|
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 |
$13.47
|
| 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 |
$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 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 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 |
$16,760.19 |
| Max. Negotiated Rate |
$48,466.98 |
| Rate for Payer: Aetna Commercial |
$24,235.20
|
| Rate for Payer: Aetna Medicare |
$31,269.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,086.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,086.28
|
| Rate for Payer: ASR ASR |
$26,120.16
|
| Rate for Payer: ASR Commercial |
$26,120.16
|
| Rate for Payer: BCBS Complete |
$17,598.20
|
| Rate for Payer: BCBS MAPPO |
$31,269.02
|
| Rate for Payer: BCBS Trust/PPO |
$22,051.34
|
| Rate for Payer: BCN Commercial |
$20,877.28
|
| Rate for Payer: BCN Medicare Advantage |
$31,269.02
|
| 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 |
$31,269.02
|
| Rate for Payer: Healthscope Commercial |
$26,928.00
|
| Rate for Payer: Healthscope Whirlpool |
$26,120.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,269.02
|
| Rate for Payer: Mclaren Commercial |
$24,235.20
|
| Rate for Payer: Mclaren Medicaid |
$16,760.19
|
| Rate for Payer: Mclaren Medicare |
$31,269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,832.47
|
| Rate for Payer: Meridian Medicaid |
$17,598.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,959.37
|
| 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 |
$29,705.57
|
| Rate for Payer: PACE SWMI |
$31,269.02
|
| Rate for Payer: PHP Commercial |
$34,395.92
|
| Rate for Payer: PHP Medicaid |
$16,760.19
|
| Rate for Payer: PHP Medicare Advantage |
$31,269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.19
|
| 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 |
$31,269.02
|
| Rate for Payer: Priority Health Narrow Network |
$18,876.53
|
| Rate for Payer: Railroad Medicare Medicare |
$31,269.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,696.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,269.02
|
| Rate for Payer: UHC Exchange |
$48,466.98
|
| Rate for Payer: UHC Medicare Advantage |
$31,269.02
|
| Rate for Payer: UHCCP DNSP |
$31,269.02
|
| Rate for Payer: UHCCP Medicaid |
$16,760.19
|
| Rate for Payer: VA VA |
$31,269.02
|
|
|
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 |
$33,931.55 |
| Rate for Payer: Aetna Commercial |
$10,299.96
|
| Rate for Payer: Aetna Medicare |
$21,891.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,364.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,364.15
|
| Rate for Payer: ASR ASR |
$11,101.07
|
| Rate for Payer: ASR Commercial |
$11,101.07
|
| Rate for Payer: BCBS Complete |
$12,320.43
|
| Rate for Payer: BCBS MAPPO |
$21,891.32
|
| Rate for Payer: BCBS Trust/PPO |
$9,371.82
|
| Rate for Payer: BCN Commercial |
$8,872.84
|
| Rate for Payer: BCN Medicare Advantage |
$21,891.32
|
| 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 |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$11,444.40
|
| Rate for Payer: Healthscope Whirlpool |
$11,101.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,891.32
|
| Rate for Payer: Mclaren Commercial |
$10,299.96
|
| Rate for Payer: Mclaren Medicaid |
$11,733.75
|
| Rate for Payer: Mclaren Medicare |
$21,891.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,985.89
|
| Rate for Payer: Meridian Medicaid |
$12,320.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,175.02
|
| 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 |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$24,080.45
|
| Rate for Payer: PHP Medicaid |
$11,733.75
|
| Rate for Payer: PHP Medicare Advantage |
$21,891.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,733.75
|
| 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 |
$21,891.32
|
| Rate for Payer: Priority Health Narrow Network |
$8,022.52
|
| Rate for Payer: Railroad Medicare Medicare |
$21,891.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,071.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,891.32
|
| Rate for Payer: UHC Exchange |
$33,931.55
|
| Rate for Payer: UHC Medicare Advantage |
$21,891.32
|
| Rate for Payer: UHCCP DNSP |
$21,891.32
|
| Rate for Payer: UHCCP Medicaid |
$11,733.75
|
| Rate for Payer: VA VA |
$21,891.32
|
|
|
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
|
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 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 |
$5,501.48 |
| Rate for Payer: Aetna Commercial |
$2,446.09
|
| Rate for Payer: Aetna Medicare |
$3,549.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,436.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,436.68
|
| Rate for Payer: ASR ASR |
$2,636.34
|
