INJ AIR CONTRAST PERITONEAL CAVITY
|
Facility
|
OP
|
$983.76
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
36100446
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.99 |
| Max. Negotiated Rate |
$983.76 |
| Rate for Payer: Aetna Commercial |
$885.38
|
| Rate for Payer: Aetna Medicare |
$363.99
|
| Rate for Payer: ASR ASR |
$954.25
|
| Rate for Payer: BCBS Complete |
$393.50
|
| Rate for Payer: BCBS Trust/PPO |
$811.11
|
| Rate for Payer: BCN Commercial |
$811.11
|
| Rate for Payer: Cash Price |
$787.01
|
| Rate for Payer: Cofinity Commercial |
$924.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.01
|
| Rate for Payer: Healthscope Commercial |
$954.25
|
| Rate for Payer: Healthscope Whirlpool |
$983.76
|
| Rate for Payer: Mclaren Commercial |
$885.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$787.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.20
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$861.97
|
| Rate for Payer: Priority Health Narrow Network |
$689.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.71
|
|
|
HC INJ AIR CONTRAST PERITONEAL CAVITY
|
Facility
|
IP
|
$983.76
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
36100446
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.82 |
| Max. Negotiated Rate |
$983.76 |
| Rate for Payer: Aetna Commercial |
$885.38
|
| Rate for Payer: ASR ASR |
$954.25
|
| Rate for Payer: BCBS Trust/PPO |
$807.86
|
| Rate for Payer: BCN Commercial |
$807.86
|
| Rate for Payer: Cash Price |
$787.01
|
| Rate for Payer: Cofinity Commercial |
$924.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.01
|
| Rate for Payer: Healthscope Commercial |
$954.25
|
| Rate for Payer: Healthscope Whirlpool |
$983.76
|
| Rate for Payer: Mclaren Commercial |
$885.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.20
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.71
|
|
|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
IP
|
$1,292.55
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.41 |
| Max. Negotiated Rate |
$1,292.55 |
| Rate for Payer: Aetna Commercial |
$1,163.30
|
| Rate for Payer: ASR ASR |
$1,253.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.44
|
| Rate for Payer: BCN Commercial |
$1,061.44
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cofinity Commercial |
$1,215.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Healthscope Commercial |
$1,253.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.55
|
| Rate for Payer: Mclaren Commercial |
$1,163.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.44
|
|
|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
OP
|
$1,292.55
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,366.00 |
| Rate for Payer: Aetna Commercial |
$1,163.30
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,253.77
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.71
|
| Rate for Payer: BCN Commercial |
$1,065.71
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cofinity Commercial |
$1,215.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,253.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$1,163.30
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,132.53
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$906.08
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
IP
|
$1,892.32
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,419.24 |
| Max. Negotiated Rate |
$1,892.32 |
| Rate for Payer: Aetna Commercial |
$1,703.09
|
| Rate for Payer: Aetna Commercial |
$2,554.64
|
| Rate for Payer: ASR ASR |
$1,835.55
|
| Rate for Payer: ASR ASR |
$2,753.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,330.97
|
| Rate for Payer: BCN Commercial |
$1,553.97
|
| Rate for Payer: BCN Commercial |
$2,330.97
|
| Rate for Payer: Cash Price |
$2,270.79
|
| Rate for Payer: Cash Price |
$1,513.86
|
| Rate for Payer: Cofinity Commercial |
$2,668.18
|
| Rate for Payer: Cofinity Commercial |
$1,778.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.79
|
| Rate for Payer: Healthscope Commercial |
$1,835.55
|
| Rate for Payer: Healthscope Commercial |
$2,753.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,838.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,892.32
|
| Rate for Payer: Mclaren Commercial |
$2,554.64
|
| Rate for Payer: Mclaren Commercial |
$1,703.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.47
|
| Rate for Payer: Nomi Health Commercial |
$2,327.56
|
| Rate for Payer: Nomi Health Commercial |
$1,551.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,128.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,497.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.24
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
OP
|
$1,892.32
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,892.32 |
| Rate for Payer: BCBS Trust/PPO |
$1,560.22
|
| Rate for Payer: BCN Commercial |
$2,340.34
|
| Rate for Payer: BCN Commercial |
$1,560.22
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,513.86
|
| Rate for Payer: Cash Price |
$1,513.86
|
| Rate for Payer: Cash Price |
$2,270.79
|
| Rate for Payer: Cash Price |
$2,270.79
|
| Rate for Payer: Cofinity Commercial |
$1,778.78
|
| Rate for Payer: Cofinity Commercial |
$2,668.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.79
|
| Rate for Payer: Aetna Commercial |
$1,703.09
|
| Rate for Payer: Aetna Commercial |
$2,554.64
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,835.55
|
| Rate for Payer: ASR ASR |
$2,753.34
