|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$27,544.40
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$27,544.40 |
| Rate for Payer: Aetna Commercial |
$24,789.96
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$26,718.07
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$21,355.17
|
| Rate for Payer: BCN Commercial |
$21,355.17
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$22,035.52
|
| Rate for Payer: Cash Price |
$22,035.52
|
| Rate for Payer: Cofinity Commercial |
$25,891.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,035.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$27,544.40
|
| Rate for Payer: Healthscope Whirlpool |
$26,718.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$24,789.96
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,412.74
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,281.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,065.40
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$19,556.52
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,239.07
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.42
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$13.42 |
| Rate for Payer: Aetna Commercial |
$12.08
|
| Rate for Payer: ASR ASR |
$13.02
|
| Rate for Payer: BCBS Trust/PPO |
$10.40
|
| Rate for Payer: BCN Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$12.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$13.42
|
| Rate for Payer: Healthscope Whirlpool |
$13.02
|
| Rate for Payer: Mclaren Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.81
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.42
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$13.42 |
| Rate for Payer: Aetna Commercial |
$12.08
|
| Rate for Payer: ASR ASR |
$13.02
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.40
|
| Rate for Payer: BCN Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$12.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$13.42
|
| Rate for Payer: Healthscope Whirlpool |
$13.02
|
| Rate for Payer: Mclaren Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.21
|
| Rate for Payer: Priority Health Narrow Network |
$9.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.81
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,449.05
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$4,449.05 |
| Rate for Payer: Aetna Commercial |
$4,004.14
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$4,315.58
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,449.35
|
| Rate for Payer: BCN Commercial |
$3,449.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$3,559.24
|
| Rate for Payer: Cash Price |
$3,559.24
|
| Rate for Payer: Cofinity Commercial |
$4,182.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,559.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$4,449.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,315.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$4,004.14
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,781.69
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,114.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,048.64
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$3,158.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,915.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,449.05
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,114.34 |
| Max. Negotiated Rate |
$4,449.05 |
| Rate for Payer: Aetna Commercial |
$4,004.14
|
| Rate for Payer: ASR ASR |
$4,315.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,449.35
|
| Rate for Payer: BCN Commercial |
$3,449.35
|
| Rate for Payer: Cash Price |
$3,559.24
|
| Rate for Payer: Cofinity Commercial |
$4,182.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,559.24
|
| Rate for Payer: Healthscope Commercial |
$4,449.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,315.58
|
| Rate for Payer: Mclaren Commercial |
$4,004.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,781.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,114.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,915.16
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
IP
|
$6,397.73
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,478.41 |
| Max. Negotiated Rate |
$6,397.73 |
| Rate for Payer: Aetna Commercial |
$5,757.96
|
| Rate for Payer: ASR ASR |
$6,205.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,960.16
|
| Rate for Payer: BCN Commercial |
$4,960.16
|
| Rate for Payer: Cash Price |
$5,118.18
|
| Rate for Payer: Cofinity Commercial |
$6,013.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,118.18
|
| Rate for Payer: Healthscope Commercial |
$6,397.73
|
| Rate for Payer: Healthscope Whirlpool |
$6,205.80
|
| Rate for Payer: Mclaren Commercial |
