|
HC INTERMEDIATE CARE R & B
|
Facility
|
IP
|
$4,896.09
|
|
| Hospital Charge Code |
20600001
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$3,182.46 |
| Max. Negotiated Rate |
$4,896.09 |
| Rate for Payer: Aetna Commercial |
$4,406.48
|
| Rate for Payer: ASR ASR |
$4,749.21
|
| Rate for Payer: ASR Commercial |
$4,749.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.82
|
| Rate for Payer: BCN Commercial |
$3,795.94
|
| Rate for Payer: Cash Price |
$3,916.87
|
| Rate for Payer: Cofinity Commercial |
$4,602.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,916.87
|
| Rate for Payer: Healthscope Commercial |
$4,896.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,749.21
|
| Rate for Payer: Mclaren Commercial |
$4,406.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,161.68
|
| Rate for Payer: Nomi Health Commercial |
$4,014.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,182.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,308.56
|
|
|
HC INTERMEDIATE NURSERY CARE
|
Facility
|
IP
|
$2,965.64
|
|
| Hospital Charge Code |
17100001
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$1,927.67 |
| Max. Negotiated Rate |
$2,965.64 |
| Rate for Payer: Aetna Commercial |
$2,669.08
|
| Rate for Payer: ASR ASR |
$2,876.67
|
| Rate for Payer: ASR Commercial |
$2,876.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,416.70
|
| Rate for Payer: BCN Commercial |
$2,299.26
|
| Rate for Payer: Cash Price |
$2,372.51
|
| Rate for Payer: Cofinity Commercial |
$2,787.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,372.51
|
| Rate for Payer: Healthscope Commercial |
$2,965.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,876.67
|
| Rate for Payer: Mclaren Commercial |
$2,669.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,520.79
|
| Rate for Payer: Nomi Health Commercial |
$2,431.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,927.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,609.76
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
IP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.95 |
| Max. Negotiated Rate |
$536.85 |
| Rate for Payer: Aetna Commercial |
$483.17
|
| Rate for Payer: ASR ASR |
$520.74
|
| Rate for Payer: ASR Commercial |
$520.74
|
| Rate for Payer: BCBS Trust/PPO |
$437.48
|
| Rate for Payer: BCN Commercial |
$416.22
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$504.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Healthscope Commercial |
$536.85
|
| Rate for Payer: Healthscope Whirlpool |
$520.74
|
| Rate for Payer: Mclaren Commercial |
$483.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: Nomi Health Commercial |
$440.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.43
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
OP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$483.17
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$520.74
|
| Rate for Payer: ASR Commercial |
$520.74
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$439.63
|
| Rate for Payer: BCN Commercial |
$416.22
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$504.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$536.85
|
| Rate for Payer: Healthscope Whirlpool |
$520.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$483.17
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: Nomi Health Commercial |
$440.22
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.39
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$376.33
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,888.39
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$755.36 |
| Max. Negotiated Rate |
$1,888.39 |
| Rate for Payer: Aetna Commercial |
$1,699.55
|
| Rate for Payer: Aetna Medicare |
$944.20
|
| Rate for Payer: ASR ASR |
$1,831.74
|
| Rate for Payer: ASR Commercial |
$1,831.74
|
| Rate for Payer: BCBS Complete |
$755.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.40
|
| Rate for Payer: BCN Commercial |
$1,464.07
|
| Rate for Payer: Cash Price |
$1,510.71
|
| Rate for Payer: Cofinity Commercial |
$1,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.71
|
| Rate for Payer: Healthscope Commercial |
$1,888.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,831.74
|
| Rate for Payer: Mclaren Commercial |
$1,699.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.13
|
| Rate for Payer: Nomi Health Commercial |
$1,548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,654.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,661.78
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
IP
|
$1,888.39
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,227.45 |
| Max. Negotiated Rate |
$1,888.39 |
| Rate for Payer: Aetna Commercial |
$1,699.55
|
| Rate for Payer: ASR ASR |
$1,831.74
|
| Rate for Payer: ASR Commercial |
$1,831.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.85
|
| Rate for Payer: BCN Commercial |
$1,464.07
|
| Rate for Payer: Cash Price |
$1,510.71
|
| Rate for Payer: Cofinity Commercial |
$1,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.71
|
| Rate for Payer: Healthscope Commercial |
$1,888.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,831.74
|
| Rate for Payer: Mclaren Commercial |
$1,699.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.13
|
| Rate for Payer: Nomi Health Commercial |
$1,548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,661.78
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$230.59
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.73
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$197.39
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$281.59 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Trust/PPO |
$229.47
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$278.77
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$253.65
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$278.77
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.40
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$217.13
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$278.77
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Trust/PPO |
$252.42
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Mclaren Commercial |
$278.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.12 |
| Max. Negotiated Rate |
$498.64 |
| Rate for Payer: Aetna Commercial |
$448.78
|
| Rate for Payer: ASR ASR |
$483.68
|
| Rate for Payer: ASR Commercial |
$483.68
|
| Rate for Payer: BCBS Trust/PPO |
$406.34
|
| Rate for Payer: BCN Commercial |
$386.60
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$468.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$498.64
|
| Rate for Payer: Healthscope Whirlpool |
$483.68
|
| Rate for Payer: Mclaren Commercial |
$448.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.80
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$448.78
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$483.68
|
| Rate for Payer: ASR Commercial |
$483.68
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$408.34
|
| Rate for Payer: BCN Commercial |
$386.60
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$468.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$498.64
