|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,344.21 |
| Max. Negotiated Rate |
$3,606.48 |
| Rate for Payer: Aetna Commercial |
$3,245.83
|
| Rate for Payer: ASR ASR |
$3,498.29
|
| Rate for Payer: ASR Commercial |
$3,498.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,938.92
|
| Rate for Payer: BCN Commercial |
$2,796.10
|
| 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: Healthscope Commercial |
$3,606.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,498.29
|
| Rate for Payer: Mclaren Commercial |
$3,245.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: Nomi Health Commercial |
$2,957.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,173.70
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,135.56 |
| Max. Negotiated Rate |
$3,285.48 |
| Rate for Payer: Aetna Commercial |
$2,956.93
|
| Rate for Payer: ASR ASR |
$3,186.92
|
| Rate for Payer: ASR Commercial |
$3,186.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,677.34
|
| Rate for Payer: BCN Commercial |
$2,547.23
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$3,088.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Healthscope Commercial |
$3,285.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,186.92
|
| Rate for Payer: Mclaren Commercial |
$2,956.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: Nomi Health Commercial |
$2,694.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,891.22
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$2,956.93
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$3,186.92
|
| Rate for Payer: ASR Commercial |
$3,186.92
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,690.48
|
| Rate for Payer: BCN Commercial |
$2,547.23
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$3,088.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$3,285.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,186.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$2,956.93
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: Nomi Health Commercial |
$2,694.09
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,878.74
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,303.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,891.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,420.08 |
| Max. Negotiated Rate |
$2,184.74 |
| Rate for Payer: Aetna Commercial |
$1,966.27
|
| Rate for Payer: ASR ASR |
$2,119.20
|
| Rate for Payer: ASR Commercial |
$2,119.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.34
|
| Rate for Payer: BCN Commercial |
$1,693.83
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$2,053.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Healthscope Commercial |
$2,184.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,119.20
|
| Rate for Payer: Mclaren Commercial |
$1,966.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.03
|
| Rate for Payer: Nomi Health Commercial |
$1,791.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,922.57
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,966.27
|
| 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 |
$2,119.20
|
| Rate for Payer: ASR Commercial |
$2,119.20
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.08
|
| Rate for Payer: BCN Commercial |
$1,693.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$2,053.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$2,184.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,119.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,966.27
|
| 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 |
$1,857.03
|
| Rate for Payer: Nomi Health Commercial |
$1,791.49
|
| 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 |
$1,420.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,252.09
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,001.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,922.57
|
| 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 INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
IP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,290.98 |
| Max. Negotiated Rate |
$1,986.12 |
| Rate for Payer: Aetna Commercial |
$1,787.51
|
| Rate for Payer: ASR ASR |
$1,926.54
|
| Rate for Payer: ASR Commercial |
$1,926.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,618.49
|
| Rate for Payer: BCN Commercial |
$1,539.84
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,866.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Healthscope Commercial |
$1,986.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.54
|
| Rate for Payer: Mclaren Commercial |
$1,787.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: Nomi Health Commercial |
$1,628.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,747.79
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$324.69 |
| Max. Negotiated Rate |
$1,986.12 |
| Rate for Payer: Aetna Commercial |
$1,787.51
|
| Rate for Payer: Aetna Medicare |
$605.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: ASR ASR |
$1,926.54
|
| Rate for Payer: ASR Commercial |
$1,926.54
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.43
|
| Rate for Payer: BCN Commercial |
$1,539.84
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,866.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$1,986.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$605.76
|
| Rate for Payer: Mclaren Commercial |
$1,787.51
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: Nomi Health Commercial |
$1,628.62
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$666.34
|
| Rate for Payer: PHP Medicaid |
$324.69
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$709.85
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$567.88
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,747.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$938.93
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP DNSP |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: VA VA |
$605.76
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$55,184.05 |
| Max. Negotiated Rate |
$84,898.54 |
| Rate for Payer: Aetna Commercial |
$76,408.69
|
| Rate for Payer: ASR ASR |
$82,351.58
|
| Rate for Payer: ASR Commercial |
$82,351.58
|
| Rate for Payer: BCBS Trust/PPO |
$69,183.82
|
| Rate for Payer: BCN Commercial |
$65,821.84
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$79,804.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Healthscope Commercial |
$84,898.54
|
| Rate for Payer: Healthscope Whirlpool |
$82,351.58
|
| Rate for Payer: Mclaren Commercial |
$76,408.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: Nomi Health Commercial |
$69,616.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74,710.72
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,837.52 |
| Max. Negotiated Rate |
$84,898.54 |
| Rate for Payer: Aetna Commercial |
$76,408.69
|
| Rate for Payer: Aetna Medicare |
$31,413.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: ASR ASR |
$82,351.58
