|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$101.85
|
| Rate for Payer: ASR Commercial |
$101.85
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$85.98
|
| Rate for Payer: BCN Commercial |
$81.41
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$98.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$105.00
|
| Rate for Payer: Healthscope Whirlpool |
$101.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$94.50
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.00
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$73.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: ASR ASR |
$101.85
|
| Rate for Payer: ASR Commercial |
$101.85
|
| Rate for Payer: BCBS Trust/PPO |
$85.56
|
| Rate for Payer: BCN Commercial |
$81.41
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$98.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Healthscope Commercial |
$105.00
|
| Rate for Payer: Healthscope Whirlpool |
$101.85
|
| Rate for Payer: Mclaren Commercial |
$94.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.40
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$265.64 |
| Max. Negotiated Rate |
$408.67 |
| Rate for Payer: Aetna Commercial |
$367.80
|
| Rate for Payer: ASR ASR |
$396.41
|
| Rate for Payer: ASR Commercial |
$396.41
|
| Rate for Payer: BCBS Trust/PPO |
$333.03
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$384.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$408.67
|
| Rate for Payer: Healthscope Whirlpool |
$396.41
|
| Rate for Payer: Mclaren Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.63
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$163.47 |
| Max. Negotiated Rate |
$408.67 |
| Rate for Payer: Aetna Commercial |
$367.80
|
| Rate for Payer: Aetna Medicare |
$204.34
|
| Rate for Payer: ASR ASR |
$396.41
|
| Rate for Payer: ASR Commercial |
$396.41
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS Trust/PPO |
$334.66
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$384.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$408.67
|
| Rate for Payer: Healthscope Whirlpool |
$396.41
|
| Rate for Payer: Mclaren Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.08
|
| Rate for Payer: Priority Health Narrow Network |
$286.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.63
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$258.99 |
| Max. Negotiated Rate |
$398.44 |
| Rate for Payer: Aetna Commercial |
$358.60
|
| Rate for Payer: ASR ASR |
$386.49
|
| Rate for Payer: ASR Commercial |
$386.49
|
| Rate for Payer: BCBS Trust/PPO |
$324.69
|
| Rate for Payer: BCN Commercial |
$308.91
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$374.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$398.44
|
| Rate for Payer: Healthscope Whirlpool |
$386.49
|
| Rate for Payer: Mclaren Commercial |
$358.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.63
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$503.72 |
| Rate for Payer: Aetna Commercial |
$358.60
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$386.49
|
| Rate for Payer: ASR Commercial |
$386.49
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$326.28
|
| Rate for Payer: BCN Commercial |
$308.91
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$374.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$398.44
|
| Rate for Payer: Healthscope Whirlpool |
$386.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$358.60
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$349.11
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$279.31
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.70
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC IBD DIFF
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.52
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$43.62
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.70
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.52
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$43.62
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: ASR ASR |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$47.38
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| 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 |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$47.61
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.25
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| 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 |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$13.48
|
| 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 |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.94
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow Network |
$40.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
| 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 ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,837.52 |
| Max. Negotiated Rate |
$48,690.60 |
| Rate for Payer: Aetna Commercial |
$24,235.20
|
| Rate for Payer: Aetna Medicare |
$31,413.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: ASR ASR |
$26,120.16
|
| Rate for Payer: ASR Commercial |
$26,120.16
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$22,051.34
|
| Rate for Payer: BCN Commercial |
$20,877.28
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$25,312.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$26,928.00
|
| Rate for Payer: Healthscope Whirlpool |
$26,120.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,413.29
|
| Rate for Payer: Mclaren Commercial |
$24,235.20
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: Nomi Health Commercial |
$22,080.96
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$34,554.62
|
| Rate for Payer: PHP Medicaid |
$16,837.52
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,594.31
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$18,876.53
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,696.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$48,690.60
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP DNSP |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: VA VA |
$31,413.29
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$17,503.20 |
| Max. Negotiated Rate |
$26,928.00 |
| Rate for Payer: Aetna Commercial |
$24,235.20
|
| Rate for Payer: ASR ASR |
$26,120.16
|
| Rate for Payer: ASR Commercial |
