|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$587.84
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.88 |
| Max. Negotiated Rate |
$587.84 |
| Rate for Payer: Aetna Commercial |
$529.06
|
| Rate for Payer: ASR ASR |
$570.20
|
| Rate for Payer: BCBS Trust/PPO |
$482.73
|
| Rate for Payer: BCN Commercial |
$482.73
|
| Rate for Payer: Cash Price |
$470.27
|
| Rate for Payer: Cofinity Commercial |
$552.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.27
|
| Rate for Payer: Healthscope Commercial |
$570.20
|
| Rate for Payer: Healthscope Whirlpool |
$587.84
|
| Rate for Payer: Mclaren Commercial |
$529.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.66
|
| Rate for Payer: Nomi Health Commercial |
$482.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.30
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$587.84
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$587.84 |
| Rate for Payer: Aetna Commercial |
$529.06
|
| 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 |
$570.20
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$484.67
|
| Rate for Payer: BCN Commercial |
$484.67
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$470.27
|
| Rate for Payer: Cash Price |
$470.27
|
| Rate for Payer: Cofinity Commercial |
$552.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$570.20
|
| Rate for Payer: Healthscope Whirlpool |
$587.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$529.06
|
| 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 |
$499.66
|
| Rate for Payer: Nomi Health Commercial |
$482.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.88
|
| 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 |
$472.73
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$378.18
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.30
|
| 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 INSERT INDWELLING CATH
|
Facility
|
OP
|
$203.24
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$205.48 |
| Rate for Payer: Aetna Commercial |
$182.92
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$197.14
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$167.57
|
| Rate for Payer: BCN Commercial |
$167.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cofinity Commercial |
$191.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$197.14
|
| Rate for Payer: Healthscope Whirlpool |
$203.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$182.92
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.75
|
| Rate for Payer: Nomi Health Commercial |
$166.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.43
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.47
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$80.38
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$203.24
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.43 |
| Max. Negotiated Rate |
$203.24 |
| Rate for Payer: Aetna Commercial |
$182.92
|
| Rate for Payer: ASR ASR |
$197.14
|
| Rate for Payer: BCBS Trust/PPO |
$166.90
|
| Rate for Payer: BCN Commercial |
$166.90
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cofinity Commercial |
$191.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.59
|
| Rate for Payer: Healthscope Commercial |
$197.14
|
| Rate for Payer: Healthscope Whirlpool |
$203.24
|
| Rate for Payer: Mclaren Commercial |
$182.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.75
|
| Rate for Payer: Nomi Health Commercial |
$166.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.85
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.12 |
| Max. Negotiated Rate |
$1,094.92 |
| Rate for Payer: Aetna Commercial |
$985.43
|
| Rate for Payer: Aetna Medicare |
$405.12
|
| Rate for Payer: ASR ASR |
$1,062.07
|
| Rate for Payer: BCBS Complete |
$437.97
|
| Rate for Payer: BCBS Trust/PPO |
$902.76
|
| Rate for Payer: BCN Commercial |
$902.76
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Commercial |
$1,029.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Healthscope Commercial |
$1,062.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.92
|
| Rate for Payer: Mclaren Commercial |
$985.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$875.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Nomi Health Commercial |
$897.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$959.37
|
| Rate for Payer: Priority Health Narrow Network |
$767.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.53
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$821.19 |
| Max. Negotiated Rate |
$1,094.92 |
| Rate for Payer: Aetna Commercial |
$985.43
|
| Rate for Payer: ASR ASR |
$1,062.07
|
| Rate for Payer: BCBS Trust/PPO |
$899.15
|
| Rate for Payer: BCN Commercial |
$899.15
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Commercial |
$1,029.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Healthscope Commercial |
$1,062.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.92
|
| Rate for Payer: Mclaren Commercial |
$985.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Nomi Health Commercial |
$897.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.53
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,124.66 |
| Max. Negotiated Rate |
$1,499.55 |
| Rate for Payer: Aetna Commercial |
$1,349.60
|
| Rate for Payer: ASR ASR |
$1,454.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,231.43
|
| Rate for Payer: BCN Commercial |
$1,231.43
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Commercial |
$1,409.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Healthscope Commercial |
$1,454.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.55
|
| Rate for Payer: Mclaren Commercial |
$1,349.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Nomi Health Commercial |
$1,229.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,319.60
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$1,848.13 |
| Rate for Payer: Aetna Commercial |
$1,349.60
|
| Rate for Payer: Aetna Medicare |
$1,192.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: ASR ASR |
$1,454.56
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Commercial |
$1,409.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,454.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,192.34
|
| Rate for Payer: Mclaren Commercial |
$1,349.60
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$654.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Nomi Health Commercial |
$1,229.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,311.57
|
| Rate for Payer: PHP Medicaid |