| Rate for Payer: ASR Commercial |
$2,636.34
|
| Rate for Payer: BCBS Complete |
$1,997.57
|
| Rate for Payer: BCBS MAPPO |
$3,549.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,225.67
|
| Rate for Payer: BCN Commercial |
$2,107.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,549.34
|
| 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 |
$3,549.34
|
| Rate for Payer: Healthscope Commercial |
$2,717.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,636.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,549.34
|
| Rate for Payer: Mclaren Commercial |
$2,446.09
|
| Rate for Payer: Mclaren Medicaid |
$1,902.45
|
| Rate for Payer: Mclaren Medicare |
$3,549.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,726.81
|
| Rate for Payer: Meridian Medicaid |
$1,997.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,081.74
|
| 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 |
$3,371.87
|
| Rate for Payer: PACE SWMI |
$3,549.34
|
| Rate for Payer: PHP Commercial |
$3,904.27
|
| Rate for Payer: PHP Medicaid |
$1,902.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,549.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,902.45
|
| 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 |
$3,549.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,905.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,549.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,549.34
|
| Rate for Payer: UHC Exchange |
$5,501.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,549.34
|
| Rate for Payer: UHCCP DNSP |
$3,549.34
|
| Rate for Payer: UHCCP Medicaid |
$1,902.45
|
| Rate for Payer: VA VA |
$3,549.34
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$3,164.22 |
| Rate for Payer: Aetna Commercial |
$2,847.80
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$3,069.29
|
| Rate for Payer: ASR Commercial |
$3,069.29
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.18
|
| Rate for Payer: BCN Commercial |
$2,453.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| 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 |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$3,164.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,069.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$2,847.80
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| 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 |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| 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 |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,218.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,784.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
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 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 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 |
$48,466.98 |
| Rate for Payer: Aetna Commercial |
$17,166.60
|
| Rate for Payer: Aetna Medicare |
$31,269.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,086.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,086.28
|
| Rate for Payer: ASR ASR |
$18,501.78
|
| Rate for Payer: ASR Commercial |
$18,501.78
|
| Rate for Payer: BCBS Complete |
$17,598.20
|
| Rate for Payer: BCBS MAPPO |
$31,269.02
|
| Rate for Payer: BCBS Trust/PPO |
$15,619.70
|
| Rate for Payer: BCN Commercial |
$14,788.07
|
| Rate for Payer: BCN Medicare Advantage |
$31,269.02
|
| 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 |
$31,269.02
|
| Rate for Payer: Healthscope Commercial |
$19,074.00
|
| Rate for Payer: Healthscope Whirlpool |
$18,501.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,269.02
|
| Rate for Payer: Mclaren Commercial |
$17,166.60
|
| Rate for Payer: Mclaren Medicaid |
$16,760.19
|
| Rate for Payer: Mclaren Medicare |
$31,269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,832.47
|
| Rate for Payer: Meridian Medicaid |
$17,598.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,959.37
|
| 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 |
$29,705.57
|
| Rate for Payer: PACE SWMI |
$31,269.02
|
| Rate for Payer: PHP Commercial |
$34,395.92
|
| Rate for Payer: PHP Medicaid |
$16,760.19
|
| Rate for Payer: PHP Medicare Advantage |
$31,269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.19
|
| 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 |
$31,269.02
|
| Rate for Payer: Priority Health Narrow Network |
$13,370.87
|
| Rate for Payer: Railroad Medicare Medicare |
$31,269.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,785.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,269.02
|
| Rate for Payer: UHC Exchange |
$48,466.98
|
| Rate for Payer: UHC Medicare Advantage |
$31,269.02
|
| Rate for Payer: UHCCP DNSP |
$31,269.02
|
| Rate for Payer: UHCCP Medicaid |
$16,760.19
