|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
IP
|
$923.66
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.38 |
| Max. Negotiated Rate |
$923.66 |
| Rate for Payer: Aetna Commercial |
$831.29
|
| Rate for Payer: ASR ASR |
$895.95
|
| Rate for Payer: ASR Commercial |
$895.95
|
| Rate for Payer: BCBS Trust/PPO |
$752.69
|
| Rate for Payer: BCN Commercial |
$716.11
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cofinity Commercial |
$868.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.93
|
| Rate for Payer: Healthscope Commercial |
$923.66
|
| Rate for Payer: Healthscope Whirlpool |
$895.95
|
| Rate for Payer: Mclaren Commercial |
$831.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.11
|
| Rate for Payer: Nomi Health Commercial |
$757.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.82
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
OP
|
$923.66
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.38 |
| Max. Negotiated Rate |
$2,239.22 |
| Rate for Payer: Aetna Commercial |
$831.29
|
| Rate for Payer: Aetna Medicare |
$1,444.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: ASR ASR |
$895.95
|
| Rate for Payer: ASR Commercial |
$895.95
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCBS Trust/PPO |
$756.39
|
| Rate for Payer: BCN Commercial |
$716.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cofinity Commercial |
$868.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$923.66
|
| Rate for Payer: Healthscope Whirlpool |
$895.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,444.66
|
| Rate for Payer: Mclaren Commercial |
$831.29
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.11
|
| Rate for Payer: Nomi Health Commercial |
$757.40
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$1,589.13
|
| Rate for Payer: PHP Medicaid |
$774.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.31
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health Narrow Network |
$647.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,239.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP DNSP |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
OP
|
$1,724.42
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,724.42 |
| Rate for Payer: Aetna Commercial |
$1,551.98
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,672.69
|
| Rate for Payer: ASR Commercial |
$1,672.69
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,412.13
|
| Rate for Payer: BCN Commercial |
$1,336.94
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cofinity Commercial |
$1,620.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,724.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,672.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,551.98
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.76
|
| Rate for Payer: Nomi Health Commercial |
$1,414.02
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,510.94
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,208.82
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
IP
|
$1,724.42
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,120.87 |
| Max. Negotiated Rate |
$1,724.42 |
| Rate for Payer: Aetna Commercial |
$1,551.98
|
| Rate for Payer: ASR ASR |
$1,672.69
|
| Rate for Payer: ASR Commercial |
$1,672.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.23
|
| Rate for Payer: BCN Commercial |
$1,336.94
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cofinity Commercial |
$1,620.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.54
|
| Rate for Payer: Healthscope Commercial |
$1,724.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,672.69
|
| Rate for Payer: Mclaren Commercial |
$1,551.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.76
|
| Rate for Payer: Nomi Health Commercial |
$1,414.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.49
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
OP
|
$2,586.63
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$2,586.63 |
| Rate for Payer: Aetna Commercial |
$2,327.97
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$2,509.03
|
| Rate for Payer: ASR Commercial |
$2,509.03
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,118.19
|
| Rate for Payer: BCN Commercial |
$2,005.41
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$2,069.30
|
| Rate for Payer: Cash Price |
$2,069.30
|
| Rate for Payer: Cofinity Commercial |
$2,431.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$2,586.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$2,327.97
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,198.64
|
| Rate for Payer: Nomi Health Commercial |
$2,121.04
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,266.41
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,813.23
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
IP
|
$2,586.63
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,681.31 |
| Max. Negotiated Rate |
$2,586.63 |
| Rate for Payer: Aetna Commercial |
$2,327.97
|
| Rate for Payer: ASR ASR |
$2,509.03
|
| Rate for Payer: ASR Commercial |
$2,509.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,107.84
|
| Rate for Payer: BCN Commercial |
$2,005.41
|
| Rate for Payer: Cash Price |
$2,069.30
|
| Rate for Payer: Cofinity Commercial |
