|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,411.53
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,517.49 |
| Max. Negotiated Rate |
$5,411.53 |
| Rate for Payer: Aetna Commercial |
$4,870.38
|
| Rate for Payer: ASR ASR |
$5,249.18
|
| Rate for Payer: ASR Commercial |
$5,249.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,409.86
|
| Rate for Payer: BCN Commercial |
$4,195.56
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cofinity Commercial |
$5,086.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.22
|
| Rate for Payer: Healthscope Commercial |
$5,411.53
|
| Rate for Payer: Healthscope Whirlpool |
$5,249.18
|
| Rate for Payer: Mclaren Commercial |
$4,870.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,599.80
|
| Rate for Payer: Nomi Health Commercial |
$4,437.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,517.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,762.15
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$5,517.33 |
| Rate for Payer: Aetna Commercial |
$4,965.60
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$5,351.81
|
| Rate for Payer: ASR Commercial |
$5,351.81
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,518.14
|
| Rate for Payer: BCN Commercial |
$4,277.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$5,186.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$5,517.33
|
| Rate for Payer: Healthscope Whirlpool |
$5,351.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$4,965.60
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: Nomi Health Commercial |
$4,524.21
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,811.59
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,049.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,855.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,586.26 |
| Max. Negotiated Rate |
$5,517.33 |
| Rate for Payer: Aetna Commercial |
$4,965.60
|
| Rate for Payer: ASR ASR |
$5,351.81
|
| Rate for Payer: ASR Commercial |
$5,351.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,496.07
|
| Rate for Payer: BCN Commercial |
$4,277.59
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$5,186.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Healthscope Commercial |
$5,517.33
|
| Rate for Payer: Healthscope Whirlpool |
$5,351.81
|
| Rate for Payer: Mclaren Commercial |
$4,965.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: Nomi Health Commercial |
$4,524.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,855.25
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$111.32 |
| Rate for Payer: Aetna Commercial |
$100.19
|
| Rate for Payer: ASR ASR |
$107.98
|
| Rate for Payer: ASR Commercial |
$107.98
|
| Rate for Payer: BCBS Trust/PPO |
$90.71
|
| Rate for Payer: BCN Commercial |
$86.31
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$104.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Healthscope Commercial |
$111.32
|
| Rate for Payer: Healthscope Whirlpool |
$107.98
|
| Rate for Payer: Mclaren Commercial |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: Nomi Health Commercial |
$91.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.96
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$111.32 |
| Rate for Payer: Aetna Commercial |
$100.19
|
| Rate for Payer: Aetna Medicare |
$55.66
|
| Rate for Payer: ASR ASR |
$107.98
|
| Rate for Payer: ASR Commercial |
$107.98
|
| Rate for Payer: BCBS Complete |
$44.53
|
| Rate for Payer: BCBS Trust/PPO |
$91.16
|
| Rate for Payer: BCN Commercial |
$86.31
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$104.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Healthscope Commercial |
$111.32
|
| Rate for Payer: Healthscope Whirlpool |
$107.98
|
| Rate for Payer: Mclaren Commercial |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: Nomi Health Commercial |
$91.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.54
|
| Rate for Payer: Priority Health Narrow Network |
$78.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.96
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.52 |
| Max. Negotiated Rate |
$490.03 |
| Rate for Payer: Aetna Commercial |
$441.03
|
| Rate for Payer: ASR ASR |
$475.33
|
| Rate for Payer: ASR Commercial |
$475.33
|
| Rate for Payer: BCBS Trust/PPO |
$399.33
|
| Rate for Payer: BCN Commercial |
$379.92
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$460.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Healthscope Commercial |
$490.03
|
| Rate for Payer: Healthscope Whirlpool |
$475.33
|
| Rate for Payer: Mclaren Commercial |
$441.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.23
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.67 |
| Max. Negotiated Rate |
$929.61 |
| Rate for Payer: Aetna Commercial |
$441.03
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$475.33
|
| Rate for Payer: ASR Commercial |
$475.33
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$401.29
|
| Rate for Payer: BCN Commercial |
$379.92
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$460.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$490.03
|
| Rate for Payer: Healthscope Whirlpool |
$475.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$441.03
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.59
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$287.67
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,302.68 |
| Max. Negotiated Rate |
$2,004.12 |
| Rate for Payer: Aetna Commercial |
$1,803.71
|
| Rate for Payer: ASR ASR |
$1,944.00
|
| Rate for Payer: ASR Commercial |
$1,944.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.16
|
| Rate for Payer: BCN Commercial |
$1,553.79
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,883.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Healthscope Commercial |
$2,004.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,944.00
|
| Rate for Payer: Mclaren Commercial |