|
| Rate for Payer: VA VA |
$31,269.02
|
|
|
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 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 |
$998.33
|
| 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 I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.16 |
| Max. Negotiated Rate |
$304.11 |
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: Aetna Medicare |
$196.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.25
|
| Rate for Payer: ASR ASR |
$251.29
|
| Rate for Payer: ASR Commercial |
$251.29
|
| Rate for Payer: BCBS Complete |
$110.42
|
| Rate for Payer: BCBS MAPPO |
$196.20
|
| Rate for Payer: BCBS Trust/PPO |
$212.14
|
| Rate for Payer: BCN Commercial |
$200.85
|
| Rate for Payer: BCN Medicare Advantage |
$196.20
|
| 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 |
$196.20
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Whirlpool |
$251.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$196.20
|
| Rate for Payer: Mclaren Commercial |
$233.15
|
| Rate for Payer: Mclaren Medicaid |
$105.16
|
| Rate for Payer: Mclaren Medicare |
$196.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.01
|
| Rate for Payer: Meridian Medicaid |
$110.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$212.43
|
| Rate for Payer: PACE Medicare |
$186.39
|
| Rate for Payer: PACE SWMI |
$196.20
|
| Rate for Payer: PHP Commercial |
$215.82
|
| Rate for Payer: PHP Medicaid |
$105.16
|
| Rate for Payer: PHP Medicare Advantage |
$196.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.99
|
| Rate for Payer: Priority Health Medicare |
$196.20
|
| Rate for Payer: Priority Health Narrow Network |
$181.60
|
| Rate for Payer: Railroad Medicare Medicare |
$196.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.20
|
| Rate for Payer: UHC Exchange |
$304.11
|
| Rate for Payer: UHC Medicare Advantage |
$196.20
|
| Rate for Payer: UHCCP DNSP |
$196.20
|
| Rate for Payer: UHCCP Medicaid |
$105.16
|
| Rate for Payer: VA VA |
$196.20
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.39 |
| Max. Negotiated Rate |
$259.06 |
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: ASR ASR |
$251.29
|
| Rate for Payer: ASR Commercial |
$251.29
|
| Rate for Payer: BCBS Trust/PPO |
$211.11
|
| Rate for Payer: BCN Commercial |
$200.85
|
| 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: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Whirlpool |
$251.29
|
| Rate for Payer: Mclaren Commercial |
$233.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$212.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.97
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.41 |
| Max. Negotiated Rate |
$29.86 |
| Rate for Payer: Aetna Commercial |
$26.87
|
| Rate for Payer: ASR ASR |
$28.96
|
| Rate for Payer: ASR Commercial |
$28.96
|
| Rate for Payer: BCBS Trust/PPO |
$24.33
|
| Rate for Payer: BCN Commercial |
$23.15
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$29.86
|
| Rate for Payer: Healthscope Whirlpool |
$28.96
|
| Rate for Payer: Mclaren Commercial |
$26.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.28
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$29.86 |
| Rate for Payer: Aetna Commercial |
$26.87
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: ASR ASR |
$28.96
|
| Rate for Payer: ASR Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$24.45
|
| Rate for Payer: BCN Commercial |
$23.15
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$29.86
|
| Rate for Payer: Healthscope Whirlpool |
$28.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$26.87
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.16
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$20.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$214.20 |
| Max. Negotiated Rate |
$535.51 |
| Rate for Payer: Aetna Commercial |
$481.96
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: ASR ASR |
$519.44
|
| Rate for Payer: ASR Commercial |
$519.44
|
| Rate for Payer: BCBS Complete |
$214.20
|
| Rate for Payer: BCBS Trust/PPO |
$438.53
|
| Rate for Payer: BCN Commercial |
$415.18
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$503.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Healthscope Commercial |
$535.51
|
| Rate for Payer: Healthscope Whirlpool |
$519.44
|
| Rate for Payer: Mclaren Commercial |
$481.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.21
|
| Rate for Payer: Priority Health Narrow Network |
$375.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$471.25
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$348.08 |
| Max. Negotiated Rate |
$535.51 |
| Rate for Payer: Aetna Commercial |
$481.96
|
| Rate for Payer: ASR ASR |
$519.44
|
| Rate for Payer: ASR Commercial |
$519.44
|
