|
HC HYDROCORTIZONE CREAM
|
Facility
|
OP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Medicare |
$4.96
|
| Rate for Payer: ASR ASR |
$9.62
|
| Rate for Payer: ASR Commercial |
$9.62
|
| Rate for Payer: BCBS Complete |
$3.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.12
|
| Rate for Payer: BCN Commercial |
$7.69
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$9.92
|
| Rate for Payer: Healthscope Whirlpool |
$9.62
|
| Rate for Payer: Mclaren Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: Nomi Health Commercial |
$8.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.69
|
| Rate for Payer: Priority Health Narrow Network |
$6.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.73
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
IP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: ASR ASR |
$9.62
|
| Rate for Payer: ASR Commercial |
$9.62
|
| Rate for Payer: BCBS Trust/PPO |
$8.08
|
| Rate for Payer: BCN Commercial |
$7.69
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$9.92
|
| Rate for Payer: Healthscope Whirlpool |
$9.62
|
| Rate for Payer: Mclaren Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: Nomi Health Commercial |
$8.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.73
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Trust/PPO |
$548.59
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.86
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$471.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$79.87
|
| Rate for Payer: ASR ASR |
$86.08
|
| Rate for Payer: ASR Commercial |
$86.08
|
| Rate for Payer: BCBS Trust/PPO |
$72.31
|
| Rate for Payer: BCN Commercial |
$68.80
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Healthscope Whirlpool |
$86.08
|
| Rate for Payer: Mclaren Commercial |
$79.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.09
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$79.87
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.51
|
| Rate for Payer: ASR ASR |
$86.08
|
| Rate for Payer: ASR Commercial |
$86.08
|
| Rate for Payer: BCBS Complete |
$12.84
|
| Rate for Payer: BCBS MAPPO |
$22.81
|
| Rate for Payer: BCBS Trust/PPO |
$72.67
|
| Rate for Payer: BCN Commercial |
$68.80
|
| Rate for Payer: BCN Medicare Advantage |
$22.81
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Healthscope Whirlpool |
$86.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.81
|
| Rate for Payer: Mclaren Commercial |
$79.87
|
| Rate for Payer: Mclaren Medicaid |
$12.23
|
| Rate for Payer: Mclaren Medicare |
$22.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.95
|
| Rate for Payer: Meridian Medicaid |
$12.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PACE Medicare |
$21.67
|
| Rate for Payer: PACE SWMI |
$22.81
|
| Rate for Payer: PHP Commercial |
$25.09
|
| Rate for Payer: PHP Medicaid |
$12.23
|
| Rate for Payer: PHP Medicare Advantage |
$22.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.75
|
| Rate for Payer: Priority Health Medicare |
$22.81
|
| Rate for Payer: Priority Health Narrow Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$22.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.81
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicare Advantage |
$22.81
|
| Rate for Payer: UHCCP DNSP |
$22.81
|
| Rate for Payer: UHCCP Medicaid |
$12.23
|
| Rate for Payer: VA VA |
$22.81
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: ASR Commercial |
$44.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.96
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: ASR Commercial |
$44.62
|
| Rate for Payer: BCBS Complete |
$15.29
|
| Rate for Payer: BCBS MAPPO |
$27.17
|
| Rate for Payer: BCBS Trust/PPO |
$37.67
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.17
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.17
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Mclaren Medicaid |
$14.56
|
| Rate for Payer: Mclaren Medicare |
$27.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.53
|
| Rate for Payer: Meridian Medicaid |
$15.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: PACE Medicare |
$25.81
|
| Rate for Payer: PACE SWMI |
$27.17
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicaid |
$14.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.31
|
| Rate for Payer: Priority Health Medicare |
$27.17
|
| Rate for Payer: Priority Health Narrow Network |
$32.25
|
| Rate for Payer: Railroad Medicare Medicare |
$27.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.17
|
| Rate for Payer: UHC Exchange |
$42.11
|
| Rate for Payer: UHC Medicare Advantage |
$27.17
|
| Rate for Payer: UHCCP DNSP |
$27.17
|
| Rate for Payer: UHCCP Medicaid |
$14.56
|
| Rate for Payer: VA VA |
$27.17
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: Aetna Medicare |
$12.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$13.47
|
| Rate for Payer: PHP Medicaid |
$6.57
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.61
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow Network |
$19.69
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Exchange |
$18.99
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: UHCCP DNSP |
$12.25
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: VA VA |
$12.25
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.74
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.55
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$20.42
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
OP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Medicare |
$7.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: ASR ASR |
$22.07
|
| Rate for Payer: ASR Commercial |
$22.07
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCBS Trust/PPO |
$18.63
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$22.75
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.82
|
| Rate for Payer: Mclaren Commercial |
$20.48
|
| Rate for Payer: Mclaren Medicaid |
$4.19
|
| Rate for Payer: Mclaren Medicare |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: Nomi Health Commercial |
$18.66
|
| Rate for Payer: PACE Medicare |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$8.60
|
| Rate for Payer: PHP Medicaid |
$4.19
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.93
|
| Rate for Payer: Priority Health Medicare |
$7.82
|
| Rate for Payer: Priority Health Narrow Network |
$15.95
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.82
