|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,942.81
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$5,529.67 |
| Rate for Payer: Aetna Commercial |
$4,448.53
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$4,794.53
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,075.35
|
| Rate for Payer: BCN Commercial |
$4,075.35
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,954.25
|
| Rate for Payer: Cash Price |
$3,954.25
|
| Rate for Payer: Cofinity Commercial |
$4,646.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$4,794.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,942.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$4,448.53
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.39
|
| Rate for Payer: Nomi Health Commercial |
$4,053.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.11
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,330.89
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$3,464.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,349.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Exchange |
$5,529.67
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,942.81
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,707.11 |
| Max. Negotiated Rate |
$4,942.81 |
| Rate for Payer: Aetna Commercial |
$4,448.53
|
| Rate for Payer: ASR ASR |
$4,794.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,059.04
|
| Rate for Payer: BCN Commercial |
$4,059.04
|
| Rate for Payer: Cash Price |
$3,954.25
|
| Rate for Payer: Cofinity Commercial |
$4,646.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.25
|
| Rate for Payer: Healthscope Commercial |
$4,794.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,942.81
|
| Rate for Payer: Mclaren Commercial |
$4,448.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.39
|
| Rate for Payer: Nomi Health Commercial |
$4,053.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,349.67
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$5,103.92
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,827.94 |
| Max. Negotiated Rate |
$5,103.92 |
| Rate for Payer: Aetna Commercial |
$4,593.53
|
| Rate for Payer: ASR ASR |
$4,950.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,191.34
|
| Rate for Payer: BCN Commercial |
$4,191.34
|
| Rate for Payer: Cash Price |
$4,083.14
|
| Rate for Payer: Cofinity Commercial |
$4,797.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,083.14
|
| Rate for Payer: Healthscope Commercial |
$4,950.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,103.92
|
| Rate for Payer: Mclaren Commercial |
$4,593.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,338.33
|
| Rate for Payer: Nomi Health Commercial |
$4,185.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,827.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,491.45
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$5,103.92
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$5,103.92 |
| Rate for Payer: Aetna Commercial |
$4,593.53
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,950.80
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,208.18
|
| Rate for Payer: BCN Commercial |
$4,208.18
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,083.14
|
| Rate for Payer: Cash Price |
$4,083.14
|
| Rate for Payer: Cofinity Commercial |
$4,797.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,083.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,950.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,103.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,593.53
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,338.33
|
| Rate for Payer: Nomi Health Commercial |
$4,185.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,827.94
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,472.05
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,577.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,491.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,665.30
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,846.54
|
| Rate for Payer: BCN Commercial |
$3,846.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,087.74
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,270.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,665.30
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,498.97 |
| Max. Negotiated Rate |
$4,665.30 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,831.14
|
| Rate for Payer: BCN Commercial |
$3,831.14
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,963.24
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$4,466.92
|
| Rate for Payer: Aetna Medicare |
$5,544.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: ASR ASR |
$4,814.34
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,092.19
|
| Rate for Payer: BCN Commercial |
$4,092.19
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cofinity Commercial |
$4,665.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,970.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$4,814.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,963.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$4,466.92
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$3,045.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,218.75
|
| Rate for Payer: Nomi Health Commercial |
$4,069.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,722.43
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$6,098.93
|
| Rate for Payer: PHP Medicaid |
$2,971.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,348.79
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,479.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,367.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$8,593.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP DNSP |
$5,544.48
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,963.24
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,722.43 |
| Max. Negotiated Rate |
$4,963.24 |
| Rate for Payer: Aetna Commercial |
$4,466.92
|
| Rate for Payer: ASR ASR |
$4,814.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,075.81
|
| Rate for Payer: BCN Commercial |
$4,075.81
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cofinity Commercial |
$4,665.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,970.59
|
| Rate for Payer: Healthscope Commercial |
$4,814.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,963.24
|
| Rate for Payer: Mclaren Commercial |
$4,466.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,218.75
|
| Rate for Payer: Nomi Health Commercial |
$4,069.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,722.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,367.65
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$2,015.23
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,412.68 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$1,813.71
