|
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
|
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 COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,970.00 |
| Rate for Payer: Aetna Commercial |
$7,173.00
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$7,730.90
|
| Rate for Payer: ASR Commercial |
$7,730.90
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,526.63
|
| Rate for Payer: BCN Commercial |
$6,179.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| 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 |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,970.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,730.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$7,173.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| 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 |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,983.31
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,586.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,013.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
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 |
$121.39 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna Medicare |
$226.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: ASR ASR |
$643.11
|
| Rate for Payer: ASR Commercial |
$643.11
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCBS Trust/PPO |
$542.93
|
| Rate for Payer: BCN Commercial |
$514.02
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| 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 |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$663.00
|
| Rate for Payer: Healthscope Whirlpool |
$643.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$226.48
|
| Rate for Payer: Mclaren Commercial |
$596.70
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$543.66
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$249.13
|
| Rate for Payer: PHP Medicaid |
$121.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.92
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health Narrow Network |
$464.76
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$351.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP DNSP |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$226.48
|
|
|
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 |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,674.94
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$1,805.22
|
| Rate for Payer: ASR Commercial |
$1,805.22
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.01
|
| Rate for Payer: BCN Commercial |
$1,442.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,861.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,805.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,674.94
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| 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 |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,630.65
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,304.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,637.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$873.62
|
| 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 |
$941.57
|
| Rate for Payer: ASR Commercial |
$941.57
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$794.90
|
| Rate for Payer: BCN Commercial |
$752.58
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$970.69
|
| Rate for Payer: Healthscope Whirlpool |
$941.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$873.62
|
| 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 |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| 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 |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.52
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$680.45
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.21
|
| 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 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 |
$127.14 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Aetna Commercial |
$268.14
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$288.99
|
| Rate for Payer: ASR Commercial |
$288.99
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$243.97
|
| Rate for Payer: BCN Commercial |
$230.99
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| 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 |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$297.93
|
| Rate for Payer: Healthscope Whirlpool |
$288.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$268.14
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.05
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$208.85
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
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 |
$266.21 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| 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 |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| 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 |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| 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 |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$2,517.88
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$2,713.71
|
| Rate for Payer: ASR Commercial |
$2,713.71
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,290.99
|
| Rate for Payer: BCN Commercial |
$2,169.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| 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 |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,797.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,713.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,517.88
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| 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 |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| 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 |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,961.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,461.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
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 INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$758.09 |
| Max. Negotiated Rate |
$1,166.29 |
| Rate for Payer: Aetna Commercial |
$1,049.66
|
| Rate for Payer: ASR ASR |
$1,131.30
|
| Rate for Payer: ASR Commercial |
$1,131.30
|
| Rate for Payer: BCBS Trust/PPO |
$950.41
|
| Rate for Payer: BCN Commercial |
$904.22
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,096.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Healthscope Commercial |
$1,166.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,131.30
|
| Rate for Payer: Mclaren Commercial |
$1,049.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: Nomi Health Commercial |
$956.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,026.34
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$1,166.29 |
| Rate for Payer: Aetna Commercial |
$1,049.66
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$1,131.30
|
| Rate for Payer: ASR Commercial |
$1,131.30
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$955.07
|
| Rate for Payer: BCN Commercial |
$904.22
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,096.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$1,166.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,131.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$1,049.66
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: Nomi Health Commercial |
$956.36
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.90
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$817.57
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,026.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Trust/PPO |
$475.31
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$1,108.70 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: Aetna Medicare |
$715.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$894.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$894.11
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Complete |
$402.57
|
| Rate for Payer: BCBS MAPPO |
$715.29
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: BCN Medicare Advantage |
$715.29
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.29
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$715.29
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Mclaren Medicaid |