$5,757.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,438.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,478.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,630.00
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
OP
|
$6,397.73
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,559.09 |
| Max. Negotiated Rate |
$6,397.73 |
| Rate for Payer: Aetna Commercial |
$5,757.96
|
| Rate for Payer: ASR ASR |
$6,205.80
|
| Rate for Payer: BCBS Complete |
$2,559.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,960.16
|
| Rate for Payer: BCN Commercial |
$4,960.16
|
| Rate for Payer: Cash Price |
$5,118.18
|
| Rate for Payer: Cofinity Commercial |
$6,013.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,118.18
|
| Rate for Payer: Healthscope Commercial |
$6,397.73
|
| Rate for Payer: Healthscope Whirlpool |
$6,205.80
|
| Rate for Payer: Mclaren Commercial |
$5,757.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,438.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,478.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,821.93
|
| Rate for Payer: Priority Health Narrow Network |
$4,542.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,630.00
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
OP
|
$2,495.36
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$2,495.36 |
| Rate for Payer: Aetna Commercial |
$2,245.82
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$2,420.50
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.65
|
| Rate for Payer: BCN Commercial |
$1,934.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,996.29
|
| Rate for Payer: Cash Price |
$1,996.29
|
| Rate for Payer: Cofinity Commercial |
$2,345.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$2,495.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$2,245.82
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.06
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,745.12
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,396.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,495.36
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,746.75 |
| Max. Negotiated Rate |
$2,495.36 |
| Rate for Payer: Aetna Commercial |
$2,245.82
|
| Rate for Payer: ASR ASR |
$2,420.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.65
|
| Rate for Payer: BCN Commercial |
$1,934.65
|
| Rate for Payer: Cash Price |
$1,996.29
|
| Rate for Payer: Cofinity Commercial |
$2,345.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.29
|
| Rate for Payer: Healthscope Commercial |
$2,495.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.50
|
| Rate for Payer: Mclaren Commercial |
$2,245.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.92
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$101.22
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$101.22 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$98.18
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$78.48
|
| Rate for Payer: BCN Commercial |
$78.48
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cofinity Commercial |
$95.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$101.22
|
| Rate for Payer: Healthscope Whirlpool |
$98.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$91.10
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.04
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.11
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$71.87
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.07
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
IP
|
$101.22
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$70.85 |
| Max. Negotiated Rate |
$101.22 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: ASR ASR |
$98.18
|
| Rate for Payer: BCBS Trust/PPO |
$78.48
|
| Rate for Payer: BCN Commercial |
$78.48
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cofinity Commercial |
$95.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.98
|
| Rate for Payer: Healthscope Commercial |
$101.22
|
| Rate for Payer: Healthscope Whirlpool |
$98.18
|
| Rate for Payer: Mclaren Commercial |
$91.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.07
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
IP
|
$278.26
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.78 |
| Max. Negotiated Rate |
$278.26 |
| Rate for Payer: Aetna Commercial |
$250.43
|
| Rate for Payer: ASR ASR |
$269.91
|
| Rate for Payer: BCBS Trust/PPO |
$215.73
|
| Rate for Payer: BCN Commercial |
$215.73
|
| Rate for Payer: Cash Price |
$222.61
|
| Rate for Payer: Cofinity Commercial |
$261.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.61
|
| Rate for Payer: Healthscope Commercial |
$278.26
|
| Rate for Payer: Healthscope Whirlpool |
$269.91
|
| Rate for Payer: Mclaren Commercial |
$250.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.87
