|
HC IR CATHETER.
|
Facility
|
IP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.08 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$214.89
|
| Rate for Payer: ASR ASR |
$231.61
|
| Rate for Payer: BCBS Trust/PPO |
$196.08
|
| Rate for Payer: BCN Commercial |
$196.08
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$224.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$231.61
|
| Rate for Payer: Healthscope Whirlpool |
$238.77
|
| Rate for Payer: Mclaren Commercial |
$214.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.12
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.34 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$214.89
|
| Rate for Payer: Aetna Medicare |
$88.34
|
| Rate for Payer: ASR ASR |
$231.61
|
| Rate for Payer: BCBS Complete |
$95.51
|
| Rate for Payer: BCBS Trust/PPO |
$196.87
|
| Rate for Payer: BCN Commercial |
$196.87
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$224.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$231.61
|
| Rate for Payer: Healthscope Whirlpool |
$238.77
|
| Rate for Payer: Mclaren Commercial |
$214.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.21
|
| Rate for Payer: Priority Health Narrow Network |
$167.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.12
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$566.77 |
| Rate for Payer: Aetna Commercial |
$510.09
|
| Rate for Payer: Aetna Medicare |
$211.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$264.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$264.93
|
| Rate for Payer: ASR ASR |
$549.77
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$211.94
|
| Rate for Payer: BCBS Trust/PPO |
$467.30
|
| Rate for Payer: BCN Commercial |
$467.30
|
| Rate for Payer: BCN Medicare Advantage |
$211.94
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$532.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.94
|
| Rate for Payer: Healthscope Commercial |
$549.77
|
| Rate for Payer: Healthscope Whirlpool |
$566.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$211.94
|
| Rate for Payer: Mclaren Commercial |
$510.09
|
| Rate for Payer: Mclaren Medicaid |
$211.94
|
| Rate for Payer: Mclaren Medicare |
$211.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.54
|
| Rate for Payer: Meridian Medicaid |
$116.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PACE Medicare |
$201.34
|
| Rate for Payer: PACE SWMI |
$211.94
|
| Rate for Payer: PHP Commercial |
$233.13
|
| Rate for Payer: PHP Medicaid |
$113.60
|
| Rate for Payer: PHP Medicare Advantage |
$211.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$391.00
|
| Rate for Payer: Priority Health Medicare |
$211.94
|
| Rate for Payer: Priority Health Narrow Network |
$312.80
|
| Rate for Payer: Railroad Medicare Medicare |
$211.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.94
|
| Rate for Payer: UHC Exchange |
$328.51
|
| Rate for Payer: UHC Medicaid |
$110.84
|
| Rate for Payer: UHCCP DNSP |
$211.94
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$211.94
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.08 |
| Max. Negotiated Rate |
$566.77 |
| Rate for Payer: Aetna Commercial |
$510.09
|
| Rate for Payer: ASR ASR |
$549.77
|
| Rate for Payer: BCBS Trust/PPO |
$465.43
|
| Rate for Payer: BCN Commercial |
$465.43
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$532.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$549.77
|
| Rate for Payer: Healthscope Whirlpool |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$510.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.76
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,631.99 |
| Rate for Payer: Aetna Commercial |
$3,268.79
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$3,523.03
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,994.58
|
| Rate for Payer: BCN Commercial |
$2,994.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Commercial |
$3,414.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,523.03
|
| Rate for Payer: Healthscope Whirlpool |
$3,631.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$3,268.79
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Nomi Health Commercial |
$2,978.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,182.35
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,546.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,196.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,723.99 |
| Max. Negotiated Rate |
$3,631.99 |
| Rate for Payer: Aetna Commercial |
$3,268.79
|
| Rate for Payer: ASR ASR |
$3,523.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,982.59
|
| Rate for Payer: BCN Commercial |
$2,982.59
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Commercial |
$3,414.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Healthscope Commercial |
$3,523.03
|
| Rate for Payer: Healthscope Whirlpool |
$3,631.99
|
| Rate for Payer: Mclaren Commercial |
$3,268.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Nomi Health Commercial |
$2,978.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,196.15
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$3,015.84 |
| Rate for Payer: Aetna Commercial |
$2,348.37
|
| Rate for Payer: Aetna Medicare |
$1,945.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: ASR ASR |
$2,531.02
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.37
|
| Rate for Payer: BCN Commercial |
$2,151.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Commercial |
$2,452.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,531.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,609.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,945.70
|
| Rate for Payer: Mclaren Commercial |
$2,348.37
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$1,068.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Nomi Health Commercial |
$2,139.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,140.27
|
| Rate for Payer: PHP Medicaid |
$1,042.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,286.27
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,829.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,296.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Exchange |
$3,015.84
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP DNSP |
$1,945.70
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,956.97 |
| Max. Negotiated Rate |
$2,609.30 |
| Rate for Payer: Aetna Commercial |
