|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,187.64
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,431.35 |
| Max. Negotiated Rate |
$19,187.64 |
| Rate for Payer: Aetna Commercial |
$17,268.88
|
| Rate for Payer: ASR ASR |
$18,612.01
|
| Rate for Payer: BCBS Trust/PPO |
$14,876.18
|
| Rate for Payer: BCN Commercial |
$14,876.18
|
| Rate for Payer: Cash Price |
$15,350.11
|
| Rate for Payer: Cofinity Commercial |
$18,036.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,350.11
|
| Rate for Payer: Healthscope Commercial |
$19,187.64
|
| Rate for Payer: Healthscope Whirlpool |
$18,612.01
|
| Rate for Payer: Mclaren Commercial |
$17,268.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,309.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,431.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,885.12
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,187.64
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,675.06 |
| Max. Negotiated Rate |
$19,187.64 |
| Rate for Payer: Aetna Commercial |
$17,268.88
|
| Rate for Payer: ASR ASR |
$18,612.01
|
| Rate for Payer: BCBS Complete |
$7,675.06
|
| Rate for Payer: BCBS Trust/PPO |
$14,876.18
|
| Rate for Payer: BCN Commercial |
$14,876.18
|
| Rate for Payer: Cash Price |
$15,350.11
|
| Rate for Payer: Cofinity Commercial |
$18,036.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,350.11
|
| Rate for Payer: Healthscope Commercial |
$19,187.64
|
| Rate for Payer: Healthscope Whirlpool |
$18,612.01
|
| Rate for Payer: Mclaren Commercial |
$17,268.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,309.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,431.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,460.75
|
| Rate for Payer: Priority Health Narrow Network |
$13,623.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,885.12
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PISTACHIO NUT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PITOCIN AUGMENTATION
|
Facility
|
IP
|
$465.72
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$326.00 |
| Max. Negotiated Rate |
$465.72 |
| Rate for Payer: Aetna Commercial |
$419.15
|
| Rate for Payer: ASR ASR |
$451.75
|
| Rate for Payer: BCBS Trust/PPO |
$361.07
|
| Rate for Payer: BCN Commercial |
$361.07
|
| Rate for Payer: Cash Price |
$372.58
|
| Rate for Payer: Cofinity Commercial |
$437.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.58
|
| Rate for Payer: Healthscope Commercial |
$465.72
|
| Rate for Payer: Healthscope Whirlpool |
$451.75
|
| Rate for Payer: Mclaren Commercial |
$419.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$395.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$409.83
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
OP
|
$465.72
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$186.29 |
| Max. Negotiated Rate |
$465.72 |
| Rate for Payer: Aetna Commercial |
$419.15
|
| Rate for Payer: ASR ASR |
$451.75
|
| Rate for Payer: BCBS Complete |
$186.29
|
| Rate for Payer: BCBS Trust/PPO |
$361.07
|
| Rate for Payer: BCN Commercial |
$361.07
|
| Rate for Payer: Cash Price |
$372.58
|
| Rate for Payer: Cofinity Commercial |
$437.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.58
|
| Rate for Payer: Healthscope Commercial |
$465.72
|
| Rate for Payer: Healthscope Whirlpool |
$451.75
|
| Rate for Payer: Mclaren Commercial |
$419.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$395.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.81
|
| Rate for Payer: Priority Health Narrow Network |
$330.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$409.83
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$21.40
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$177.52 |
| Rate for Payer: Aetna Commercial |
$19.26
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$20.76
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$16.59
|
| Rate for Payer: BCN Commercial |
$16.59
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$21.40
|
| Rate for Payer: Healthscope Whirlpool |
$20.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.50
|
| Rate for Payer: Mclaren Commercial |
$19.26
|
| Rate for Payer: Mclaren Medicaid |
$3.01
|
| Rate for Payer: Mclaren Medicare |
$5.50
|
| Rate for Payer: Meridian Medicaid |
$3.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.19
|
| Rate for Payer: PACE Medicare |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.50
|
| Rate for Payer: PHP Commercial |
$6.05
|
| Rate for Payer: PHP Medicaid |
$3.01
|
| Rate for Payer: PHP Medicare Advantage |
$5.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.52
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$142.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.83
|
| Rate for Payer: UHC Medicare Advantage |
$5.66
|
| Rate for Payer: VA VA |
$5.50
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$21.40
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$21.40 |
| Rate for Payer: Aetna Commercial |
$19.26
|
| Rate for Payer: ASR ASR |
$20.76
|
| Rate for Payer: BCBS Trust/PPO |
$16.59
|
| Rate for Payer: BCN Commercial |
$16.59
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$21.40
|
| Rate for Payer: Healthscope Whirlpool |
$20.76
|
| Rate for Payer: Mclaren Commercial |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.83
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,527.57 |
| Max. Negotiated Rate |
$8,406.09 |
| Rate for Payer: Aetna Commercial |
$3,249.74
|
| Rate for Payer: Aetna Medicare |
$6,724.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,406.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,406.09
|
| Rate for Payer: ASR ASR |
$3,502.50
|
| Rate for Payer: BCBS Complete |
$3,862.77
|
| Rate for Payer: BCBS MAPPO |
$6,724.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,799.47
|
| Rate for Payer: BCN Commercial |
$2,799.47
|
| Rate for Payer: BCN Medicare Advantage |
$6,724.87
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,394.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,724.87