$639.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,313.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,051.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,319.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Exchange |
$1,848.13
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP DNSP |
$1,192.34
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,163.84 |
| Max. Negotiated Rate |
$1,551.78 |
| Rate for Payer: Aetna Commercial |
$1,396.60
|
| Rate for Payer: ASR ASR |
$1,505.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.32
|
| Rate for Payer: BCN Commercial |
$1,274.32
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Commercial |
$1,458.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Healthscope Commercial |
$1,505.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,551.78
|
| Rate for Payer: Mclaren Commercial |
$1,396.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Nomi Health Commercial |
$1,272.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,365.57
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$999.98 |
| Max. Negotiated Rate |
$2,963.62 |
| Rate for Payer: Aetna Commercial |
$1,396.60
|
| Rate for Payer: Aetna Medicare |
$1,912.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: ASR ASR |
$1,505.23
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.44
|
| Rate for Payer: BCN Commercial |
$1,279.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Commercial |
$1,458.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,505.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,551.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,912.01
|
| Rate for Payer: Mclaren Commercial |
$1,396.60
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$1,050.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Nomi Health Commercial |
$1,272.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,103.21
|
| Rate for Payer: PHP Medicaid |
$1,024.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,359.67
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,087.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,365.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Exchange |
$2,963.62
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP DNSP |
$1,912.01
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$169.51
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.13 |
| Max. Negotiated Rate |
$169.51 |
| Rate for Payer: Aetna Commercial |
$152.56
|
| Rate for Payer: ASR ASR |
$164.42
|
| Rate for Payer: BCBS Trust/PPO |
$139.20
|
| Rate for Payer: BCN Commercial |
$139.20
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cofinity Commercial |
$159.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.61
|
| Rate for Payer: Healthscope Commercial |
$164.42
|
| Rate for Payer: Healthscope Whirlpool |
$169.51
|
| Rate for Payer: Mclaren Commercial |
$152.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.08
|
| Rate for Payer: Nomi Health Commercial |
$139.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.17
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$169.51
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$205.48 |
| Rate for Payer: Aetna Commercial |
$152.56
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$164.42
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$139.76
|
| Rate for Payer: BCN Commercial |
$139.76
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cofinity Commercial |
$159.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$164.42
|
| Rate for Payer: Healthscope Whirlpool |
$169.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$152.56
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.08
|
| Rate for Payer: Nomi Health Commercial |
$139.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.13
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$148.52
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$118.83
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,105.90 |
| Max. Negotiated Rate |
$1,474.53 |
| Rate for Payer: Aetna Commercial |
$1,327.08
|
| Rate for Payer: ASR ASR |
$1,430.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,210.88
|
| Rate for Payer: BCN Commercial |
$1,210.88
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Commercial |
$1,386.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Healthscope Commercial |
$1,430.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,474.53
|
| Rate for Payer: Mclaren Commercial |
$1,327.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Nomi Health Commercial |
$1,209.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,297.59
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$999.98 |
| Max. Negotiated Rate |
$2,963.62 |
| Rate for Payer: Aetna Commercial |
$1,327.08
|
| Rate for Payer: Aetna Medicare |
$1,912.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: ASR ASR |
$1,430.29
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,215.75
|
| Rate for Payer: BCN Commercial |
$1,215.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Commercial |
$1,386.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,430.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,474.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,912.01
|
| Rate for Payer: Mclaren Commercial |
$1,327.08
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$1,050.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Nomi Health Commercial |
$1,209.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,103.21
|
| Rate for Payer: PHP Medicaid |
$1,024.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,291.98
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,297.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Exchange |
$2,963.62
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP DNSP |
$1,912.01
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$290.65 |
| Max. Negotiated Rate |
$387.53 |
| Rate for Payer: Aetna Commercial |
$348.78
|
| Rate for Payer: ASR ASR |
$375.90
|
| Rate for Payer: BCBS Trust/PPO |
$318.24
|
| Rate for Payer: BCN Commercial |
$318.24
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Commercial |
$364.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$375.90
|
| Rate for Payer: Healthscope Whirlpool |
$387.53
|
| Rate for Payer: Mclaren Commercial |
$348.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Nomi Health Commercial |
$317.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.03
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.39 |
| Max. Negotiated Rate |