$2,431.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.30
|
| Rate for Payer: Healthscope Commercial |
$2,586.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.03
|
| Rate for Payer: Mclaren Commercial |
$2,327.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,198.64
|
| Rate for Payer: Nomi Health Commercial |
$2,121.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.23
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
OP
|
$911.49
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.60 |
| Max. Negotiated Rate |
$911.49 |
| Rate for Payer: Aetna Commercial |
$820.34
|
| Rate for Payer: Aetna Medicare |
$455.75
|
| Rate for Payer: ASR ASR |
$884.15
|
| Rate for Payer: ASR Commercial |
$884.15
|
| Rate for Payer: BCBS Complete |
$364.60
|
| Rate for Payer: BCBS Trust/PPO |
$746.42
|
| Rate for Payer: BCN Commercial |
$706.68
|
| Rate for Payer: Cash Price |
$729.19
|
| Rate for Payer: Cofinity Commercial |
$856.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.19
|
| Rate for Payer: Healthscope Commercial |
$911.49
|
| Rate for Payer: Healthscope Whirlpool |
$884.15
|
| Rate for Payer: Mclaren Commercial |
$820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: Nomi Health Commercial |
$747.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$798.65
|
| Rate for Payer: Priority Health Narrow Network |
$638.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$802.11
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
IP
|
$911.49
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.47 |
| Max. Negotiated Rate |
$911.49 |
| Rate for Payer: Aetna Commercial |
$820.34
|
| Rate for Payer: ASR ASR |
$884.15
|
| Rate for Payer: ASR Commercial |
$884.15
|
| Rate for Payer: BCBS Trust/PPO |
$742.77
|
| Rate for Payer: BCN Commercial |
$706.68
|
| Rate for Payer: Cash Price |
$729.19
|
| Rate for Payer: Cofinity Commercial |
$856.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.19
|
| Rate for Payer: Healthscope Commercial |
$911.49
|
| Rate for Payer: Healthscope Whirlpool |
$884.15
|
| Rate for Payer: Mclaren Commercial |
$820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: Nomi Health Commercial |
$747.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$802.11
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
OP
|
$1,367.24
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.90 |
| Max. Negotiated Rate |
$1,367.24 |
| Rate for Payer: Aetna Commercial |
$1,230.52
|
| Rate for Payer: Aetna Medicare |
$683.62
|
| Rate for Payer: ASR ASR |
$1,326.22
|
| Rate for Payer: ASR Commercial |
$1,326.22
|
| Rate for Payer: BCBS Complete |
$546.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,119.63
|
| Rate for Payer: BCN Commercial |
$1,060.02
|
| Rate for Payer: Cash Price |
$1,093.79
|
| Rate for Payer: Cofinity Commercial |
$1,285.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.79
|
| Rate for Payer: Healthscope Commercial |
$1,367.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,326.22
|
| Rate for Payer: Mclaren Commercial |
$1,230.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.15
|
| Rate for Payer: Nomi Health Commercial |
$1,121.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.98
|
| Rate for Payer: Priority Health Narrow Network |
$958.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.17
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
IP
|
$1,367.24
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$888.71 |
| Max. Negotiated Rate |
$1,367.24 |
| Rate for Payer: Aetna Commercial |
$1,230.52
|
| Rate for Payer: ASR ASR |
$1,326.22
|
| Rate for Payer: ASR Commercial |
$1,326.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,114.16
|
| Rate for Payer: BCN Commercial |
$1,060.02
|
| Rate for Payer: Cash Price |
$1,093.79
|
| Rate for Payer: Cofinity Commercial |
$1,285.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.79
|
| Rate for Payer: Healthscope Commercial |
$1,367.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,326.22
|
| Rate for Payer: Mclaren Commercial |
$1,230.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.15
|
| Rate for Payer: Nomi Health Commercial |
$1,121.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.17
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
OP
|
$972.13
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$388.85 |
| Max. Negotiated Rate |
$972.13 |
| Rate for Payer: Aetna Commercial |
$874.92
|
| Rate for Payer: Aetna Medicare |
$486.06
|
| Rate for Payer: ASR ASR |
$942.97
|
| Rate for Payer: ASR Commercial |
$942.97
|
| Rate for Payer: BCBS Complete |
$388.85
|
| Rate for Payer: BCBS Trust/PPO |
$796.08
|
| Rate for Payer: BCN Commercial |
$753.69
|
| Rate for Payer: Cash Price |
$777.70
|
| Rate for Payer: Cofinity Commercial |
$913.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.70
|
| Rate for Payer: Healthscope Commercial |
$972.13
|
| Rate for Payer: Healthscope Whirlpool |
$942.97
|
| Rate for Payer: Mclaren Commercial |
$874.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.31
|
| Rate for Payer: Nomi Health Commercial |
$797.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.78
|
| Rate for Payer: Priority Health Narrow Network |
$681.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.47