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,340.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,835.55
|
| Rate for Payer: Healthscope Commercial |
$2,753.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,892.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,838.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$2,554.64
|
| Rate for Payer: Mclaren Commercial |
$1,703.09
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.72
|
| Rate for Payer: Nomi Health Commercial |
$2,327.56
|
| Rate for Payer: Nomi Health Commercial |
$1,551.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,128.87
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.02
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.02
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,497.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
OP
|
$1,292.55
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,366.00 |
| Rate for Payer: Aetna Commercial |
$1,163.30
|
| Rate for Payer: Aetna Commercial |
$1,744.96
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,880.67
|
| Rate for Payer: ASR ASR |
$1,253.77
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.71
|
| Rate for Payer: BCN Commercial |
$1,065.71
|
| Rate for Payer: BCN Commercial |
$1,598.57
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,551.07
|
| Rate for Payer: Cash Price |
$1,551.07
|
| Rate for Payer: Cofinity Commercial |
$1,215.00
|
| Rate for Payer: Cofinity Commercial |
$1,822.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,253.77
|
| Rate for Payer: Healthscope Commercial |
$1,880.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$1,744.96
|
| Rate for Payer: Mclaren Commercial |
$1,163.30
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Nomi Health Commercial |
$1,589.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,454.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,132.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,698.81
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$906.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.13
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,706.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
IP
|
$1,292.55
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.41 |
| Max. Negotiated Rate |
$1,292.55 |
| Rate for Payer: Aetna Commercial |
$1,163.30
|
| Rate for Payer: Aetna Commercial |
$1,744.96
|
| Rate for Payer: ASR ASR |
$1,253.77
|
| Rate for Payer: ASR ASR |
$1,880.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.18
|
| Rate for Payer: BCN Commercial |
$1,061.44
|
| Rate for Payer: BCN Commercial |
$1,592.18
|
| Rate for Payer: Cash Price |
$1,551.07
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cofinity Commercial |
$1,822.51
|
| Rate for Payer: Cofinity Commercial |
$1,215.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.07
|
| Rate for Payer: Healthscope Commercial |
$1,253.77
|
| Rate for Payer: Healthscope Commercial |
$1,880.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.55
|
| Rate for Payer: Mclaren Commercial |
$1,744.96
|
| Rate for Payer: Mclaren Commercial |
$1,163.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,589.85
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,454.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,706.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.44
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
IP
|
$1,949.46
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,462.10 |
| Max. Negotiated Rate |
$1,949.46 |
| Rate for Payer: Aetna Commercial |
$1,754.51
|
| Rate for Payer: Aetna Commercial |
$2,631.78
|
| Rate for Payer: ASR ASR |
$1,890.98
|
| Rate for Payer: ASR ASR |
$2,836.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,401.35
|
| Rate for Payer: BCN Commercial |
$1,600.90
|
| Rate for Payer: BCN Commercial |
$2,401.35
|
| Rate for Payer: Cash Price |
$2,339.36
|
| Rate for Payer: Cash Price |
$1,559.57
|
| Rate for Payer: Cofinity Commercial |
$2,748.75
|
| Rate for Payer: Cofinity Commercial |
$1,832.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,339.36
|
| Rate for Payer: Healthscope Commercial |
$1,890.98
|
| Rate for Payer: Healthscope Commercial |
$2,836.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,924.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,949.46
|
| Rate for Payer: Mclaren Commercial |
$2,631.78
|
| Rate for Payer: Mclaren Commercial |
$1,754.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,485.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,657.04
|
| Rate for Payer: Nomi Health Commercial |
$2,397.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,193.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,573.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,715.52
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
OP
|
$1,949.46
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,949.46 |
| Rate for Payer: Aetna Commercial |
$1,754.51
|
| Rate for Payer: Aetna Commercial |
$2,631.78
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,890.98
|
| Rate for Payer: ASR ASR |
$2,836.47
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.33
|
| Rate for Payer: BCN Commercial |
$2,411.00
|
| Rate for Payer: BCN Commercial |
$1,607.33
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,559.57
|
| Rate for Payer: Cash Price |
$1,559.57
|
| Rate for Payer: Cash Price |
$2,339.36
|
| Rate for Payer: Cash Price |
$2,339.36
|
| Rate for Payer: Cofinity Commercial |