$387.53 |
| Rate for Payer: Aetna Commercial |
$348.78
|
| Rate for Payer: Aetna Medicare |
$143.39
|
| Rate for Payer: ASR ASR |
$375.90
|
| Rate for Payer: BCBS Complete |
$155.01
|
| Rate for Payer: BCBS Trust/PPO |
$319.52
|
| Rate for Payer: BCN Commercial |
$319.52
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Commercial |
$364.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$375.90
|
| Rate for Payer: Healthscope Whirlpool |
$387.53
|
| Rate for Payer: Mclaren Commercial |
$348.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Nomi Health Commercial |
$317.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$339.55
|
| Rate for Payer: Priority Health Narrow Network |
$271.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.03
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,500.12 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,336.80
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,518.56
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.77
|
| Rate for Payer: BCN Commercial |
$2,140.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Commercial |
$2,440.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,518.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,336.80
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$2,129.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,875.15
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,500.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.34 |
| Max. Negotiated Rate |
$2,596.45 |
| Rate for Payer: Aetna Commercial |
$2,336.80
|
| Rate for Payer: ASR ASR |
$2,518.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.20
|
| Rate for Payer: BCN Commercial |
$2,132.20
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Commercial |
$2,440.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,518.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.45
|
| Rate for Payer: Mclaren Commercial |
$2,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$2,129.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.88
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,947.34 |
| Max. Negotiated Rate |
$2,596.45 |
| Rate for Payer: Aetna Commercial |
$2,336.80
|
| Rate for Payer: ASR ASR |
$2,518.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.20
|
| Rate for Payer: BCN Commercial |
$2,132.20
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Commercial |
$2,440.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,518.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.45
|
| Rate for Payer: Mclaren Commercial |
$2,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$2,129.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.88
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,336.80
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,518.56
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.77
|
| Rate for Payer: BCN Commercial |
$2,140.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Commercial |
$2,440.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,518.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,336.80
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$2,129.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,275.01
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,820.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,719.64
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,931.17
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.49
|
| Rate for Payer: BCN Commercial |
$2,491.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,840.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,931.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,021.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,719.64
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,647.72
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,118.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,266.36 |
| Max. Negotiated Rate |
$3,021.82 |
| Rate for Payer: Aetna Commercial |
$2,719.64
|
| Rate for Payer: ASR ASR |
$2,931.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,481.52
|
| Rate for Payer: BCN Commercial |
$2,481.52
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,840.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,931.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,021.82
|
| Rate for Payer: Mclaren Commercial |
$2,719.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.20
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,719.64
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,931.17
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.49
|
| Rate for Payer: BCN Commercial |
$2,491.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,840.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,931.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,021.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,719.64
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,647.72
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,118.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,266.36 |
| Max. Negotiated Rate |
$3,021.82 |
| Rate for Payer: Aetna Commercial |
$2,719.64
|
| Rate for Payer: ASR ASR |
$2,931.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,481.52
|
| Rate for Payer: BCN Commercial |
$2,481.52
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,840.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,931.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,021.82
|
| Rate for Payer: Mclaren Commercial |
$2,719.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.20
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,806.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$1,625.44
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$1,751.87
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.09
|
| Rate for Payer: BCN Commercial |
$1,489.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cofinity Commercial |
$1,697.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,751.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,806.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,625.44
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.14
|
| Rate for Payer: Nomi Health Commercial |
$1,480.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,354.54
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,705.66
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,364.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,589.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