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$1,954.77
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.56
|
| Rate for Payer: BCN Commercial |
$1,661.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cofinity Commercial |
$1,894.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,954.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,015.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$1,813.71
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.95
|
| Rate for Payer: Nomi Health Commercial |
$1,652.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,511.42
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,765.74
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,412.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$2,015.23
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,511.42 |
| Max. Negotiated Rate |
$2,015.23 |
| Rate for Payer: Aetna Commercial |
$1,813.71
|
| Rate for Payer: ASR ASR |
$1,954.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.91
|
| Rate for Payer: BCN Commercial |
$1,654.91
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cofinity Commercial |
$1,894.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.18
|
| Rate for Payer: Healthscope Commercial |
$1,954.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,015.23
|
| Rate for Payer: Mclaren Commercial |
$1,813.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.95
|
| Rate for Payer: Nomi Health Commercial |
$1,652.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,511.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.40
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,375.24
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,559.99
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,175.99
|
| Rate for Payer: BCN Commercial |
$2,175.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Commercial |
$2,480.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,559.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,639.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,375.24
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Nomi Health Commercial |
$2,164.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,312.43
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,850.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,322.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,979.37 |
| Max. Negotiated Rate |
$2,639.16 |
| Rate for Payer: Aetna Commercial |
$2,375.24
|
| Rate for Payer: ASR ASR |
$2,559.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,167.28
|
| Rate for Payer: BCN Commercial |
$2,167.28
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Commercial |
$2,480.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Healthscope Commercial |
$2,559.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,639.16
|
| Rate for Payer: Mclaren Commercial |
$2,375.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Nomi Health Commercial |
$2,164.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,322.46
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,594.66 |
| Max. Negotiated Rate |
$12,417.99 |
| Rate for Payer: Aetna Commercial |
$11,176.19
|
| Rate for Payer: Aetna Medicare |
$4,594.66
|
| Rate for Payer: ASR ASR |
$12,045.45
|
| Rate for Payer: BCBS Complete |
$4,967.20
|
| Rate for Payer: BCBS Trust/PPO |
$10,238.63
|
| Rate for Payer: BCN Commercial |
$10,238.63
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$11,672.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$12,045.45
|
| Rate for Payer: Healthscope Whirlpool |
$12,417.99
|
| Rate for Payer: Mclaren Commercial |
$11,176.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,934.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,369.77
|
| Rate for Payer: Priority Health Narrow Network |
$8,295.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,927.83
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,313.49 |
| Max. Negotiated Rate |
$12,417.99 |
| Rate for Payer: Aetna Commercial |
$11,176.19
|
| Rate for Payer: ASR ASR |
$12,045.45
|
| Rate for Payer: BCBS Trust/PPO |
$10,197.65
|
| Rate for Payer: BCN Commercial |
$10,197.65
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$11,672.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$12,045.45
|
| Rate for Payer: Healthscope Whirlpool |
$12,417.99
|
| Rate for Payer: Mclaren Commercial |
$11,176.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,927.83
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,096.85 |
| Max. Negotiated Rate |
$1,462.47 |
| Rate for Payer: Aetna Commercial |
$1,316.22
|
| Rate for Payer: ASR ASR |
$1,418.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.98
|
| Rate for Payer: BCN Commercial |
$1,200.98
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,374.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Healthscope Commercial |
$1,418.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,462.47
|
| Rate for Payer: Mclaren Commercial |
$1,316.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Nomi Health Commercial |
$1,199.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,286.97
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,462.47 |
| Rate for Payer: Aetna Commercial |
$1,316.22
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,418.60
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.81
|
| Rate for Payer: BCN Commercial |
$1,205.81
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,374.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,418.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,462.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$1,316.22
|
| Rate for Payer: Mclaren Medicaid |
$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 Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Nomi Health Commercial |
$1,199.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| 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 Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$631.11
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,286.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,115.76 |
| Rate for Payer: Aetna Commercial |
$1,004.18
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,082.29
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$919.94
|
| Rate for Payer: BCN Commercial |
$919.94
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Commercial |
$1,048.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,082.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,115.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$1,004.18
|
| Rate for Payer: Mclaren Medicaid |
$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 Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Nomi Health Commercial |