| Rate for Payer: BCBS Trust/PPO |
$436.39
|
| Rate for Payer: BCN Commercial |
$415.18
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$503.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Healthscope Commercial |
$535.51
|
| Rate for Payer: Healthscope Whirlpool |
$519.44
|
| Rate for Payer: Mclaren Commercial |
$481.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$471.25
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$931.90
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$903.94
|
| Rate for Payer: ASR Commercial |
$903.94
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$763.13
|
| Rate for Payer: BCN Commercial |
$722.50
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cofinity Commercial |
$875.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$931.90
|
| Rate for Payer: Healthscope Whirlpool |
$903.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$838.71
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$792.12
|
| Rate for Payer: Nomi Health Commercial |
$764.16
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.53
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$653.26
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$820.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$931.90
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$605.74 |
| Max. Negotiated Rate |
$931.90 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: ASR ASR |
$903.94
|
| Rate for Payer: ASR Commercial |
$903.94
|
| Rate for Payer: BCBS Trust/PPO |
$759.41
|
| Rate for Payer: BCN Commercial |
$722.50
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cofinity Commercial |
$875.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.52
|
| Rate for Payer: Healthscope Commercial |
$931.90
|
| Rate for Payer: Healthscope Whirlpool |
$903.94
|
| Rate for Payer: Mclaren Commercial |
$838.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$792.12
|
| Rate for Payer: Nomi Health Commercial |
$764.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$820.07
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$490.15
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$318.60 |
| Max. Negotiated Rate |
$490.15 |
| Rate for Payer: Aetna Commercial |
$441.13
|
| Rate for Payer: ASR ASR |
$475.45
|
| Rate for Payer: ASR Commercial |
$475.45
|
| Rate for Payer: BCBS Trust/PPO |
$399.42
|
| Rate for Payer: BCN Commercial |
$380.01
|
| Rate for Payer: Cash Price |
$392.12
|
| Rate for Payer: Cofinity Commercial |
$460.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.12
|
| Rate for Payer: Healthscope Commercial |
$490.15
|
| Rate for Payer: Healthscope Whirlpool |
$475.45
|
| Rate for Payer: Mclaren Commercial |
$441.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.63
|
| Rate for Payer: Nomi Health Commercial |
$401.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.33
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$490.15
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$196.06 |
| Max. Negotiated Rate |
$490.15 |
| Rate for Payer: Aetna Commercial |
$441.13
|
| Rate for Payer: Aetna Medicare |
$245.07
|
| Rate for Payer: ASR ASR |
$475.45
|
| Rate for Payer: ASR Commercial |
$475.45
|
| Rate for Payer: BCBS Complete |
$196.06
|
| Rate for Payer: BCBS Trust/PPO |
$401.38
|
| Rate for Payer: BCN Commercial |
$380.01
|
| Rate for Payer: Cash Price |
$392.12
|
| Rate for Payer: Cofinity Commercial |
$460.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.12
|
| Rate for Payer: Healthscope Commercial |
$490.15
|
| Rate for Payer: Healthscope Whirlpool |
$475.45
|
| Rate for Payer: Mclaren Commercial |
$441.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.63
|
| Rate for Payer: Nomi Health Commercial |
$401.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.47
|
| Rate for Payer: Priority Health Narrow Network |
$343.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.33
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$849.27
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$552.03 |
| Max. Negotiated Rate |
$849.27 |
| Rate for Payer: Aetna Commercial |
$764.34
|
| Rate for Payer: ASR ASR |
$823.79
|
| Rate for Payer: ASR Commercial |
$823.79
|
| Rate for Payer: BCBS Trust/PPO |
$692.07
|
| Rate for Payer: BCN Commercial |
$658.44
|
| Rate for Payer: Cash Price |
$679.42
|
| Rate for Payer: Cofinity Commercial |
$798.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$679.42
|
| Rate for Payer: Healthscope Commercial |
$849.27
|
| Rate for Payer: Healthscope Whirlpool |
$823.79
|
| Rate for Payer: Mclaren Commercial |
$764.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$721.88
|
| Rate for Payer: Nomi Health Commercial |
$696.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$747.36
|
|