|
| Rate for Payer: Healthscope Commercial |
$3,610.82
|
| Rate for Payer: Healthscope Whirlpool |
$3,502.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,724.87
|
| Rate for Payer: Mclaren Commercial |
$3,249.74
|
| Rate for Payer: Mclaren Medicaid |
$3,678.50
|
| Rate for Payer: Mclaren Medicare |
$6,724.87
|
| Rate for Payer: Meridian Medicaid |
$3,862.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,061.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Medicare |
$6,388.63
|
| Rate for Payer: PACE SWMI |
$6,724.87
|
| Rate for Payer: PHP Commercial |
$7,397.36
|
| Rate for Payer: PHP Medicaid |
$3,678.50
|
| Rate for Payer: PHP Medicare Advantage |
$6,724.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,678.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,285.85
|
| Rate for Payer: Priority Health Medicare |
$6,724.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,563.68
|
| Rate for Payer: Railroad Medicare Medicare |
$6,724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,177.52
|
| Rate for Payer: UHC Medicare Advantage |
$6,926.62
|
| Rate for Payer: VA VA |
$6,724.87
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,527.57 |
| Max. Negotiated Rate |
$3,610.82 |
| Rate for Payer: Aetna Commercial |
$3,249.74
|
| Rate for Payer: ASR ASR |
$3,502.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,799.47
|
| Rate for Payer: BCN Commercial |
$2,799.47
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,394.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,610.82
|
| Rate for Payer: Healthscope Whirlpool |
$3,502.50
|
| Rate for Payer: Mclaren Commercial |
$3,249.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,177.52
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,682.15 |
| Max. Negotiated Rate |
$3,844.02 |
| Rate for Payer: Aetna Commercial |
$3,249.74
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$3,502.50
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,799.47
|
| Rate for Payer: BCN Commercial |
$2,799.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,394.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,610.82
|
| Rate for Payer: Healthscope Whirlpool |
$3,502.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$3,249.74
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,285.85
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,563.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,177.52
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,527.57 |
| Max. Negotiated Rate |
$3,610.82 |
| Rate for Payer: Aetna Commercial |
$3,249.74
|
| Rate for Payer: ASR ASR |
$3,502.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,799.47
|
| Rate for Payer: BCN Commercial |
$2,799.47
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,394.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,610.82
|
| Rate for Payer: Healthscope Whirlpool |
$3,502.50
|
| Rate for Payer: Mclaren Commercial |
$3,249.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,177.52
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,682.15 |
| Max. Negotiated Rate |
$3,844.02 |
| Rate for Payer: Aetna Commercial |
$2,807.24
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$3,025.59
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.28
|
| Rate for Payer: BCN Commercial |
$2,418.28
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,932.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,119.16
|
| Rate for Payer: Healthscope Whirlpool |
$3,025.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$2,807.24
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,838.44
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,214.60
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,744.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,183.41 |
| Max. Negotiated Rate |
$3,119.16 |
| Rate for Payer: Aetna Commercial |
$2,807.24
|
| Rate for Payer: ASR ASR |
$3,025.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.28
|
| Rate for Payer: BCN Commercial |
$2,418.28
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,932.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Healthscope Commercial |
$3,119.16
|
| Rate for Payer: Healthscope Whirlpool |
$3,025.59
|
| Rate for Payer: Mclaren Commercial |
$2,807.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,744.86
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$800.00 |
| Max. Negotiated Rate |
$1,142.85 |
| Rate for Payer: Aetna Commercial |
$1,028.56
|
| Rate for Payer: ASR ASR |
$1,108.56
|
| Rate for Payer: BCBS Trust/PPO |
$886.05
|
| Rate for Payer: BCN Commercial |
$886.05
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$1,074.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Healthscope Commercial |
$1,142.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,108.56
|
| Rate for Payer: Mclaren Commercial |
$1,028.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,005.71
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.33 |
| Max. Negotiated Rate |
$1,142.85 |
| Rate for Payer: Aetna Commercial |
$1,028.56
|
| Rate for Payer: ASR ASR |
$1,108.56
|
| Rate for Payer: BCBS Complete |
$457.14
|
| Rate for Payer: BCBS Trust/PPO |
$886.05
|
| Rate for Payer: BCCCP Commercial |
$176.03
|
| Rate for Payer: BCN Commercial |
$886.05
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$1,074.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Healthscope Commercial |
$1,142.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,108.56
|
| Rate for Payer: Mclaren Commercial |
$1,028.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.16
|
| Rate for Payer: Priority Health Narrow Network |
$107.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,005.71
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,205.08 |
| Max. Negotiated Rate |
$1,721.55 |
| Rate for Payer: Aetna Commercial |
$1,549.40
|
| Rate for Payer: ASR ASR |
$1,669.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,334.72
|
