|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
IP
|
$547.59
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$410.69 |
| Max. Negotiated Rate |
$547.59 |
| Rate for Payer: Aetna Commercial |
$492.83
|
| Rate for Payer: ASR ASR |
$531.16
|
| Rate for Payer: BCBS Trust/PPO |
$449.68
|
| Rate for Payer: BCN Commercial |
$449.68
|
| Rate for Payer: Cash Price |
$438.07
|
| Rate for Payer: Cofinity Commercial |
$514.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.07
|
| Rate for Payer: Healthscope Commercial |
$531.16
|
| Rate for Payer: Healthscope Whirlpool |
$547.59
|
| Rate for Payer: Mclaren Commercial |
$492.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.45
|
| Rate for Payer: Nomi Health Commercial |
$449.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$410.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$481.88
|
|
|
HC INTERMEDIATE REPAIR WOUND N/H/F/XTRNL GENT 7.6 TO 12.5 CM
|
Facility
|
IP
|
$1,886.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
76100544
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,414.50 |
| Max. Negotiated Rate |
$1,886.00 |
| Rate for Payer: Aetna Commercial |
$1,697.40
|
| Rate for Payer: ASR ASR |
$1,829.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.78
|
| Rate for Payer: BCN Commercial |
$1,548.78
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,772.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,886.00
|
| Rate for Payer: Mclaren Commercial |
$1,697.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.10
|
| Rate for Payer: Nomi Health Commercial |
$1,546.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.68
|
|
|
HC INTERMEDIATE REPAIR WOUND N/H/F/XTRNL GENT 7.6 TO 12.5 CM
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
76100544
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.60 |
| Max. Negotiated Rate |
$1,886.00 |
| Rate for Payer: Aetna Commercial |
$1,697.40
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$1,829.42
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,555.01
|
| Rate for Payer: BCN Commercial |
$1,555.01
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,772.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$1,829.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,886.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$1,697.40
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.10
|
| Rate for Payer: Nomi Health Commercial |
$1,546.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.50
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
IP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,444.62 |
| Max. Negotiated Rate |
$1,926.16 |
| Rate for Payer: Aetna Commercial |
$1,733.54
|
| Rate for Payer: ASR ASR |
$1,868.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,581.76
|
| Rate for Payer: BCN Commercial |
$1,581.76
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Commercial |
$1,810.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Healthscope Commercial |
$1,868.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.16
|
| Rate for Payer: Mclaren Commercial |
$1,733.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Nomi Health Commercial |
$1,579.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,695.02
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$712.68 |
| Max. Negotiated Rate |
$1,926.16 |
| Rate for Payer: Aetna Commercial |
$1,733.54
|
| Rate for Payer: Aetna Medicare |
$712.68
|
| Rate for Payer: ASR ASR |
$1,868.38
|
| Rate for Payer: BCBS Complete |
$770.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.12
|
| Rate for Payer: BCN Commercial |
$1,588.12
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Commercial |
$1,810.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Healthscope Commercial |
$1,868.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.16
|
| Rate for Payer: Mclaren Commercial |
$1,733.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,540.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Nomi Health Commercial |
$1,579.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,687.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,695.02
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.41 |
| Max. Negotiated Rate |
$287.22 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Trust/PPO |
$235.87
|
| Rate for Payer: BCN Commercial |
$235.87
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$236.81
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.96 |
| Max. Negotiated Rate |
$315.95 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Trust/PPO |
$259.46
|
| Rate for Payer: BCN Commercial |
$259.46
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$260.50
|
| Rate for Payer: BCN Commercial |
$260.50
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$422.24
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$457.75
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$493.35
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$419.35
|
| Rate for Payer: BCN Commercial |
$419.35
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$478.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$493.35
|
| Rate for Payer: Healthscope Whirlpool |
$508.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$457.75
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$381.46 |
| Max. Negotiated Rate |
$508.61 |
| Rate for Payer: Aetna Commercial |
$457.75
|
| Rate for Payer: ASR ASR |
$493.35
|
| Rate for Payer: BCBS Trust/PPO |
$417.67
|
| Rate for Payer: BCN Commercial |
$417.67
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$478.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$493.35
|
| Rate for Payer: Healthscope Whirlpool |
$508.61
|
| Rate for Payer: Mclaren Commercial |
$457.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.58
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.41 |
| Max. Negotiated Rate |
$287.22 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Trust/PPO |
$235.87
|
| Rate for Payer: BCN Commercial |
$235.87
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$236.81
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$422.24
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$260.50
|
| Rate for Payer: BCN Commercial |
$260.50
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.96 |
| Max. Negotiated Rate |
$315.95 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Trust/PPO |
$259.46
|
| Rate for Payer: BCN Commercial |
$259.46
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$917.52 |
| Rate for Payer: Aetna Commercial |
$825.77
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$889.99
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$756.50
|
| Rate for Payer: BCN Commercial |
$756.50
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Commercial |
$862.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$889.99
|
| Rate for Payer: Healthscope Whirlpool |
$917.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$825.77
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Nomi Health Commercial |
$752.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$807.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$688.14 |
| Max. Negotiated Rate |
$917.52 |
| Rate for Payer: Aetna Commercial |
$825.77
|
| Rate for Payer: ASR ASR |
$889.99
|
| Rate for Payer: BCBS Trust/PPO |
$753.47
|
| Rate for Payer: BCN Commercial |
$753.47
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Commercial |