$383.40
|
| Rate for Payer: Mclaren Medicare |
$715.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.05
|
| Rate for Payer: Meridian Medicaid |
$402.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$822.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Medicare |
$679.53
|
| Rate for Payer: PACE SWMI |
$715.29
|
| Rate for Payer: PHP Commercial |
$786.82
|
| Rate for Payer: PHP Medicaid |
$383.40
|
| Rate for Payer: PHP Medicare Advantage |
$715.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.07
|
| Rate for Payer: Priority Health Medicare |
$715.29
|
| Rate for Payer: Priority Health Narrow Network |
$408.88
|
| Rate for Payer: Railroad Medicare Medicare |
$715.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.29
|
| Rate for Payer: UHC Exchange |
$1,108.70
|
| Rate for Payer: UHC Medicare Advantage |
$715.29
|
| Rate for Payer: UHCCP DNSP |
$715.29
|
| Rate for Payer: UHCCP Medicaid |
$383.40
|
| Rate for Payer: VA VA |
$715.29
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
OP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$414.14 |
| Max. Negotiated Rate |
$2,661.14 |
| Rate for Payer: Aetna Commercial |
$2,395.03
|
| Rate for Payer: Aetna Medicare |
$772.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$965.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$965.80
|
| Rate for Payer: ASR ASR |
$2,581.31
|
| Rate for Payer: ASR Commercial |
$2,581.31
|
| Rate for Payer: BCBS Complete |
$434.84
|
| Rate for Payer: BCBS MAPPO |
$772.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,179.21
|
| Rate for Payer: BCN Commercial |
$2,063.18
|
| Rate for Payer: BCN Medicare Advantage |
$772.64
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$2,501.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.64
|
| Rate for Payer: Healthscope Commercial |
$2,661.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$772.64
|
| Rate for Payer: Mclaren Commercial |
$2,395.03
|
| Rate for Payer: Mclaren Medicaid |
$414.14
|
| Rate for Payer: Mclaren Medicare |
$772.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.27
|
| Rate for Payer: Meridian Medicaid |
$434.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: Nomi Health Commercial |
$2,182.13
|
| Rate for Payer: PACE Medicare |
$734.01
|
| Rate for Payer: PACE SWMI |
$772.64
|
| Rate for Payer: PHP Commercial |
$849.90
|
| Rate for Payer: PHP Medicaid |
$414.14
|
| Rate for Payer: PHP Medicare Advantage |
$772.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,331.69
|
| Rate for Payer: Priority Health Medicare |
$772.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,865.46
|
| Rate for Payer: Railroad Medicare Medicare |
$772.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,341.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.64
|
| Rate for Payer: UHC Exchange |
$1,197.59
|
| Rate for Payer: UHC Medicare Advantage |
$772.64
|
| Rate for Payer: UHCCP DNSP |
$772.64
|
| Rate for Payer: UHCCP Medicaid |
$414.14
|
| Rate for Payer: VA VA |
$772.64
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,729.74 |
| Max. Negotiated Rate |
$2,661.14 |
| Rate for Payer: Aetna Commercial |
$2,395.03
|
| Rate for Payer: ASR ASR |
$2,581.31
|
| Rate for Payer: ASR Commercial |
$2,581.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,168.56
|
| Rate for Payer: BCN Commercial |
$2,063.18
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$2,501.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Healthscope Commercial |
$2,661.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.31
|
| Rate for Payer: Mclaren Commercial |
$2,395.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: Nomi Health Commercial |
$2,182.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,341.80
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
OP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$65.90 |
| Max. Negotiated Rate |
$164.75 |
| Rate for Payer: Aetna Commercial |
$148.28
|
| Rate for Payer: Aetna Medicare |
$82.38
|
| Rate for Payer: ASR ASR |
$159.81
|
| Rate for Payer: ASR Commercial |
$159.81
|
| Rate for Payer: BCBS Complete |
$65.90
|
| Rate for Payer: BCBS Trust/PPO |
$134.91
|
| Rate for Payer: BCN Commercial |
$127.73
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$154.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Healthscope Commercial |
$164.75
|
| Rate for Payer: Healthscope Whirlpool |
$159.81
|
| Rate for Payer: Mclaren Commercial |
$148.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: Nomi Health Commercial |
$135.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.35
|
| Rate for Payer: Priority Health Narrow Network |
$115.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.98
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
IP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$107.09 |
| Max. Negotiated Rate |
$164.75 |
| Rate for Payer: Aetna Commercial |
$148.28
|
| Rate for Payer: ASR ASR |
$159.81
|
| Rate for Payer: ASR Commercial |
$159.81
|
| Rate for Payer: BCBS Trust/PPO |
$134.25
|
| Rate for Payer: BCN Commercial |
$127.73
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$154.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Healthscope Commercial |
$164.75
|
| Rate for Payer: Healthscope Whirlpool |
$159.81
|
| Rate for Payer: Mclaren Commercial |
$148.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: Nomi Health Commercial |
$135.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.98
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
OP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.61 |
| Max. Negotiated Rate |
$3,753.24 |
| Rate for Payer: Aetna Commercial |
$3,377.92
|
| Rate for Payer: Aetna Medicare |
$1,183.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,479.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,479.97
|
| Rate for Payer: ASR ASR |
$3,640.64
|
| Rate for Payer: ASR Commercial |
$3,640.64
|
| Rate for Payer: BCBS Complete |
$666.34
|
| Rate for Payer: BCBS MAPPO |
$1,183.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,073.53
|
| Rate for Payer: BCN Commercial |
$2,909.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,183.98
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$3,528.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,183.98
|
| Rate for Payer: Healthscope Commercial |
$3,753.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,640.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,183.98
|
| Rate for Payer: Mclaren Commercial |
$3,377.92
|
| Rate for Payer: Mclaren Medicaid |
$634.61
|
| Rate for Payer: Mclaren Medicare |
$1,183.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.18
|
| Rate for Payer: Meridian Medicaid |
$666.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,361.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: Nomi Health Commercial |
$3,077.66
|
| Rate for Payer: PACE Medicare |
$1,124.78
|
| Rate for Payer: PACE SWMI |
$1,183.98
|
| Rate for Payer: PHP Commercial |
$1,302.38
|
| Rate for Payer: PHP Medicaid |
$634.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,183.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,288.59
|
| Rate for Payer: Priority Health Medicare |
$1,183.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,631.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,302.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,183.98
|
| Rate for Payer: UHC Exchange |
$1,835.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,183.98
|
| Rate for Payer: UHCCP DNSP |
$1,183.98
|
| Rate for Payer: UHCCP Medicaid |
$634.61
|
| Rate for Payer: VA VA |
$1,183.98
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
IP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,439.61 |
| Max. Negotiated Rate |
$3,753.24 |
| Rate for Payer: Aetna Commercial |
$3,377.92
|
| Rate for Payer: ASR ASR |
$3,640.64
|
| Rate for Payer: ASR Commercial |
$3,640.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,058.52
|
| Rate for Payer: BCN Commercial |
$2,909.89
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$3,528.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Healthscope Commercial |
$3,753.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,640.64
|
| Rate for Payer: Mclaren Commercial |
$3,377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: Nomi Health Commercial |
$3,077.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,302.85
|
|
