|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,323.14
|
| Rate for Payer: Aetna Medicare |
$1,155.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: ASR ASR |
$1,426.05
|
| Rate for Payer: ASR Commercial |
$1,426.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.91
|
| Rate for Payer: BCN Commercial |
$1,139.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,381.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,470.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,323.14
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: Nomi Health Commercial |
$1,205.52
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,270.76
|
| Rate for Payer: PHP Medicaid |
$619.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.15
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,030.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,293.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$1,790.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP DNSP |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$955.60 |
| Max. Negotiated Rate |
$1,470.15 |
| Rate for Payer: Aetna Commercial |
$1,323.14
|
| Rate for Payer: ASR ASR |
$1,426.05
|
| Rate for Payer: ASR Commercial |
$1,426.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.03
|
| Rate for Payer: BCN Commercial |
$1,139.81
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,381.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Healthscope Commercial |
$1,470.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.05
|
| Rate for Payer: Mclaren Commercial |
$1,323.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: Nomi Health Commercial |
$1,205.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,293.73
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$988.88 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$1,369.22
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$1,475.71
|
| Rate for Payer: ASR Commercial |
$1,475.71
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.83
|
| Rate for Payer: BCN Commercial |
$1,179.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,430.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,521.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$1,369.22
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: Nomi Health Commercial |
$1,247.51
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,333.01
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,066.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$988.88 |
| Max. Negotiated Rate |
$1,521.35 |
| Rate for Payer: Aetna Commercial |
$1,369.22
|
| Rate for Payer: ASR ASR |
$1,475.71
|
| Rate for Payer: ASR Commercial |
$1,475.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.75
|
| Rate for Payer: BCN Commercial |
$1,179.50
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,430.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Healthscope Commercial |
$1,521.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.71
|
| Rate for Payer: Mclaren Commercial |
$1,369.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: Nomi Health Commercial |
$1,247.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.79
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.02 |
| Max. Negotiated Rate |
$166.19 |
| Rate for Payer: Aetna Commercial |
$149.57
|
| Rate for Payer: ASR ASR |
$161.20
|
| Rate for Payer: ASR Commercial |
$161.20
|
| Rate for Payer: BCBS Trust/PPO |
$135.43
|
| Rate for Payer: BCN Commercial |
$128.85
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$156.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Healthscope Commercial |
$166.19
|
| Rate for Payer: Healthscope Whirlpool |
$161.20
|
| Rate for Payer: Mclaren Commercial |
$149.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: Nomi Health Commercial |
$136.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.25
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$149.57
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$161.20
|
| Rate for Payer: ASR Commercial |
$161.20
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$136.09
|
| Rate for Payer: BCN Commercial |
$128.85
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$156.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$166.19
|
| Rate for Payer: Healthscope Whirlpool |
$161.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$149.57
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: Nomi Health Commercial |
$136.28
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.62
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$116.50
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,445.62
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$939.65 |
| Max. Negotiated Rate |
$1,445.62 |
| Rate for Payer: Aetna Commercial |
$1,301.06
|
| Rate for Payer: ASR ASR |
$1,402.25
|
| Rate for Payer: ASR Commercial |
$1,402.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,178.04
|
| Rate for Payer: BCN Commercial |
$1,120.79
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cofinity Commercial |
$1,358.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.50
|
| Rate for Payer: Healthscope Commercial |
$1,445.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,402.25
|
| Rate for Payer: Mclaren Commercial |
$1,301.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,228.78
|
| Rate for Payer: Nomi Health Commercial |
$1,185.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,272.15
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,445.62
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$939.65 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$1,301.06
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$1,402.25
|
| Rate for Payer: ASR Commercial |
$1,402.25
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.82
|
| Rate for Payer: BCN Commercial |
$1,120.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cofinity Commercial |
$1,358.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,445.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,402.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$1,301.06
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,228.78
|
| Rate for Payer: Nomi Health Commercial |
$1,185.41
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,266.65
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,013.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,272.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$379.93
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.97 |
| Max. Negotiated Rate |
$379.93 |
| Rate for Payer: Aetna Commercial |
$341.94
|
| Rate for Payer: Aetna Medicare |
$189.96
|
| Rate for Payer: ASR ASR |
$368.53
|
| Rate for Payer: ASR Commercial |
$368.53
|
| Rate for Payer: BCBS Complete |
$151.97
|
| Rate for Payer: BCBS Trust/PPO |
$311.12
|
| Rate for Payer: BCN Commercial |
$294.56
|
| Rate for Payer: Cash Price |
$303.94
|
| Rate for Payer: Cofinity Commercial |
$357.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.94
|
| Rate for Payer: Healthscope Commercial |
$379.93
|
| Rate for Payer: Healthscope Whirlpool |
$368.53
|
| Rate for Payer: Mclaren Commercial |
$341.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.94
|
| Rate for Payer: Nomi Health Commercial |
$311.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.89
|
| Rate for Payer: Priority Health Narrow Network |
$266.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.34
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$379.93
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$246.95 |
| Max. Negotiated Rate |
$379.93 |
| Rate for Payer: Aetna Commercial |
$341.94
|
| Rate for Payer: ASR ASR |
$368.53
|
| Rate for Payer: ASR Commercial |
$368.53
|
| Rate for Payer: BCBS Trust/PPO |
$309.60
|
| Rate for Payer: BCN Commercial |