$862.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Healthscope Commercial |
$889.99
|
| Rate for Payer: Healthscope Whirlpool |
$917.52
|
| Rate for Payer: Mclaren Commercial |
$825.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Nomi Health Commercial |
$752.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$807.42
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$832.47 |
| Max. Negotiated Rate |
$12,355.25 |
| Rate for Payer: Aetna Commercial |
$2,024.93
|
| Rate for Payer: Aetna Medicare |
$832.47
|
| Rate for Payer: ASR ASR |
$2,182.42
|
| Rate for Payer: BCBS Complete |
$899.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,855.06
|
| Rate for Payer: BCN Commercial |
$1,855.06
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Commercial |
$2,114.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Healthscope Commercial |
$2,182.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,249.92
|
| Rate for Payer: Mclaren Commercial |
$2,024.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,799.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Nomi Health Commercial |
$1,844.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,971.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,577.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,979.93
|
| Rate for Payer: UHC Exchange |
$12,355.25
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,687.44 |
| Max. Negotiated Rate |
$2,249.92 |
| Rate for Payer: Aetna Commercial |
$2,024.93
|
| Rate for Payer: ASR ASR |
$2,182.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,847.63
|
| Rate for Payer: BCN Commercial |
$1,847.63
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Commercial |
$2,114.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Healthscope Commercial |
$2,182.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,249.92
|
| Rate for Payer: Mclaren Commercial |
$2,024.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Nomi Health Commercial |
$1,844.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,979.93
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,025.28 |
| Max. Negotiated Rate |
$1,367.04 |
| Rate for Payer: Aetna Commercial |
$1,230.34
|
| Rate for Payer: ASR ASR |
$1,326.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.61
|
| Rate for Payer: BCN Commercial |
$1,122.61
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Commercial |
$1,285.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Healthscope Commercial |
$1,326.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,367.04
|
| Rate for Payer: Mclaren Commercial |
$1,230.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.00
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$505.80 |
| Max. Negotiated Rate |
$12,355.25 |
| Rate for Payer: Aetna Commercial |
$1,230.34
|
| Rate for Payer: Aetna Medicare |
$505.80
|
| Rate for Payer: ASR ASR |
$1,326.03
|
| Rate for Payer: BCBS Complete |
$546.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.12
|
| Rate for Payer: BCN Commercial |
$1,127.12
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Commercial |
$1,285.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Healthscope Commercial |
$1,326.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,367.04
|
| Rate for Payer: Mclaren Commercial |
$1,230.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,093.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,197.80
|
| Rate for Payer: Priority Health Narrow Network |
$958.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.00
|
| Rate for Payer: UHC Exchange |
$12,355.25
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$1,094.58 |
| Rate for Payer: Aetna Commercial |
$985.12
|
| Rate for Payer: Aetna Medicare |
$232.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: ASR ASR |
$1,061.74
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$902.48
|
| Rate for Payer: BCN Commercial |
$902.48
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Commercial |
$1,028.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$1,061.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$232.50
|
| Rate for Payer: Mclaren Commercial |
$985.12
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$127.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Nomi Health Commercial |
$897.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$255.75
|
| Rate for Payer: PHP Medicaid |
$124.62
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$959.07
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health Narrow Network |
$767.30
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$360.38
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP DNSP |
$232.50
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: VA VA |
$232.50
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$820.93 |
| Max. Negotiated Rate |
$1,094.58 |
| Rate for Payer: Aetna Commercial |
$985.12
|
| Rate for Payer: ASR ASR |
$1,061.74
|
| Rate for Payer: BCBS Trust/PPO |
$898.87
|
| Rate for Payer: BCN Commercial |
$898.87
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Commercial |
$1,028.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Healthscope Commercial |
$1,061.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.58
|
| Rate for Payer: Mclaren Commercial |
$985.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Nomi Health Commercial |
$897.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.23
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,251.23 |
| Max. Negotiated Rate |
$12,046.01 |
| Rate for Payer: Aetna Commercial |
$2,890.31
|
| Rate for Payer: Aetna Medicare |
$7,771.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: ASR ASR |
$3,115.12
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,647.85
|
| Rate for Payer: BCN Commercial |
$2,647.85
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Commercial |
$3,018.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,115.12
|
| Rate for Payer: Healthscope Whirlpool |
$3,211.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,771.62
|
| Rate for Payer: Mclaren Commercial |
$2,890.31
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$4,268.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Nomi Health Commercial |
$2,633.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$8,548.78
|
| Rate for Payer: PHP Medicaid |
$4,165.59
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,813.88
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,251.23
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,826.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Exchange |
$12,046.01
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP DNSP |
$7,771.62
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,408.59 |
| Max. Negotiated Rate |
$3,211.46 |
| Rate for Payer: Aetna Commercial |
$2,890.31
|
| Rate for Payer: ASR ASR |
$3,115.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,637.25
|
| Rate for Payer: BCN Commercial |
$2,637.25
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Commercial |
$3,018.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Healthscope Commercial |
$3,115.12
|
| Rate for Payer: Healthscope Whirlpool |
$3,211.46
|
| Rate for Payer: Mclaren Commercial |
$2,890.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Nomi Health Commercial |
$2,633.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,826.08
|
|