| Rate for Payer: BCN Commercial |
$1,334.72
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,618.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Healthscope Commercial |
$1,721.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.90
|
| Rate for Payer: Mclaren Commercial |
$1,549.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.96
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.76 |
| Max. Negotiated Rate |
$1,721.55 |
| Rate for Payer: Aetna Commercial |
$1,549.40
|
| Rate for Payer: ASR ASR |
$1,669.90
|
| Rate for Payer: BCBS Complete |
$688.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,334.72
|
| Rate for Payer: BCCCP Commercial |
$506.78
|
| Rate for Payer: BCN Commercial |
$1,334.72
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,618.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Healthscope Commercial |
$1,721.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.90
|
| Rate for Payer: Mclaren Commercial |
$1,549.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.45
|
| Rate for Payer: Priority Health Narrow Network |
$138.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.96
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$108.10 |
| Max. Negotiated Rate |
$2,065.76 |
| Rate for Payer: Aetna Commercial |
$1,859.18
|
| Rate for Payer: ASR ASR |
$2,003.79
|
| Rate for Payer: BCBS Complete |
$826.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.58
|
| Rate for Payer: BCCCP Commercial |
$197.10
|
| Rate for Payer: BCN Commercial |
$1,601.58
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,941.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Healthscope Commercial |
$2,065.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,003.79
|
| Rate for Payer: Mclaren Commercial |
$1,859.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.12
|
| Rate for Payer: Priority Health Narrow Network |
$108.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,817.87
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,446.03 |
| Max. Negotiated Rate |
$2,065.76 |
| Rate for Payer: Aetna Commercial |
$1,859.18
|
| Rate for Payer: ASR ASR |
$2,003.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.58
|
| Rate for Payer: BCN Commercial |
$1,601.58
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,941.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Healthscope Commercial |
$2,065.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,003.79
|
| Rate for Payer: Mclaren Commercial |
$1,859.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,817.87
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,003.02 |
| Max. Negotiated Rate |
$2,861.45 |
| Rate for Payer: Aetna Commercial |
$2,575.30
|
| Rate for Payer: ASR ASR |
$2,775.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,218.48
|
| Rate for Payer: BCN Commercial |
$2,218.48
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,689.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Healthscope Commercial |
$2,861.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,775.61
|
| Rate for Payer: Mclaren Commercial |
$2,575.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,518.08
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.76 |
| Max. Negotiated Rate |
$2,861.45 |
| Rate for Payer: Aetna Commercial |
$2,575.30
|
| Rate for Payer: ASR ASR |
$2,775.61
|
| Rate for Payer: BCBS Complete |
$1,144.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,218.48
|
| Rate for Payer: BCCCP Commercial |
$312.47
|
| Rate for Payer: BCN Commercial |
$2,218.48
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,689.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Healthscope Commercial |
$2,861.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,775.61
|
| Rate for Payer: Mclaren Commercial |
$2,575.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.95
|
| Rate for Payer: Priority Health Narrow Network |
$92.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,518.08
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.10 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,278.34
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$1,377.77
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.22
|
| Rate for Payer: BCCCP Commercial |
$248.73
|
| Rate for Payer: BCN Commercial |
$1,101.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,335.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,420.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,377.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,278.34
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.13
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$84.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,249.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$994.27 |
| Max. Negotiated Rate |
$1,420.38 |
| Rate for Payer: Aetna Commercial |
$1,278.34
|
| Rate for Payer: ASR ASR |
$1,377.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.22
|
| Rate for Payer: BCN Commercial |
$1,101.22
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,335.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Healthscope Commercial |
$1,420.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,377.77
|
| Rate for Payer: Mclaren Commercial |
$1,278.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,249.93
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,660.51
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,162.36 |
| Max. Negotiated Rate |
$1,660.51 |
| Rate for Payer: Aetna Commercial |
$1,494.46
|
| Rate for Payer: ASR ASR |
$1,610.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.39
|
| Rate for Payer: BCN Commercial |
$1,287.39
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cofinity Commercial |
$1,560.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.41
|
| Rate for Payer: Healthscope Commercial |
$1,660.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,610.69
|
| Rate for Payer: Mclaren Commercial |
$1,494.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,461.25
|
|