$1,832.49
|
| Rate for Payer: Cofinity Commercial |
$2,748.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,339.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,890.98
|
| Rate for Payer: Healthscope Commercial |
$2,836.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,949.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,924.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$2,631.78
|
| Rate for Payer: Mclaren Commercial |
$1,754.51
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,657.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,485.57
|
| Rate for Payer: Nomi Health Commercial |
$2,397.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,193.15
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$744.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$744.49
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$595.59
|
| Rate for Payer: Priority Health Narrow Network |
$595.59
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,573.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,715.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
IP
|
$3,235.56
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,426.67 |
| Max. Negotiated Rate |
$3,235.56 |
| Rate for Payer: Aetna Commercial |
$2,912.00
|
| Rate for Payer: Aetna Commercial |
$4,368.01
|
| Rate for Payer: ASR ASR |
$3,138.49
|
| Rate for Payer: ASR ASR |
$4,707.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,657.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,985.56
|
| Rate for Payer: BCN Commercial |
$2,657.04
|
| Rate for Payer: BCN Commercial |
$3,985.56
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cofinity Commercial |
$4,562.14
|
| Rate for Payer: Cofinity Commercial |
$3,041.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Healthscope Commercial |
$3,138.49
|
| Rate for Payer: Healthscope Commercial |
$4,707.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,853.34
|
| Rate for Payer: Healthscope Whirlpool |
$3,235.56
|
| Rate for Payer: Mclaren Commercial |
$4,368.01
|
| Rate for Payer: Mclaren Commercial |
$2,912.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,270.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,847.29
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
OP
|
$3,235.56
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$3,235.56 |
| Rate for Payer: Aetna Commercial |
$2,912.00
|
| Rate for Payer: Aetna Commercial |
$4,368.01
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$3,138.49
|
| Rate for Payer: ASR ASR |
$4,707.74
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,001.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,667.72
|
| Rate for Payer: BCN Commercial |
$4,001.58
|
| Rate for Payer: BCN Commercial |
$2,667.72
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cofinity Commercial |
$3,041.43
|
| Rate for Payer: Cofinity Commercial |
$4,562.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$3,138.49
|
| Rate for Payer: Healthscope Commercial |
$4,707.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,235.56
|
| Rate for Payer: Healthscope Whirlpool |
$4,853.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$4,368.01
|
| Rate for Payer: Mclaren Commercial |
$2,912.00
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,270.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,847.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
OP
|
$2,600.63
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,600.63 |
| Rate for Payer: Aetna Commercial |
$2,340.57
|
| Rate for Payer: Aetna Commercial |
$3,510.86
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$2,522.61
|
| Rate for Payer: ASR ASR |
$3,783.92
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,216.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,144.22
|
| Rate for Payer: BCN Commercial |
$3,216.33
|
| Rate for Payer: BCN Commercial |
$2,144.22
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$2,080.50
|
| Rate for Payer: Cash Price |
$2,080.50
|
| Rate for Payer: Cash Price |
$3,120.76
|
| Rate for Payer: Cash Price |
$3,120.76
|
| Rate for Payer: Cofinity Commercial |
$2,444.59
|
| Rate for Payer: Cofinity Commercial |
$3,666.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,080.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$2,522.61
|
| Rate for Payer: Healthscope Commercial |
$3,783.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,600.63
|
| Rate for Payer: Healthscope Whirlpool |
$3,900.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$3,510.86
|
| Rate for Payer: Mclaren Commercial |
$2,340.57
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,210.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,315.81
|
| Rate for Payer: Nomi Health Commercial |
$3,198.78
|
| Rate for Payer: Nomi Health Commercial |
$2,132.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,925.71
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.02
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.02
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,432.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,288.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
IP
|
$2,600.63
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,950.47 |
| Max. Negotiated Rate |
$2,600.63 |
| Rate for Payer: Aetna Commercial |
$2,340.57
|
| Rate for Payer: Aetna Commercial |
$3,510.86
|
| Rate for Payer: ASR ASR |
$2,522.61
|
| Rate for Payer: ASR ASR |