$2,348.37
|
| Rate for Payer: ASR ASR |
$2,531.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,142.76
|
| Rate for Payer: BCN Commercial |
$2,142.76
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Commercial |
$2,452.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Healthscope Commercial |
$2,531.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,609.30
|
| Rate for Payer: Mclaren Commercial |
$2,348.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Nomi Health Commercial |
$2,139.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,296.18
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,240.71 |
| Max. Negotiated Rate |
$2,987.61 |
| Rate for Payer: Aetna Commercial |
$2,688.85
|
| Rate for Payer: ASR ASR |
$2,897.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,453.43
|
| Rate for Payer: BCN Commercial |
$2,453.43
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Commercial |
$2,808.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Healthscope Commercial |
$2,897.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,987.61
|
| Rate for Payer: Mclaren Commercial |
$2,688.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Nomi Health Commercial |
$2,449.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,629.10
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$3,015.84 |
| Rate for Payer: Aetna Commercial |
$2,688.85
|
| Rate for Payer: Aetna Medicare |
$1,945.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: ASR ASR |
$2,897.98
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,463.28
|
| Rate for Payer: BCN Commercial |
$2,463.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Commercial |
$2,808.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,897.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,987.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,945.70
|
| Rate for Payer: Mclaren Commercial |
$2,688.85
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$1,068.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Nomi Health Commercial |
$2,449.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,140.27
|
| Rate for Payer: PHP Medicaid |
$1,042.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,617.74
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,094.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,629.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Exchange |
$3,015.84
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP DNSP |
$1,945.70
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,320.72 |
| Max. Negotiated Rate |
$3,569.52 |
| Rate for Payer: Aetna Commercial |
$3,212.57
|
| Rate for Payer: Aetna Medicare |
$1,320.72
|
| Rate for Payer: ASR ASR |
$3,462.43
|
| Rate for Payer: BCBS Complete |
$1,427.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,943.07
|
| Rate for Payer: BCN Commercial |
$2,943.07
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,355.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,462.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,569.52
|
| Rate for Payer: Mclaren Commercial |
$3,212.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,855.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,127.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.18
|
|
|
HC IR EMBOLIZATION
|
Facility
|
IP
|
$3,569.52
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,677.14 |
| Max. Negotiated Rate |
$3,569.52 |
| Rate for Payer: Aetna Commercial |
$3,212.57
|
| Rate for Payer: ASR ASR |
$3,462.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,931.29
|
| Rate for Payer: BCN Commercial |
$2,931.29
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,355.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,462.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,569.52
|
| Rate for Payer: Mclaren Commercial |
$3,212.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.18
|
|
|
HC IR ERCP
|
Facility
|
IP
|
$832.99
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$624.74 |
| Max. Negotiated Rate |
$832.99 |
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$808.00
|
| Rate for Payer: BCBS Trust/PPO |
$684.05
|
| Rate for Payer: BCN Commercial |
$684.05
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$783.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Healthscope Commercial |
$808.00
|
| Rate for Payer: Healthscope Whirlpool |
$832.99
|
| Rate for Payer: Mclaren Commercial |
$749.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.03
|
|
|
HC IR ERCP
|
Facility
|
OP
|
$832.99
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$832.99 |
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: Aetna Medicare |
$308.21
|
| Rate for Payer: ASR ASR |
$808.00
|
| Rate for Payer: BCBS Complete |
$333.20
|
| Rate for Payer: BCBS Trust/PPO |
$686.80
|
| Rate for Payer: BCN Commercial |
$686.80
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$783.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Healthscope Commercial |
$808.00
|
| Rate for Payer: Healthscope Whirlpool |
$832.99
|
| Rate for Payer: Mclaren Commercial |
$749.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$666.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.87
|
| Rate for Payer: Priority Health Narrow Network |
$583.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.03
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
IP
|
$641.52
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$481.14 |
| Max. Negotiated Rate |
$641.52 |
| Rate for Payer: Aetna Commercial |
$577.37
|
| Rate for Payer: ASR ASR |
$622.27
|
| Rate for Payer: BCBS Trust/PPO |
$526.82
|
| Rate for Payer: BCN Commercial |
$526.82
|
| Rate for Payer: Cash Price |
$513.22
|
| Rate for Payer: Cofinity Commercial |
$603.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.22
|
| Rate for Payer: Healthscope Commercial |
$622.27
|
| Rate for Payer: Healthscope Whirlpool |
$641.52
|
| Rate for Payer: Mclaren Commercial |
$577.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.29
|
| Rate for Payer: Nomi Health Commercial |
$526.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$481.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.54
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
OP
|
$641.52
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$237.36 |
| Max. Negotiated Rate |
$641.52 |
| Rate for Payer: Aetna Commercial |
$577.37
|