$1,803.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: Nomi Health Commercial |
$1,643.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,763.63
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$801.65 |
| Max. Negotiated Rate |
$2,004.12 |
| Rate for Payer: Aetna Commercial |
$1,803.71
|
| Rate for Payer: Aetna Medicare |
$1,002.06
|
| Rate for Payer: ASR ASR |
$1,944.00
|
| Rate for Payer: ASR Commercial |
$1,944.00
|
| Rate for Payer: BCBS Complete |
$801.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.17
|
| Rate for Payer: BCN Commercial |
$1,553.79
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,883.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Healthscope Commercial |
$2,004.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,944.00
|
| Rate for Payer: Mclaren Commercial |
$1,803.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: Nomi Health Commercial |
$1,643.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,756.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,763.63
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$628.32 |
| Rate for Payer: Aetna Commercial |
$565.49
|
| Rate for Payer: Aetna Medicare |
$227.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: ASR ASR |
$609.47
|
| Rate for Payer: ASR Commercial |
$609.47
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$514.53
|
| Rate for Payer: BCN Commercial |
$487.14
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$590.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$628.32
|
| Rate for Payer: Healthscope Whirlpool |
$609.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$227.52
|
| Rate for Payer: Mclaren Commercial |
$565.49
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$250.27
|
| Rate for Payer: PHP Medicaid |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.03
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$430.42
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$352.66
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP DNSP |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: VA VA |
$227.52
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$408.41 |
| Max. Negotiated Rate |
$628.32 |
| Rate for Payer: Aetna Commercial |
$565.49
|
| Rate for Payer: ASR ASR |
$609.47
|
| Rate for Payer: ASR Commercial |
$609.47
|
| Rate for Payer: BCBS Trust/PPO |
$512.02
|
| Rate for Payer: BCN Commercial |
$487.14
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$590.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$628.32
|
| Rate for Payer: Healthscope Whirlpool |
$609.47
|
| Rate for Payer: Mclaren Commercial |
$565.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.92
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$7,970.00 |
| Rate for Payer: Aetna Commercial |
$7,173.00
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$7,730.90
|
| Rate for Payer: ASR Commercial |
$7,730.90
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$6,526.63
|
| Rate for Payer: BCN Commercial |
$6,179.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$7,491.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$7,970.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,730.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$7,173.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: Nomi Health Commercial |
$6,535.40
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,055.76
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,444.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,013.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,180.50 |
| Max. Negotiated Rate |
$7,970.00 |
| Rate for Payer: Aetna Commercial |
$7,173.00
|
| Rate for Payer: ASR ASR |
$7,730.90
|
| Rate for Payer: ASR Commercial |
$7,730.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,494.75
|
| Rate for Payer: BCN Commercial |
$6,179.14
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$7,491.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Healthscope Commercial |
$7,970.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,730.90
|
| Rate for Payer: Mclaren Commercial |
$7,173.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: Nomi Health Commercial |
$6,535.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,013.60
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.95 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: ASR ASR |
$643.11
|
| Rate for Payer: ASR Commercial |
$643.11
|
| Rate for Payer: BCBS Trust/PPO |
$540.28
|
| Rate for Payer: BCN Commercial |
$514.02
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$623.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$663.00
|
| Rate for Payer: Healthscope Whirlpool |
$643.11
|
| Rate for Payer: Mclaren Commercial |
$596.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$543.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.44
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna Medicare |
$227.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: ASR ASR |
$643.11
|
| Rate for Payer: ASR Commercial |
$643.11
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$542.93
|
| Rate for Payer: BCN Commercial |
$514.02
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$623.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$663.00
|
| Rate for Payer: Healthscope Whirlpool |
$643.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$227.52
|
| Rate for Payer: Mclaren Commercial |
$596.70
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$543.66
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$250.27
|
| Rate for Payer: PHP Medicaid |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.03
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$430.42
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$352.66
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP DNSP |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: VA VA |
$227.52
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,674.94