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
IP
|
$972.13
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.88 |
| Max. Negotiated Rate |
$972.13 |
| Rate for Payer: Aetna Commercial |
$874.92
|
| Rate for Payer: ASR ASR |
$942.97
|
| Rate for Payer: ASR Commercial |
$942.97
|
| Rate for Payer: BCBS Trust/PPO |
$792.19
|
| Rate for Payer: BCN Commercial |
$753.69
|
| Rate for Payer: Cash Price |
$777.70
|
| Rate for Payer: Cofinity Commercial |
$913.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.70
|
| Rate for Payer: Healthscope Commercial |
$972.13
|
| Rate for Payer: Healthscope Whirlpool |
$942.97
|
| Rate for Payer: Mclaren Commercial |
$874.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.31
|
| Rate for Payer: Nomi Health Commercial |
$797.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.47
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
OP
|
$1,458.19
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.28 |
| Max. Negotiated Rate |
$1,458.19 |
| Rate for Payer: Aetna Commercial |
$1,312.37
|
| Rate for Payer: Aetna Medicare |
$729.10
|
| Rate for Payer: ASR ASR |
$1,414.44
|
| Rate for Payer: ASR Commercial |
$1,414.44
|
| Rate for Payer: BCBS Complete |
$583.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.11
|
| Rate for Payer: BCN Commercial |
$1,130.53
|
| Rate for Payer: Cash Price |
$1,166.55
|
| Rate for Payer: Cofinity Commercial |
$1,370.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.55
|
| Rate for Payer: Healthscope Commercial |
$1,458.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,414.44
|
| Rate for Payer: Mclaren Commercial |
$1,312.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.46
|
| Rate for Payer: Nomi Health Commercial |
$1,195.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,277.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,283.21
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
IP
|
$1,458.19
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$947.82 |
| Max. Negotiated Rate |
$1,458.19 |
| Rate for Payer: Aetna Commercial |
$1,312.37
|
| Rate for Payer: ASR ASR |
$1,414.44
|
| Rate for Payer: ASR Commercial |
$1,414.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.28
|
| Rate for Payer: BCN Commercial |
$1,130.53
|
| Rate for Payer: Cash Price |
$1,166.55
|
| Rate for Payer: Cofinity Commercial |
$1,370.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.55
|
| Rate for Payer: Healthscope Commercial |
$1,458.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,414.44
|
| Rate for Payer: Mclaren Commercial |
$1,312.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.46
|
| Rate for Payer: Nomi Health Commercial |
$1,195.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,283.21
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
IP
|
$1,536.98
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$999.04 |
| Max. Negotiated Rate |
$1,536.98 |
| Rate for Payer: Aetna Commercial |
$1,383.28
|
| Rate for Payer: ASR ASR |
$1,490.87
|
| Rate for Payer: ASR Commercial |
$1,490.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.49
|
| Rate for Payer: BCN Commercial |
$1,191.62
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cofinity Commercial |
$1,444.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.58
|
| Rate for Payer: Healthscope Commercial |
$1,536.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,490.87
|
| Rate for Payer: Mclaren Commercial |
$1,383.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.43
|
| Rate for Payer: Nomi Health Commercial |
$1,260.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.54
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
OP
|
$1,536.98
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,536.98 |
| Rate for Payer: Aetna Commercial |
$1,383.28
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,490.87
|
| Rate for Payer: ASR Commercial |
$1,490.87
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.63
|
| Rate for Payer: BCN Commercial |
$1,191.62
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cofinity Commercial |
$1,444.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,536.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,490.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,383.28
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.43
|
| Rate for Payer: Nomi Health Commercial |
$1,260.32
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.70
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.42
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
OP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,066.72
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,149.69
|
| Rate for Payer: ASR Commercial |
$1,149.69
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$970.60
|
| Rate for Payer: BCN Commercial |
$918.92
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,066.72
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.52
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$830.86
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
IP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$770.41 |
| Max. Negotiated Rate |
$1,185.25 |
| Rate for Payer: Aetna Commercial |
$1,066.72
|
| Rate for Payer: ASR ASR |
$1,149.69
|
| Rate for Payer: ASR Commercial |