$26,120.16
|
| Rate for Payer: BCBS Trust/PPO |
$21,943.63
|
| Rate for Payer: BCN Commercial |
$20,877.28
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$25,312.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Healthscope Commercial |
$26,928.00
|
| Rate for Payer: Healthscope Whirlpool |
$26,120.16
|
| Rate for Payer: Mclaren Commercial |
$24,235.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: Nomi Health Commercial |
$22,080.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,696.64
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,444.40
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,438.86 |
| Max. Negotiated Rate |
$34,088.11 |
| Rate for Payer: Aetna Commercial |
$10,299.96
|
| Rate for Payer: Aetna Medicare |
$21,992.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,490.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,490.41
|
| Rate for Payer: ASR ASR |
$11,101.07
|
| Rate for Payer: ASR Commercial |
$11,101.07
|
| Rate for Payer: BCBS Complete |
$12,377.28
|
| Rate for Payer: BCBS MAPPO |
$21,992.33
|
| Rate for Payer: BCBS Trust/PPO |
$9,371.82
|
| Rate for Payer: BCN Commercial |
$8,872.84
|
| Rate for Payer: BCN Medicare Advantage |
$21,992.33
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cofinity Commercial |
$10,757.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,155.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,992.33
|
| Rate for Payer: Healthscope Commercial |
$11,444.40
|
| Rate for Payer: Healthscope Whirlpool |
$11,101.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,992.33
|
| Rate for Payer: Mclaren Commercial |
$10,299.96
|
| Rate for Payer: Mclaren Medicaid |
$11,787.89
|
| Rate for Payer: Mclaren Medicare |
$21,992.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,091.95
|
| Rate for Payer: Meridian Medicaid |
$12,377.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,291.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,727.74
|
| Rate for Payer: Nomi Health Commercial |
$9,384.41
|
| Rate for Payer: PACE Medicare |
$20,892.71
|
| Rate for Payer: PACE SWMI |
$21,992.33
|
| Rate for Payer: PHP Commercial |
$24,191.56
|
| Rate for Payer: PHP Medicaid |
$11,787.89
|
| Rate for Payer: PHP Medicare Advantage |
$21,992.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,787.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,438.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,027.58
|
| Rate for Payer: Priority Health Medicare |
$21,992.33
|
| Rate for Payer: Priority Health Narrow Network |
$8,022.52
|
| Rate for Payer: Railroad Medicare Medicare |
$21,992.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,071.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,992.33
|
| Rate for Payer: UHC Exchange |
$34,088.11
|
| Rate for Payer: UHC Medicare Advantage |
$21,992.33
|
| Rate for Payer: UHCCP DNSP |
$21,992.33
|
| Rate for Payer: UHCCP Medicaid |
$11,787.89
|
| Rate for Payer: VA VA |
$21,992.33
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,444.40
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,438.86 |
| Max. Negotiated Rate |
$11,444.40 |
| Rate for Payer: Aetna Commercial |
$10,299.96
|
| Rate for Payer: ASR ASR |
$11,101.07
|
| Rate for Payer: ASR Commercial |
$11,101.07
|
| Rate for Payer: BCBS Trust/PPO |
$9,326.04
|
| Rate for Payer: BCN Commercial |
$8,872.84
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cofinity Commercial |
$10,757.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,155.52
|
| Rate for Payer: Healthscope Commercial |
$11,444.40
|
| Rate for Payer: Healthscope Whirlpool |
$11,101.07
|
| Rate for Payer: Mclaren Commercial |
$10,299.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,727.74
|
| Rate for Payer: Nomi Health Commercial |
$9,384.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,438.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,071.07
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,766.62 |
| Max. Negotiated Rate |
$5,526.85 |
| Rate for Payer: Aetna Commercial |
$2,446.09
|
| Rate for Payer: Aetna Medicare |
$3,565.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: ASR ASR |
$2,636.34
|
| Rate for Payer: ASR Commercial |
$2,636.34
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,225.67
|
| Rate for Payer: BCN Commercial |
$2,107.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$2,554.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$2,717.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,636.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,565.71
|
| Rate for Payer: Mclaren Commercial |
$2,446.09
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: Nomi Health Commercial |
$2,228.66
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$3,922.28
|
| Rate for Payer: PHP Medicaid |
$1,911.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,381.41
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,905.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$5,526.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP DNSP |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: VA VA |
$3,565.71
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,766.62 |
| Max. Negotiated Rate |
$2,717.88 |
| Rate for Payer: Aetna Commercial |
$2,446.09
|
| Rate for Payer: ASR ASR |
$2,636.34
|
| Rate for Payer: ASR Commercial |
$2,636.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.80
|
| Rate for Payer: BCN Commercial |
$2,107.17
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$2,554.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Healthscope Commercial |
$2,717.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,636.34
|
| Rate for Payer: Mclaren Commercial |
$2,446.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: Nomi Health Commercial |
$2,228.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.73
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,056.74 |
| Max. Negotiated Rate |
$3,164.22 |
| Rate for Payer: Aetna Commercial |
$2,847.80
|
| Rate for Payer: ASR ASR |
$3,069.29
|
| Rate for Payer: ASR Commercial |
$3,069.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,578.52
|
| Rate for Payer: BCN Commercial |
$2,453.22
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,974.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Healthscope Commercial |