$3,783.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,135.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.46
|
| Rate for Payer: BCN Commercial |
$2,135.64
|
| Rate for Payer: BCN Commercial |
$3,203.46
|
| Rate for Payer: Cash Price |
$3,120.76
|
| Rate for Payer: Cash Price |
$2,080.50
|
| Rate for Payer: Cofinity Commercial |
$3,666.89
|
| Rate for Payer: Cofinity Commercial |
$2,444.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,080.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.76
|
| Rate for Payer: Healthscope Commercial |
$2,522.61
|
| Rate for Payer: Healthscope Commercial |
$3,783.92
|
| Rate for Payer: Healthscope Whirlpool |
$3,900.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,600.63
|
| Rate for Payer: Mclaren Commercial |
$3,510.86
|
| Rate for Payer: Mclaren Commercial |
$2,340.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,315.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,210.54
|
| Rate for Payer: Nomi Health Commercial |
$3,198.78
|
| Rate for Payer: Nomi Health Commercial |
$2,132.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,925.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,432.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,288.55
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
IP
|
$1,492.45
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,119.34 |
| Max. Negotiated Rate |
$1,492.45 |
| Rate for Payer: Aetna Commercial |
$1,343.20
|
| Rate for Payer: Aetna Commercial |
$895.47
|
| Rate for Payer: ASR ASR |
$1,447.68
|
| Rate for Payer: ASR ASR |
$965.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.60
|
| Rate for Payer: BCBS Trust/PPO |
$817.07
|
| Rate for Payer: BCN Commercial |
$1,225.60
|
| Rate for Payer: BCN Commercial |
$817.07
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cash Price |
$1,193.96
|
| Rate for Payer: Cofinity Commercial |
$935.27
|
| Rate for Payer: Cofinity Commercial |
$1,402.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Healthscope Commercial |
$1,447.68
|
| Rate for Payer: Healthscope Commercial |
$965.12
|
| Rate for Payer: Healthscope Whirlpool |
$994.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.45
|
| Rate for Payer: Mclaren Commercial |
$895.47
|
| Rate for Payer: Mclaren Commercial |
$1,343.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.58
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Nomi Health Commercial |
$1,223.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.36
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
OP
|
$1,492.45
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,492.45 |
| Rate for Payer: Aetna Commercial |
$1,343.20
|
| Rate for Payer: Aetna Commercial |
$895.47
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,447.68
|
| Rate for Payer: ASR ASR |
$965.12
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$820.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.53
|
| Rate for Payer: BCN Commercial |
$820.35
|
| Rate for Payer: BCN Commercial |
$1,230.53
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,193.96
|
| Rate for Payer: Cash Price |
$1,193.96
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Commercial |
$1,402.90
|
| Rate for Payer: Cofinity Commercial |
$935.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,447.68
|
| Rate for Payer: Healthscope Commercial |
$965.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.45
|
| Rate for Payer: Healthscope Whirlpool |
$994.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$895.47
|
| Rate for Payer: Mclaren Commercial |
$1,343.20
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Nomi Health Commercial |
$1,223.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.65
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$518.12
|
| Rate for Payer: Priority Health Narrow Network |
$518.12
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
IP
|
$1,564.96
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,173.72 |
| Max. Negotiated Rate |
$1,564.96 |
| Rate for Payer: Aetna Commercial |
$1,408.46
|
| Rate for Payer: Aetna Commercial |
$2,112.70
|
| Rate for Payer: ASR ASR |
$1,518.01
|
| Rate for Payer: ASR ASR |
$2,277.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.72
|
| Rate for Payer: BCN Commercial |
$1,285.15
|
| Rate for Payer: BCN Commercial |
$1,927.72
|
| Rate for Payer: Cash Price |
$1,877.95
|
| Rate for Payer: Cash Price |
$1,251.97
|
| Rate for Payer: Cofinity Commercial |
$2,206.59
|
| Rate for Payer: Cofinity Commercial |
$1,471.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,877.95
|
| Rate for Payer: Healthscope Commercial |
$1,518.01
|
| Rate for Payer: Healthscope Commercial |
$2,277.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,347.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,564.96
|
| Rate for Payer: Mclaren Commercial |
$2,112.70
|
| Rate for Payer: Mclaren Commercial |
$1,408.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,995.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,330.22
|
| Rate for Payer: Nomi Health Commercial |
$1,924.90
|
| Rate for Payer: Nomi Health Commercial |
$1,283.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,760.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,065.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,377.16
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
OP
|
$1,564.96
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,564.96 |
| Rate for Payer: Aetna Commercial |