$1,149.69
|
| Rate for Payer: BCBS Trust/PPO |
$965.86
|
| Rate for Payer: BCN Commercial |
$918.92
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.69
|
| Rate for Payer: Mclaren Commercial |
$1,066.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.02
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.53
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.12
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
IP
|
$566.97
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$368.53 |
| Max. Negotiated Rate |
$566.97 |
| Rate for Payer: Aetna Commercial |
$510.27
|
| Rate for Payer: ASR ASR |
$549.96
|
| Rate for Payer: ASR Commercial |
$549.96
|
| Rate for Payer: BCBS Trust/PPO |
$462.02
|
| Rate for Payer: BCN Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$453.58
|
| Rate for Payer: Cofinity Commercial |
$532.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.58
|
| Rate for Payer: Healthscope Commercial |
$566.97
|
| Rate for Payer: Healthscope Whirlpool |
$549.96
|
| Rate for Payer: Mclaren Commercial |
$510.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.92
|
| Rate for Payer: Nomi Health Commercial |
$464.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.93
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
OP
|
$566.97
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$226.79 |
| Max. Negotiated Rate |
$566.97 |
| Rate for Payer: Aetna Commercial |
$510.27
|
| Rate for Payer: Aetna Medicare |
$283.49
|
| Rate for Payer: ASR ASR |
$549.96
|
| Rate for Payer: ASR Commercial |
$549.96
|
| Rate for Payer: BCBS Complete |
$226.79
|
| Rate for Payer: BCBS Trust/PPO |
$464.29
|
| Rate for Payer: BCN Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$453.58
|
| Rate for Payer: Cofinity Commercial |
$532.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.58
|
| Rate for Payer: Healthscope Commercial |
$566.97
|
| Rate for Payer: Healthscope Whirlpool |
$549.96
|
| Rate for Payer: Mclaren Commercial |
$510.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.92
|
| Rate for Payer: Nomi Health Commercial |
$464.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.78
|
| Rate for Payer: Priority Health Narrow Network |
$397.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.93
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
IP
|
$1,152.20
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$748.93 |
| Max. Negotiated Rate |
$1,152.20 |
| Rate for Payer: Aetna Commercial |
$1,036.98
|
| Rate for Payer: ASR ASR |
$1,117.63
|
| Rate for Payer: ASR Commercial |
$1,117.63
|
| Rate for Payer: BCBS Trust/PPO |
$938.93
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: Cash Price |
$921.76
|
| Rate for Payer: Cofinity Commercial |
$1,083.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.76
|
| Rate for Payer: Healthscope Commercial |
$1,152.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.63
|
| Rate for Payer: Mclaren Commercial |
$1,036.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$979.37
|
| Rate for Payer: Nomi Health Commercial |
$944.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,013.94
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
OP
|
$1,152.20
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.88 |
| Max. Negotiated Rate |
$1,152.20 |
| Rate for Payer: Aetna Commercial |
$1,036.98
|
| Rate for Payer: Aetna Medicare |
$576.10
|
| Rate for Payer: ASR ASR |
$1,117.63
|
| Rate for Payer: ASR Commercial |
$1,117.63
|
| Rate for Payer: BCBS Complete |
$460.88
|
| Rate for Payer: BCBS Trust/PPO |
$943.54
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: Cash Price |
$921.76
|
| Rate for Payer: Cofinity Commercial |
$1,083.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.76
|
| Rate for Payer: Healthscope Commercial |
$1,152.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.63
|
| Rate for Payer: Mclaren Commercial |
$1,036.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$979.37
|
| Rate for Payer: Nomi Health Commercial |
$944.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.56
|
| Rate for Payer: Priority Health Narrow Network |
$807.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,013.94
|
|
|
HC INJECT/IRRIGATE CORPORA CAVERNOSA
|
Facility
|
OP
|
$373.37
|
|
| Hospital Charge Code |
45000094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.35 |
| Max. Negotiated Rate |
$373.37 |
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: Aetna Medicare |
$186.69
|
| Rate for Payer: ASR ASR |
$362.17
|
| Rate for Payer: ASR Commercial |
$362.17
|
| Rate for Payer: BCBS Complete |
$149.35
|
| Rate for Payer: BCBS Trust/PPO |
$305.75
|
| Rate for Payer: BCN Commercial |
$289.47
|
| Rate for Payer: Cash Price |
$298.70
|
| Rate for Payer: Cofinity Commercial |
$350.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.70
|
| Rate for Payer: Healthscope Commercial |
$373.37
|
| Rate for Payer: Healthscope Whirlpool |
$362.17
|
| Rate for Payer: Mclaren Commercial |
$336.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.36
|
| Rate for Payer: Nomi Health Commercial |
$306.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.15
|
| Rate for Payer: Priority Health Narrow Network |
$261.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.57
|
|