$294.56
|
| Rate for Payer: Cash Price |
$303.94
|
| Rate for Payer: Cofinity Commercial |
$357.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.94
|
| Rate for Payer: Healthscope Commercial |
$379.93
|
| Rate for Payer: Healthscope Whirlpool |
$368.53
|
| Rate for Payer: Mclaren Commercial |
$341.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.94
|
| Rate for Payer: Nomi Health Commercial |
$311.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.34
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,545.54
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,360.66 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.54
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,700.82
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,545.54
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,654.60 |
| Max. Negotiated Rate |
$2,545.54 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.36
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,545.54
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.54
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,230.40
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,545.54
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,654.60 |
| Max. Negotiated Rate |
$2,545.54 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.36
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,426.05
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,595.80
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,962.57 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.20
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,426.05
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,595.80
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,962.57 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.20
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,720.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,118.03 |
| Max. Negotiated Rate |
$1,720.05 |
| Rate for Payer: Aetna Commercial |
$1,548.04
|
| Rate for Payer: ASR ASR |
$1,668.45
|
| Rate for Payer: ASR Commercial |
$1,668.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.67
|
| Rate for Payer: BCN Commercial |
$1,333.55
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cofinity Commercial |
$1,616.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.04
|
| Rate for Payer: Healthscope Commercial |
$1,720.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,668.45
|
| Rate for Payer: Mclaren Commercial |
$1,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.04
|
| Rate for Payer: Nomi Health Commercial |
$1,410.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,513.64
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,720.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,548.04
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,668.45
|
| Rate for Payer: ASR Commercial |
$1,668.45
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,408.55
|
| Rate for Payer: BCN Commercial |
$1,333.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cofinity Commercial |
$1,616.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,720.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,668.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,548.04
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.04
|
| Rate for Payer: Nomi Health Commercial |
$1,410.44
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,547.09
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,237.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,513.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,067.46 |
| Max. Negotiated Rate |
$1,642.24 |
| Rate for Payer: Aetna Commercial |
$1,478.02
|
| Rate for Payer: ASR ASR |
$1,592.97
|
| Rate for Payer: ASR Commercial |
$1,592.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.26
|
| Rate for Payer: BCN Commercial |
$1,273.23
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,543.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,642.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,592.97
|
| Rate for Payer: Mclaren Commercial |
$1,478.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,445.17
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,478.02
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,592.97
|
| Rate for Payer: ASR Commercial |
$1,592.97
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,344.83
|
| Rate for Payer: BCN Commercial |
$1,273.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,543.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,642.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,592.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,478.02
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,438.93
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,445.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,609.87
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,046.42 |
| Max. Negotiated Rate |
$1,609.87 |
| Rate for Payer: Aetna Commercial |
$1,448.88
|
| Rate for Payer: ASR ASR |
$1,561.57
|
| Rate for Payer: ASR Commercial |
$1,561.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.88
|
| Rate for Payer: BCN Commercial |
$1,248.13
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cofinity Commercial |
$1,513.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,287.90
|
| Rate for Payer: Healthscope Commercial |
$1,609.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.57
|
| Rate for Payer: Mclaren Commercial |
$1,448.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,368.39
|
| Rate for Payer: Nomi Health Commercial |
$1,320.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.69
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,609.87
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$672.86 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,448.88
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,561.57
|
| Rate for Payer: ASR Commercial |
$1,561.57
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,318.32
|
| Rate for Payer: BCN Commercial |
$1,248.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cofinity Commercial |
$1,513.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,287.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,609.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,448.88
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,368.39
|
| Rate for Payer: Nomi Health Commercial |
$1,320.09
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.07
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$672.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,344.21 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$3,245.83
|
| Rate for Payer: Aetna Medicare |
$5,296.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: ASR ASR |
$3,498.29
|
| Rate for Payer: ASR Commercial |
$3,498.29
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,953.35
|
| Rate for Payer: BCN Commercial |
$2,796.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cofinity Commercial |
$3,390.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$3,606.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,498.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$3,245.83
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: Nomi Health Commercial |
$2,957.31
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$5,826.04
|
| Rate for Payer: PHP Medicaid |
$2,838.87
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,160.00
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,528.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,173.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$8,209.42
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP DNSP |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: VA VA |
$5,296.40
|
|