|
| Rate for Payer: UHC Exchange |
$12.12
|
| Rate for Payer: UHC Medicare Advantage |
$7.82
|
| Rate for Payer: UHCCP DNSP |
$7.82
|
| Rate for Payer: UHCCP Medicaid |
$4.19
|
| Rate for Payer: VA VA |
$7.82
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
IP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.79 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: ASR ASR |
$22.07
|
| Rate for Payer: ASR Commercial |
$22.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.54
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Healthscope Commercial |
$22.75
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Mclaren Commercial |
$20.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: Nomi Health Commercial |
$18.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.02
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,093.79
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$4,806.44 |
| Rate for Payer: Aetna Commercial |
$3,684.41
|
| Rate for Payer: Aetna Medicare |
$3,100.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: ASR ASR |
$3,970.98
|
| Rate for Payer: ASR Commercial |
$3,970.98
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,352.40
|
| Rate for Payer: BCN Commercial |
$3,173.92
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,848.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$4,093.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,970.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,100.93
|
| Rate for Payer: Mclaren Commercial |
$3,684.41
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,411.02
|
| Rate for Payer: PHP Medicaid |
$1,662.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,586.98
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,869.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,602.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$4,806.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP DNSP |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$4,093.79
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,660.96 |
| Max. Negotiated Rate |
$4,093.79 |
| Rate for Payer: Aetna Commercial |
$3,684.41
|
| Rate for Payer: ASR ASR |
$3,970.98
|
| Rate for Payer: ASR Commercial |
$3,970.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,336.03
|
| Rate for Payer: BCN Commercial |
$3,173.92
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,848.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Healthscope Commercial |
$4,093.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,970.98
|
| Rate for Payer: Mclaren Commercial |
$3,684.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,602.54
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: Aetna Medicare |
$4,814.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,935.21
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,814.42
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$5,295.86
|
| Rate for Payer: PHP Medicaid |
$2,580.53
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,700.36
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health Narrow Network |
$9,360.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$7,462.35
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP DNSP |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: VA VA |
$4,814.42
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,881.79
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,100.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,100.93
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,411.02
|
| Rate for Payer: PHP Medicaid |
$1,662.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$4,806.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP DNSP |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,474.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: Aetna Medicare |
$4,814.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,935.21
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,814.42
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$5,295.86
|
| Rate for Payer: PHP Medicaid |
$2,580.53
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,700.36
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health Narrow Network |
$9,360.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$7,462.35
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP DNSP |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: VA VA |
$4,814.42
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,881.79
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: Aetna Medicare |
$4,814.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,935.21
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,814.42
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$5,295.86
|
| Rate for Payer: PHP Medicaid |
$2,580.53
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,700.36
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health Narrow Network |
$9,360.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$7,462.35
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP DNSP |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: VA VA |
$4,814.42
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$13,353.53 |
| Rate for Payer: Aetna Commercial |
$12,018.18
|
| Rate for Payer: ASR ASR |
$12,952.92
|
| Rate for Payer: ASR Commercial |
$12,952.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,881.79
|
| Rate for Payer: BCN Commercial |
$10,352.99
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$12,552.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$13,353.53
|
| Rate for Payer: Healthscope Whirlpool |
$12,952.92
|
| Rate for Payer: Mclaren Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,751.11
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
IP
|
$4,093.79
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,660.96 |
| Max. Negotiated Rate |
$4,093.79 |
| Rate for Payer: Aetna Commercial |
$3,684.41
|
| Rate for Payer: ASR ASR |
$3,970.98
|
| Rate for Payer: ASR Commercial |
$3,970.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,336.03
|
| Rate for Payer: BCN Commercial |
$3,173.92
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,848.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Healthscope Commercial |
$4,093.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,970.98
|
| Rate for Payer: Mclaren Commercial |
$3,684.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,602.54
|
|