|
| Rate for Payer: ASR Commercial |
$82,351.58
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$69,523.41
|
| Rate for Payer: BCN Commercial |
$65,821.84
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$79,804.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$84,898.54
|
| Rate for Payer: Healthscope Whirlpool |
$82,351.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,413.29
|
| Rate for Payer: Mclaren Commercial |
$76,408.69
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: Nomi Health Commercial |
$69,616.80
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$34,554.62
|
| Rate for Payer: PHP Medicaid |
$16,837.52
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74,388.10
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$59,513.88
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74,710.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$48,690.60
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP DNSP |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: VA VA |
$31,413.29
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$166.77
|
| 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 |
$179.74
|
| Rate for Payer: ASR Commercial |
$179.74
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$151.74
|
| Rate for Payer: BCN Commercial |
$143.66
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$174.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$185.30
|
| Rate for Payer: Healthscope Whirlpool |
$179.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$166.77
|
| 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 |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$151.95
|
| 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 |
$120.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.39
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$93.11
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.06
|
| 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 INSERT STRAIGHT CATH
|
Facility
|
IP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$185.30 |
| Rate for Payer: Aetna Commercial |
$166.77
|
| Rate for Payer: ASR ASR |
$179.74
|
| Rate for Payer: ASR Commercial |
$179.74
|
| Rate for Payer: BCBS Trust/PPO |
$151.00
|
| Rate for Payer: BCN Commercial |
$143.66
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$174.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Healthscope Commercial |
$185.30
|
| Rate for Payer: Healthscope Whirlpool |
$179.74
|
| Rate for Payer: Mclaren Commercial |
$166.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$151.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.06
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,650.04 |
| Max. Negotiated Rate |
$4,076.99 |
| Rate for Payer: Aetna Commercial |
$3,669.29
|
| Rate for Payer: ASR ASR |
$3,954.68
|
| Rate for Payer: ASR Commercial |
$3,954.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,322.34
|
| Rate for Payer: BCN Commercial |
$3,160.89
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,832.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Healthscope Commercial |
$4,076.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,954.68
|
| Rate for Payer: Mclaren Commercial |
$3,669.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,587.75
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,669.29
|
| 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 |
$3,954.68
|
| Rate for Payer: ASR Commercial |
$3,954.68
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,338.65
|
| Rate for Payer: BCN Commercial |
$3,160.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,832.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,076.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,954.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,669.29
|
| 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 |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| 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 |
$2,650.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,572.26
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,857.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,587.75
|
| 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 INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,690.71 |
| Max. Negotiated Rate |
$4,139.56 |
| Rate for Payer: Aetna Commercial |
$3,725.60
|
| Rate for Payer: ASR ASR |
$4,015.37
|
| Rate for Payer: ASR Commercial |
$4,015.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,373.33
|
| Rate for Payer: BCN Commercial |
$3,209.40
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,891.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Healthscope Commercial |
$4,139.56
|
| Rate for Payer: Healthscope Whirlpool |
$4,015.37
|
| Rate for Payer: Mclaren Commercial |
$3,725.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,642.81
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,690.71 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$3,725.60
|
| 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 |
$4,015.37
|
| Rate for Payer: ASR Commercial |
$4,015.37
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,389.89
|
| Rate for Payer: BCN Commercial |
$3,209.40
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,891.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$4,139.56
|
| Rate for Payer: Healthscope Whirlpool |
$4,015.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$3,725.60
|
| 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 |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| 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 |
$2,690.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,627.08
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,901.83
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,642.81
|
| 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
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$265.10 |
| Rate for Payer: Aetna Commercial |
$238.59
|
| Rate for Payer: Aetna Medicare |
$132.55
|
| Rate for Payer: ASR ASR |
$257.15
|
| Rate for Payer: ASR Commercial |
$257.15
|
| Rate for Payer: BCBS Complete |
$106.04
|
| Rate for Payer: BCBS Trust/PPO |
$217.09
|
| Rate for Payer: BCCCP Commercial |
$119.98
|
| Rate for Payer: BCN Commercial |
$205.53
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$265.10
|
| Rate for Payer: Healthscope Whirlpool |
$257.15
|
| Rate for Payer: Mclaren Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.28
|
| Rate for Payer: Priority Health Narrow Network |
$185.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.29
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$172.32 |
| Max. Negotiated Rate |
$265.10 |
| Rate for Payer: Aetna Commercial |
$238.59
|
| Rate for Payer: ASR ASR |
$257.15
|
| Rate for Payer: ASR Commercial |
$257.15
|
| Rate for Payer: BCBS Trust/PPO |
$216.03
|
| Rate for Payer: BCN Commercial |
$205.53