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
OP
|
$278.26
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$278.26 |
| Rate for Payer: Aetna Commercial |
$250.43
|
| Rate for Payer: ASR ASR |
$269.91
|
| Rate for Payer: BCBS Complete |
$111.30
|
| Rate for Payer: BCBS Trust/PPO |
$215.73
|
| Rate for Payer: BCN Commercial |
$215.73
|
| Rate for Payer: Cash Price |
$222.61
|
| Rate for Payer: Cofinity Commercial |
$261.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.61
|
| Rate for Payer: Healthscope Commercial |
$278.26
|
| Rate for Payer: Healthscope Whirlpool |
$269.91
|
| Rate for Payer: Mclaren Commercial |
$250.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.22
|
| Rate for Payer: Priority Health Narrow Network |
$197.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.87
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
OP
|
$670.87
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$268.35 |
| Max. Negotiated Rate |
$670.87 |
| Rate for Payer: Aetna Commercial |
$603.78
|
| Rate for Payer: ASR ASR |
$650.74
|
| Rate for Payer: BCBS Complete |
$268.35
|
| Rate for Payer: BCBS Trust/PPO |
$520.13
|
| Rate for Payer: BCN Commercial |
$520.13
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$630.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$670.87
|
| Rate for Payer: Healthscope Whirlpool |
$650.74
|
| Rate for Payer: Mclaren Commercial |
$603.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.49
|
| Rate for Payer: Priority Health Narrow Network |
$476.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.37
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
IP
|
$670.87
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$469.61 |
| Max. Negotiated Rate |
$670.87 |
| Rate for Payer: Aetna Commercial |
$603.78
|
| Rate for Payer: ASR ASR |
$650.74
|
| Rate for Payer: BCBS Trust/PPO |
$520.13
|
| Rate for Payer: BCN Commercial |
$520.13
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$630.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$670.87
|
| Rate for Payer: Healthscope Whirlpool |
$650.74
|
| Rate for Payer: Mclaren Commercial |
$603.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.37
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
OP
|
$938.26
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$215.35 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$844.43
|
| Rate for Payer: Aetna Medicare |
$393.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.11
|
| Rate for Payer: ASR ASR |
$910.11
|
| Rate for Payer: BCBS Complete |
$226.14
|
| Rate for Payer: BCBS MAPPO |
$393.69
|
| Rate for Payer: BCBS Trust/PPO |
$727.43
|
| Rate for Payer: BCN Commercial |
$727.43
|
| Rate for Payer: BCN Medicare Advantage |
$393.69
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cofinity Commercial |
$881.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.69
|
| Rate for Payer: Healthscope Commercial |
$938.26
|
| Rate for Payer: Healthscope Whirlpool |
$910.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$393.69
|
| Rate for Payer: Mclaren Commercial |
$844.43
|
| Rate for Payer: Mclaren Medicaid |
$215.35
|
| Rate for Payer: Mclaren Medicare |
$393.69
|
| Rate for Payer: Meridian Medicaid |
$226.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.52
|
| Rate for Payer: PACE Medicare |
$374.01
|
| Rate for Payer: PACE SWMI |
$393.69
|
| Rate for Payer: PHP Commercial |
$433.06
|
| Rate for Payer: PHP Medicaid |
$215.35
|
| Rate for Payer: PHP Medicare Advantage |
$393.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$853.82
|
| Rate for Payer: Priority Health Medicare |
$393.69
|
| Rate for Payer: Priority Health Narrow Network |
$666.16
|
| Rate for Payer: Railroad Medicare Medicare |
$393.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.67
|
| Rate for Payer: UHC Medicare Advantage |
$405.50
|
| Rate for Payer: VA VA |
$393.69
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
IP
|
$938.26
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$656.78 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$844.43
|
| Rate for Payer: ASR ASR |
$910.11
|
| Rate for Payer: BCBS Trust/PPO |
$727.43
|
| Rate for Payer: BCN Commercial |
$727.43
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cofinity Commercial |
$881.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.61
|
| Rate for Payer: Healthscope Commercial |
$938.26
|
| Rate for Payer: Healthscope Whirlpool |
$910.11
|
| Rate for Payer: Mclaren Commercial |
$844.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.67
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
IP
|
$693.53
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$485.47 |
| Max. Negotiated Rate |
$693.53 |
| Rate for Payer: Aetna Commercial |
$624.18
|
| Rate for Payer: ASR ASR |
$672.72
|