$1,408.46
|
| Rate for Payer: Aetna Commercial |
$2,112.70
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,518.01
|
| Rate for Payer: ASR ASR |
$2,277.02
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.31
|
| Rate for Payer: BCN Commercial |
$1,935.46
|
| Rate for Payer: BCN Commercial |
$1,290.31
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,251.97
|
| Rate for Payer: Cash Price |
$1,251.97
|
| Rate for Payer: Cash Price |
$1,877.95
|
| Rate for Payer: Cash Price |
$1,877.95
|
| Rate for Payer: Cofinity Commercial |
$1,471.06
|
| Rate for Payer: Cofinity Commercial |
$2,206.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,877.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,518.01
|
| Rate for Payer: Healthscope Commercial |
$2,277.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,564.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,347.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$2,112.70
|
| Rate for Payer: Mclaren Commercial |
$1,408.46
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,330.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,995.32
|
| Rate for Payer: Nomi Health Commercial |
$1,924.90
|
| Rate for Payer: Nomi Health Commercial |
$1,283.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,760.58
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,065.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,377.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
IP
|
$1,362.21
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,021.66 |
| Max. Negotiated Rate |
$1,362.21 |
| Rate for Payer: Aetna Commercial |
$1,225.99
|
| Rate for Payer: Aetna Commercial |
$817.33
|
| Rate for Payer: ASR ASR |
$1,321.34
|
| Rate for Payer: ASR ASR |
$880.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.65
|
| Rate for Payer: BCBS Trust/PPO |
$745.76
|
| Rate for Payer: BCN Commercial |
$1,118.65
|
| Rate for Payer: BCN Commercial |
$745.76
|
| Rate for Payer: Cash Price |
$726.51
|
| Rate for Payer: Cash Price |
$1,089.77
|
| Rate for Payer: Cofinity Commercial |
$853.65
|
| Rate for Payer: Cofinity Commercial |
$1,280.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.51
|
| Rate for Payer: Healthscope Commercial |
$1,321.34
|
| Rate for Payer: Healthscope Commercial |
$880.90
|
| Rate for Payer: Healthscope Whirlpool |
$908.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,362.21
|
| Rate for Payer: Mclaren Commercial |
$817.33
|
| Rate for Payer: Mclaren Commercial |
$1,225.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.88
|
| Rate for Payer: Nomi Health Commercial |
$744.67
|
| Rate for Payer: Nomi Health Commercial |
$1,117.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,198.74
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
OP
|
$1,362.21
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,362.21 |
| Rate for Payer: Aetna Commercial |
$1,225.99
|
| Rate for Payer: Aetna Commercial |
$817.33
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,321.34
|
| Rate for Payer: ASR ASR |
$880.90
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$748.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,123.14
|
| Rate for Payer: BCN Commercial |
$748.76
|
| Rate for Payer: BCN Commercial |
$1,123.14
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,089.77
|
| Rate for Payer: Cash Price |
$1,089.77
|
| Rate for Payer: Cash Price |
$726.51
|
| Rate for Payer: Cash Price |
$726.51
|
| Rate for Payer: Cofinity Commercial |
$1,280.48
|
| Rate for Payer: Cofinity Commercial |
$853.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,321.34
|
| Rate for Payer: Healthscope Commercial |
$880.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,362.21
|
| Rate for Payer: Healthscope Whirlpool |
$908.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$817.33
|
| Rate for Payer: Mclaren Commercial |
$1,225.99
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.92
|
| Rate for Payer: Nomi Health Commercial |
$744.67
|
| Rate for Payer: Nomi Health Commercial |
$1,117.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.11
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$657.32
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Priority Health Narrow Network |
$525.86
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,198.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
IP
|
$3,235.56
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,426.67 |
| Max. Negotiated Rate |
$3,235.56 |
| Rate for Payer: Aetna Commercial |
$2,912.00
|
| Rate for Payer: Aetna Commercial |
$4,368.01
|
| Rate for Payer: ASR ASR |
$3,138.49
|
| Rate for Payer: ASR ASR |
$4,707.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,657.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,985.56
|
| Rate for Payer: BCN Commercial |
$2,657.04
|
| Rate for Payer: BCN Commercial |
$3,985.56
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cofinity Commercial |
$4,562.14
|
| Rate for Payer: Cofinity Commercial |
$3,041.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Healthscope Commercial |
$3,138.49
|
| Rate for Payer: Healthscope Commercial |
$4,707.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,853.34
|
| Rate for Payer: Healthscope Whirlpool |
$3,235.56
|
| Rate for Payer: Mclaren Commercial |
$4,368.01
|
| Rate for Payer: Mclaren Commercial |
$2,912.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,270.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,847.29
|
|