| Rate for Payer: Aetna Medicare |
$237.36
|
| Rate for Payer: ASR ASR |
$622.27
|
| Rate for Payer: BCBS Complete |
$256.61
|
| Rate for Payer: BCBS Trust/PPO |
$528.93
|
| Rate for Payer: BCN Commercial |
$528.93
|
| Rate for Payer: Cash Price |
$513.22
|
| Rate for Payer: Cofinity Commercial |
$603.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.22
|
| Rate for Payer: Healthscope Commercial |
$622.27
|
| Rate for Payer: Healthscope Whirlpool |
$641.52
|
| Rate for Payer: Mclaren Commercial |
$577.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$513.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.29
|
| Rate for Payer: Nomi Health Commercial |
$526.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$481.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$562.10
|
| Rate for Payer: Priority Health Narrow Network |
$449.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.54
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.42 |
| Max. Negotiated Rate |
$312.56 |
| Rate for Payer: Aetna Commercial |
$281.30
|
| Rate for Payer: ASR ASR |
$303.18
|
| Rate for Payer: BCBS Trust/PPO |
$256.67
|
| Rate for Payer: BCN Commercial |
$256.67
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$293.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$303.18
|
| Rate for Payer: Healthscope Whirlpool |
$312.56
|
| Rate for Payer: Mclaren Commercial |
$281.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.05
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$115.65 |
| Max. Negotiated Rate |
$312.56 |
| Rate for Payer: Aetna Commercial |
$281.30
|
| Rate for Payer: Aetna Medicare |
$115.65
|
| Rate for Payer: ASR ASR |
$303.18
|
| Rate for Payer: BCBS Complete |
$125.02
|
| Rate for Payer: BCBS Trust/PPO |
$257.71
|
| Rate for Payer: BCN Commercial |
$257.71
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$293.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$303.18
|
| Rate for Payer: Healthscope Whirlpool |
$312.56
|
| Rate for Payer: Mclaren Commercial |
$281.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$262.08
|
| Rate for Payer: Priority Health Narrow Network |
$209.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.05
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.90 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: Aetna Medicare |
$211.94
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Complete |
$229.13
|
| Rate for Payer: BCBS Trust/PPO |
$472.29
|
| Rate for Payer: BCN Commercial |
$472.29
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$99.88
|
| Rate for Payer: Priority Health Narrow Network |
$79.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Trust/PPO |
$470.40
|
| Rate for Payer: BCN Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$472.29
|
| Rate for Payer: BCN Commercial |
$472.29
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$501.90
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$401.55
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Trust/PPO |
$470.40
|
| Rate for Payer: BCN Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$1,492.33
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,119.25 |
| Max. Negotiated Rate |
$1,492.33 |
| Rate for Payer: Aetna Commercial |
$1,343.10
|
| Rate for Payer: Aetna Commercial |
$895.40
|
| Rate for Payer: ASR ASR |
$1,447.56
|
| Rate for Payer: ASR ASR |
$965.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.50
|
| Rate for Payer: BCBS Trust/PPO |
$817.00
|
| Rate for Payer: BCN Commercial |
$1,225.50
|
| Rate for Payer: BCN Commercial |
$817.00
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cofinity Commercial |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$1,402.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Healthscope Commercial |
$1,447.56
|
| Rate for Payer: Healthscope Commercial |
$965.04
|
| Rate for Payer: Healthscope Whirlpool |
$994.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.33
|
| Rate for Payer: Mclaren Commercial |
$895.40
|
| Rate for Payer: Mclaren Commercial |
$1,343.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.25
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$1,492.33
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,492.33 |
| Rate for Payer: Aetna Commercial |
$1,343.10
|
| Rate for Payer: Aetna Commercial |
$895.40
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,447.56
|
| Rate for Payer: ASR ASR |
$965.04
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$820.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.43
|
| Rate for Payer: BCN Commercial |
$820.29
|
| Rate for Payer: BCN Commercial |
$1,230.43
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Commercial |
$1,402.79
|
| Rate for Payer: Cofinity Commercial |
$935.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,447.56
|
| Rate for Payer: Healthscope Commercial |
$965.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.33
|
| Rate for Payer: Healthscope Whirlpool |
$994.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$895.40
|
| Rate for Payer: Mclaren Commercial |
$1,343.10
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$788.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$788.89
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$631.11
|
| Rate for Payer: Priority Health Narrow Network |
$631.11
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
OP
|
$1,537.04
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$568.70 |
| Max. Negotiated Rate |
$1,537.04 |
| Rate for Payer: Aetna Commercial |
$1,383.34
|
| Rate for Payer: Aetna Medicare |
$568.70
|
| Rate for Payer: ASR ASR |
$1,490.93
|
| Rate for Payer: BCBS Complete |
$614.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.29
|
| Rate for Payer: BCN Commercial |
$1,267.29
|
| Rate for Payer: Cash Price |
$1,229.63
|
| Rate for Payer: Cofinity Commercial |
$1,444.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.63
|
| Rate for Payer: Healthscope Commercial |
$1,490.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,537.04
|
| Rate for Payer: Mclaren Commercial |
$1,383.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,229.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.48
|
| Rate for Payer: Nomi Health Commercial |
$1,260.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,152.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,346.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.60
|
|