| Rate for Payer: BCBS Trust/PPO |
$537.69
|
| Rate for Payer: BCN Commercial |
$537.69
|
| Rate for Payer: Cash Price |
$554.82
|
| Rate for Payer: Cofinity Commercial |
$651.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.82
|
| Rate for Payer: Healthscope Commercial |
$693.53
|
| Rate for Payer: Healthscope Whirlpool |
$672.72
|
| Rate for Payer: Mclaren Commercial |
$624.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$589.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$610.31
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
OP
|
$693.53
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$277.41 |
| Max. Negotiated Rate |
$693.53 |
| Rate for Payer: Aetna Commercial |
$624.18
|
| Rate for Payer: ASR ASR |
$672.72
|
| Rate for Payer: BCBS Complete |
$277.41
|
| Rate for Payer: BCBS Trust/PPO |
$537.69
|
| Rate for Payer: BCN Commercial |
$537.69
|
| Rate for Payer: Cash Price |
$554.82
|
| Rate for Payer: Cofinity Commercial |
$651.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.82
|
| Rate for Payer: Healthscope Commercial |
$693.53
|
| Rate for Payer: Healthscope Whirlpool |
$672.72
|
| Rate for Payer: Mclaren Commercial |
$624.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$589.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.11
|
| Rate for Payer: Priority Health Narrow Network |
$492.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$610.31
|
|
|
HC PERITONEOGRAM
|
Facility
|
IP
|
$557.52
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$390.26 |
| Max. Negotiated Rate |
$557.52 |
| Rate for Payer: Aetna Commercial |
$501.77
|
| Rate for Payer: ASR ASR |
$540.79
|
| Rate for Payer: BCBS Trust/PPO |
$432.25
|
| Rate for Payer: BCN Commercial |
$432.25
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cofinity Commercial |
$524.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.02
|
| Rate for Payer: Healthscope Commercial |
$557.52
|
| Rate for Payer: Healthscope Whirlpool |
$540.79
|
| Rate for Payer: Mclaren Commercial |
$501.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$473.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$490.62
|
|
|
HC PERITONEOGRAM
|
Facility
|
OP
|
$557.52
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.23 |
| Max. Negotiated Rate |
$612.96 |
| Rate for Payer: Aetna Commercial |
$501.77
|
| Rate for Payer: Aetna Medicare |
$490.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: ASR ASR |
$540.79
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$432.25
|
| Rate for Payer: BCN Commercial |
$432.25
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cofinity Commercial |
$524.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$557.52
|
| Rate for Payer: Healthscope Whirlpool |
$540.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$490.37
|
| Rate for Payer: Mclaren Commercial |
$501.77
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$473.89
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$539.41
|
| Rate for Payer: PHP Medicaid |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$507.34
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$395.84
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$490.62
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: VA VA |
$490.37
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
OP
|
$242.23
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.89 |
| Max. Negotiated Rate |
$242.23 |
| Rate for Payer: Aetna Commercial |
$218.01
|
| Rate for Payer: ASR ASR |
$234.96
|
| Rate for Payer: BCBS Complete |
$96.89
|
| Rate for Payer: BCBS Trust/PPO |
$187.80
|
| Rate for Payer: BCN Commercial |
$187.80
|
| Rate for Payer: Cash Price |
$193.78
|
| Rate for Payer: Cofinity Commercial |
$227.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.78
|
| Rate for Payer: Healthscope Commercial |
$242.23
|
| Rate for Payer: Healthscope Whirlpool |
$234.96
|
| Rate for Payer: Mclaren Commercial |
$218.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.43
|
| Rate for Payer: Priority Health Narrow Network |
$171.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.16
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
IP
|
$242.23
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.56 |
| Max. Negotiated Rate |
$242.23 |
| Rate for Payer: Aetna Commercial |
$218.01
|
| Rate for Payer: ASR ASR |
$234.96
|
| Rate for Payer: BCBS Trust/PPO |
$187.80
|
| Rate for Payer: BCN Commercial |
$187.80
|
| Rate for Payer: Cash Price |
$193.78
|
| Rate for Payer: Cofinity Commercial |
$227.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.78
|
| Rate for Payer: Healthscope Commercial |
$242.23
|
| Rate for Payer: Healthscope Whirlpool |
$234.96
|
| Rate for Payer: Mclaren Commercial |
$218.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.16
|
|