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,805.22
|
| Rate for Payer: ASR Commercial |
$1,805.22
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.01
|
| Rate for Payer: BCN Commercial |
$1,442.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,749.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,861.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,805.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,674.94
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: Nomi Health Commercial |
$1,526.06
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.74
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,574.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,637.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,209.68 |
| Max. Negotiated Rate |
$1,861.05 |
| Rate for Payer: Aetna Commercial |
$1,674.94
|
| Rate for Payer: ASR ASR |
$1,805.22
|
| Rate for Payer: ASR Commercial |
$1,805.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.57
|
| Rate for Payer: BCN Commercial |
$1,442.87
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,749.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Healthscope Commercial |
$1,861.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,805.22
|
| Rate for Payer: Mclaren Commercial |
$1,674.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: Nomi Health Commercial |
$1,526.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,637.72
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$873.62
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$941.57
|
| Rate for Payer: ASR Commercial |
$941.57
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$794.90
|
| Rate for Payer: BCN Commercial |
$752.58
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$970.69
|
| Rate for Payer: Healthscope Whirlpool |
$941.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$873.62
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.52
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$680.45
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$630.95 |
| Max. Negotiated Rate |
$970.69 |
| Rate for Payer: Aetna Commercial |
$873.62
|
| Rate for Payer: ASR ASR |
$941.57
|
| Rate for Payer: ASR Commercial |
$941.57
|
| Rate for Payer: BCBS Trust/PPO |
$791.02
|
| Rate for Payer: BCN Commercial |
$752.58
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$970.69
|
| Rate for Payer: Healthscope Whirlpool |
$941.57
|
| Rate for Payer: Mclaren Commercial |
$873.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.21
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.65 |
| Max. Negotiated Rate |
$297.93 |
| Rate for Payer: Aetna Commercial |
$268.14
|
| Rate for Payer: ASR ASR |
$288.99
|
| Rate for Payer: ASR Commercial |
$288.99
|
| Rate for Payer: BCBS Trust/PPO |
$242.78
|
| Rate for Payer: BCN Commercial |
$230.99
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$280.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Healthscope Commercial |
$297.93
|
| Rate for Payer: Healthscope Whirlpool |
$288.99
|
| Rate for Payer: Mclaren Commercial |
$268.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.18
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$369.35 |
| Rate for Payer: Aetna Commercial |
$268.14
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$288.99
|
| Rate for Payer: ASR Commercial |
$288.99
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$243.97
|
| Rate for Payer: BCN Commercial |
$230.99
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$280.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$297.93
|
| Rate for Payer: Healthscope Whirlpool |
$288.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$268.14
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.53
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$277.22
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.12
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.44 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$498.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$498.95
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$548.84
|
| Rate for Payer: PHP Medicaid |
$267.44
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.53
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$773.37
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP DNSP |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,818.47 |
| Max. Negotiated Rate |
$2,797.64 |
| Rate for Payer: Aetna Commercial |
$2,517.88
|
| Rate for Payer: ASR ASR |
$2,713.71
|
| Rate for Payer: ASR Commercial |
$2,713.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,279.80
|
| Rate for Payer: BCN Commercial |
$2,169.01
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$2,629.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Healthscope Commercial |
$2,797.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,713.71
|
| Rate for Payer: Mclaren Commercial |
$2,517.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,377.99
|
| Rate for Payer: Nomi Health Commercial |
$2,294.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,461.92
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,517.88
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$2,713.71
|
| Rate for Payer: ASR Commercial |
$2,713.71
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,290.99
|
| Rate for Payer: BCN Commercial |
$2,169.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$2,629.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,797.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,713.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,517.88
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,377.99
|
| Rate for Payer: Nomi Health Commercial |
$2,294.06
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,451.29
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,961.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,461.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