$914.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| 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 Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$631.11
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$981.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$836.82 |
| Max. Negotiated Rate |
$1,115.76 |
| Rate for Payer: Aetna Commercial |
$1,004.18
|
| Rate for Payer: ASR ASR |
$1,082.29
|
| Rate for Payer: BCBS Trust/PPO |
$916.26
|
| Rate for Payer: BCN Commercial |
$916.26
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Commercial |
$1,048.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Healthscope Commercial |
$1,082.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,115.76
|
| Rate for Payer: Mclaren Commercial |
$1,004.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Nomi Health Commercial |
$914.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$981.87
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,779.88
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,996.09
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,546.67
|
| Rate for Payer: BCN Commercial |
$2,546.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Commercial |
$2,903.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,996.09
|
| Rate for Payer: Healthscope Whirlpool |
$3,088.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,779.88
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Nomi Health Commercial |
$2,532.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,706.36
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,165.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,718.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,316.56 |
| Max. Negotiated Rate |
$3,088.75 |
| Rate for Payer: Aetna Commercial |
$2,779.88
|
| Rate for Payer: ASR ASR |
$2,996.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,536.48
|
| Rate for Payer: BCN Commercial |
$2,536.48
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Commercial |
$2,903.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Commercial |
$2,996.09
|
| Rate for Payer: Healthscope Whirlpool |
$3,088.75
|
| Rate for Payer: Mclaren Commercial |
$2,779.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Nomi Health Commercial |
$2,532.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,718.10
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$929.24 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$1,193.03
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$1,285.82
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.95
|
| Rate for Payer: BCN Commercial |
$1,092.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Commercial |
$1,246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,285.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,325.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$1,193.03
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.75
|
| Rate for Payer: Nomi Health Commercial |
$1,086.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,161.48
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$929.24
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$994.19 |
| Max. Negotiated Rate |
$1,325.59 |
| Rate for Payer: Aetna Commercial |
$1,193.03
|
| Rate for Payer: ASR ASR |
$1,285.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.57
|
| Rate for Payer: BCN Commercial |
$1,088.57
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Commercial |
$1,246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Healthscope Commercial |
$1,285.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,325.59
|
| Rate for Payer: Mclaren Commercial |
$1,193.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.75
|
| Rate for Payer: Nomi Health Commercial |
$1,086.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.52
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.91 |
| Max. Negotiated Rate |
$681.36 |
| Rate for Payer: Aetna Commercial |
$535.46
|
| Rate for Payer: Aetna Medicare |
$439.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.49
|
| Rate for Payer: ASR ASR |
$577.10
|
| Rate for Payer: BCBS Complete |
$241.42
|
| Rate for Payer: BCBS MAPPO |
$439.59
|
| Rate for Payer: BCBS Trust/PPO |
$490.54
|
| Rate for Payer: BCN Commercial |
$490.54
|
| Rate for Payer: BCN Medicare Advantage |
$439.59
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$559.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.59
|
| Rate for Payer: Healthscope Commercial |
$577.10
|
| Rate for Payer: Healthscope Whirlpool |
$594.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$439.59
|
| Rate for Payer: Mclaren Commercial |
$535.46
|
| Rate for Payer: Mclaren Medicaid |
$439.59
|
| Rate for Payer: Mclaren Medicare |
$439.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$241.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Medicare |
$417.61
|
| Rate for Payer: PACE SWMI |
$439.59
|
| Rate for Payer: PHP Commercial |
$483.55
|
| Rate for Payer: PHP Medicaid |
$235.62
|
| Rate for Payer: PHP Medicare Advantage |
$439.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$521.30
|
| Rate for Payer: Priority Health Medicare |
$439.59
|
| Rate for Payer: Priority Health Narrow Network |
$417.06
|
| Rate for Payer: Railroad Medicare Medicare |
$439.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.59
|
| Rate for Payer: UHC Exchange |
$681.36
|
| Rate for Payer: UHC Medicaid |
$229.91
|
| Rate for Payer: UHCCP DNSP |
$439.59
|
| Rate for Payer: UHCCP Medicaid |
$229.91
|
| Rate for Payer: VA VA |
$439.59
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$446.21 |
| Max. Negotiated Rate |
$594.95 |
| Rate for Payer: Aetna Commercial |
$535.46
|
| Rate for Payer: ASR ASR |
$577.10
|
| Rate for Payer: BCBS Trust/PPO |
$488.57
|
| Rate for Payer: BCN Commercial |
$488.57
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$559.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$577.10
|
| Rate for Payer: Healthscope Whirlpool |
$594.95
|
| Rate for Payer: Mclaren Commercial |
$535.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.56
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,810.96 |
| Max. Negotiated Rate |
$3,747.95 |
| Rate for Payer: Aetna Commercial |
$3,373.16
|
| Rate for Payer: ASR ASR |
$3,635.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,077.82
|
| Rate for Payer: BCN Commercial |
$3,077.82
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Commercial |
$3,523.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,635.51
|
| Rate for Payer: Healthscope Whirlpool |
$3,747.95
|
| Rate for Payer: Mclaren Commercial |
$3,373.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Nomi Health Commercial |
$3,073.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,298.20
|
|