$3,164.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,069.29
|
| Rate for Payer: Mclaren Commercial |
$2,847.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: Nomi Health Commercial |
$2,594.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,784.51
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.64 |
| Max. Negotiated Rate |
$3,164.22 |
| Rate for Payer: Aetna Commercial |
$2,847.80
|
| Rate for Payer: Aetna Medicare |
$1,792.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: ASR ASR |
$3,069.29
|
| Rate for Payer: ASR Commercial |
$3,069.29
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.18
|
| Rate for Payer: BCN Commercial |
$2,453.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,974.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$3,164.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,069.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,792.24
|
| Rate for Payer: Mclaren Commercial |
$2,847.80
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: Nomi Health Commercial |
$2,594.66
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$1,971.46
|
| Rate for Payer: PHP Medicaid |
$960.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,772.49
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,218.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,784.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$2,777.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP DNSP |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: VA VA |
$1,792.24
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,398.10 |
| Max. Negotiated Rate |
$48,690.60 |
| Rate for Payer: Aetna Commercial |
$17,166.60
|
| Rate for Payer: Aetna Medicare |
$31,413.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: ASR ASR |
$18,501.78
|
| Rate for Payer: ASR Commercial |
$18,501.78
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$15,619.70
|
| Rate for Payer: BCN Commercial |
$14,788.07
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$17,929.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$19,074.00
|
| Rate for Payer: Healthscope Whirlpool |
$18,501.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,413.29
|
| Rate for Payer: Mclaren Commercial |
$17,166.60
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: Nomi Health Commercial |
$15,640.68
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$34,554.62
|
| Rate for Payer: PHP Medicaid |
$16,837.52
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,712.64
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$13,370.87
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,785.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$48,690.60
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP DNSP |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: VA VA |
$31,413.29
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,398.10 |
| Max. Negotiated Rate |
$19,074.00 |
| Rate for Payer: Aetna Commercial |
$17,166.60
|
| Rate for Payer: ASR ASR |
$18,501.78
|
| Rate for Payer: ASR Commercial |
$18,501.78
|
| Rate for Payer: BCBS Trust/PPO |
$15,543.40
|
| Rate for Payer: BCN Commercial |
$14,788.07
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$17,929.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Healthscope Commercial |
$19,074.00
|
| Rate for Payer: Healthscope Whirlpool |
$18,501.78
|
| Rate for Payer: Mclaren Commercial |
$17,166.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: Nomi Health Commercial |
$15,640.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,785.12
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$798.66 |
| Max. Negotiated Rate |
$1,996.65 |
| Rate for Payer: Aetna Commercial |
$1,796.98
|
| Rate for Payer: Aetna Medicare |
$998.32
|
| Rate for Payer: ASR ASR |
$1,936.75
|
| Rate for Payer: ASR Commercial |
$1,936.75
|
| Rate for Payer: BCBS Complete |
$798.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.06
|
| Rate for Payer: BCN Commercial |
$1,548.00
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,876.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Healthscope Commercial |
$1,996.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,936.75
|
| Rate for Payer: Mclaren Commercial |
$1,796.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: Nomi Health Commercial |
$1,637.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,749.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,399.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,757.05
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,297.82 |
| Max. Negotiated Rate |
$1,996.65 |
| Rate for Payer: Aetna Commercial |
$1,796.98
|
| Rate for Payer: ASR ASR |
$1,936.75
|
| Rate for Payer: ASR Commercial |
$1,936.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,627.07
|
| Rate for Payer: BCN Commercial |
$1,548.00
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,876.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Healthscope Commercial |
$1,996.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,936.75
|
| Rate for Payer: Mclaren Commercial |
$1,796.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: Nomi Health Commercial |
$1,637.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,757.05
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: Aetna Medicare |
$197.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: ASR ASR |
$251.29
|
| Rate for Payer: ASR Commercial |
$251.29
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$212.14
|
| Rate for Payer: BCN Commercial |
$200.85
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cofinity Commercial |
$243.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Whirlpool |
$251.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$197.10
|
| Rate for Payer: Mclaren Commercial |
$233.15
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$212.43
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$216.81
|
| Rate for Payer: PHP Medicaid |
$105.65
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.06
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$197.65
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Exchange |
$305.50
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP DNSP |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: VA VA |
$197.10
|
|