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$265.10
|
| Rate for Payer: Healthscope Whirlpool |
$257.15
|
| Rate for Payer: Mclaren Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.29
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
OP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$635.79
|
| Rate for Payer: ASR Commercial |
$635.79
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$536.75
|
| Rate for Payer: BCCCP Commercial |
$359.30
|
| Rate for Payer: BCN Commercial |
$508.17
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$616.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Healthscope Whirlpool |
$635.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$589.90
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.31
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$459.47
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$576.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
IP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$426.04 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: ASR ASR |
$635.79
|
| Rate for Payer: ASR Commercial |
$635.79
|
| Rate for Payer: BCBS Trust/PPO |
$534.13
|
| Rate for Payer: BCN Commercial |
$508.17
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$616.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Healthscope Whirlpool |
$635.79
|
| Rate for Payer: Mclaren Commercial |
$589.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$576.80
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
IP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$485.24 |
| Max. Negotiated Rate |
$746.53 |
| Rate for Payer: Aetna Commercial |
$671.88
|
| Rate for Payer: ASR ASR |
$724.13
|
| Rate for Payer: ASR Commercial |
$724.13
|
| Rate for Payer: BCBS Trust/PPO |
$608.35
|
| Rate for Payer: BCN Commercial |
$578.78
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$701.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Healthscope Commercial |
$746.53
|
| Rate for Payer: Healthscope Whirlpool |
$724.13
|
| Rate for Payer: Mclaren Commercial |
$671.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.95
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
OP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.53 |
| Max. Negotiated Rate |
$1,013.65 |
| Rate for Payer: Aetna Commercial |
$671.88
|
| Rate for Payer: Aetna Medicare |
$653.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.46
|
| Rate for Payer: ASR ASR |
$724.13
|
| Rate for Payer: ASR Commercial |
$724.13
|
| Rate for Payer: BCBS Complete |
$368.05
|
| Rate for Payer: BCBS MAPPO |
$653.97
|
| Rate for Payer: BCBS Trust/PPO |
$611.33
|
| Rate for Payer: BCN Commercial |
$578.78
|
| Rate for Payer: BCN Medicare Advantage |
$653.97
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$701.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.97
|
| Rate for Payer: Healthscope Commercial |
$746.53
|
| Rate for Payer: Healthscope Whirlpool |
$724.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$653.97
|
| Rate for Payer: Mclaren Commercial |
$671.88
|
| Rate for Payer: Mclaren Medicaid |
$350.53
|
| Rate for Payer: Mclaren Medicare |
$653.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.67
|
| Rate for Payer: Meridian Medicaid |
$368.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: PACE Medicare |
$621.27
|
| Rate for Payer: PACE SWMI |
$653.97
|
| Rate for Payer: PHP Commercial |
$719.37
|
| Rate for Payer: PHP Medicaid |
$350.53
|
| Rate for Payer: PHP Medicare Advantage |
$653.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.32
|
| Rate for Payer: Priority Health Medicare |
$653.97
|
| Rate for Payer: Priority Health Narrow Network |
$388.26
|
| Rate for Payer: Railroad Medicare Medicare |
$653.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.97
|
| Rate for Payer: UHC Exchange |
$1,013.65
|
| Rate for Payer: UHC Medicare Advantage |
$653.97
|
| Rate for Payer: UHCCP DNSP |
$653.97
|
| Rate for Payer: UHCCP Medicaid |
$350.53
|
| Rate for Payer: VA VA |
$653.97
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
IP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.48 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna Commercial |
$600.21
|
| Rate for Payer: ASR ASR |
$646.89
|
| Rate for Payer: ASR Commercial |
$646.89
|
| Rate for Payer: BCBS Trust/PPO |
$543.46
|
| Rate for Payer: BCN Commercial |
$517.05
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$626.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Healthscope Commercial |
$666.90
|
| Rate for Payer: Healthscope Whirlpool |
$646.89
|
| Rate for Payer: Mclaren Commercial |
$600.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.86
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.87
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
OP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna Commercial |
$600.21
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$646.89
|
| Rate for Payer: ASR Commercial |
$646.89
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$546.12
|
| Rate for Payer: BCN Commercial |
$517.05
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$626.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$666.90
|
| Rate for Payer: Healthscope Whirlpool |
$646.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$600.21
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.86
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.34
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$467.50
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC INSULIN
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.29
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: BCBS MAPPO |
$11.43
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.43
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.43
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.43
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Mclaren Medicaid |
$6.13
|
| Rate for Payer: Mclaren Medicare |
$11.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.00
|
| Rate for Payer: Meridian Medicaid |
$6.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: PACE Medicare |
$10.86
|
| Rate for Payer: PACE SWMI |
$11.43
|
| Rate for Payer: PHP Commercial |
$12.57
|
| Rate for Payer: PHP Medicaid |
$6.13
|
| Rate for Payer: PHP Medicare Advantage |
$11.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.92
|
| Rate for Payer: Priority Health Medicare |
$11.43
|
| Rate for Payer: Priority Health Narrow Network |
$35.14
|
| Rate for Payer: Railroad Medicare Medicare |
$11.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.43
|
| Rate for Payer: UHC Exchange |
$17.72
|
| Rate for Payer: UHC Medicare Advantage |
$11.43
|
| Rate for Payer: UHCCP DNSP |
$11.43
|
| Rate for Payer: UHCCP Medicaid |
$6.13
|
| Rate for Payer: VA VA |
$11.43
|
|
|
HC INSULIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Trust/PPO |
$81.46
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
|