|
| Rate for Payer: Healthscope Whirlpool |
$483.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$448.78
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.91
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$349.55
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$281.59 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Trust/PPO |
$229.47
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$230.59
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.73
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$197.39
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$278.77
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$253.65
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$278.77
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.40
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$217.13
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$278.77
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Trust/PPO |
$252.42
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Mclaren Commercial |
$278.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$899.53
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$899.53 |
| Rate for Payer: Aetna Commercial |
$809.58
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$872.54
|
| Rate for Payer: ASR Commercial |
$872.54
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$736.63
|
| Rate for Payer: BCN Commercial |
$697.41
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cofinity Commercial |
$845.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$899.53
|
| Rate for Payer: Healthscope Whirlpool |
$872.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$809.58
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.60
|
| Rate for Payer: Nomi Health Commercial |
$737.61
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.17
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$630.57
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$791.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$899.53
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$584.69 |
| Max. Negotiated Rate |
$899.53 |
| Rate for Payer: Aetna Commercial |
$809.58
|
| Rate for Payer: ASR ASR |
$872.54
|
| Rate for Payer: ASR Commercial |
$872.54
|
| Rate for Payer: BCBS Trust/PPO |
$733.03
|
| Rate for Payer: BCN Commercial |
$697.41
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cofinity Commercial |
$845.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.62
|
| Rate for Payer: Healthscope Commercial |
$899.53
|
| Rate for Payer: Healthscope Whirlpool |
$872.54
|
| Rate for Payer: Mclaren Commercial |
$809.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.60
|
| Rate for Payer: Nomi Health Commercial |
$737.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$791.59
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,205.80
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,433.77 |
| Max. Negotiated Rate |
$2,205.80 |
| Rate for Payer: Aetna Commercial |
$1,985.22
|
| Rate for Payer: ASR ASR |
$2,139.63
|
| Rate for Payer: ASR Commercial |
$2,139.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.51
|
| Rate for Payer: BCN Commercial |
$1,710.16
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cofinity Commercial |
$2,073.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.64
|
| Rate for Payer: Healthscope Commercial |
$2,205.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,139.63
|
| Rate for Payer: Mclaren Commercial |
$1,985.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.93
|
| Rate for Payer: Nomi Health Commercial |
$1,808.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,941.10
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,205.80
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$882.32 |
| Max. Negotiated Rate |
$2,205.80 |
| Rate for Payer: Aetna Commercial |
$1,985.22
|
| Rate for Payer: Aetna Medicare |
$1,102.90
|
| Rate for Payer: ASR ASR |
$2,139.63
|
| Rate for Payer: ASR Commercial |
$2,139.63
|
| Rate for Payer: BCBS Complete |
$882.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,806.33
|
| Rate for Payer: BCN Commercial |
$1,710.16
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cofinity Commercial |
$2,073.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.64
|
| Rate for Payer: Healthscope Commercial |
$2,205.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,139.63
|
| Rate for Payer: Mclaren Commercial |
$1,985.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.93
|
| Rate for Payer: Nomi Health Commercial |
$1,808.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,932.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,546.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,941.10
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,340.24
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$536.10 |
| Max. Negotiated Rate |
$1,340.24 |
| Rate for Payer: Aetna Commercial |
$1,206.22
|
| Rate for Payer: Aetna Medicare |
$670.12
|
| Rate for Payer: ASR ASR |
$1,300.03
|
| Rate for Payer: ASR Commercial |
$1,300.03
|
| Rate for Payer: BCBS Complete |
$536.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.52
|
| Rate for Payer: BCN Commercial |
$1,039.09
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cofinity Commercial |
$1,259.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.19
|
| Rate for Payer: Healthscope Commercial |
$1,340.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,300.03
|
| Rate for Payer: Mclaren Commercial |
$1,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.20
|
| Rate for Payer: Nomi Health Commercial |
$1,099.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,174.32
|
| Rate for Payer: Priority Health Narrow Network |
$939.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,179.41
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,340.24
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$871.16 |
| Max. Negotiated Rate |
$1,340.24 |
| Rate for Payer: Aetna Commercial |
$1,206.22
|
| Rate for Payer: ASR ASR |
$1,300.03
|
| Rate for Payer: ASR Commercial |
$1,300.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.16
|
| Rate for Payer: BCN Commercial |
$1,039.09
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cofinity Commercial |
$1,259.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.19
|
| Rate for Payer: Healthscope Commercial |
$1,340.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,300.03
|
| Rate for Payer: Mclaren Commercial |
$1,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.20
|
| Rate for Payer: Nomi Health Commercial |
$1,099.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,179.41
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,073.12
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$117.16 |
| Max. Negotiated Rate |
$1,073.12 |
| Rate for Payer: Aetna Commercial |
$965.81
|
| Rate for Payer: Aetna Medicare |
$218.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.24
|
| Rate for Payer: ASR ASR |
$1,040.93
|
| Rate for Payer: ASR Commercial |
$1,040.93
|
| Rate for Payer: BCBS Complete |
$123.02
|
| Rate for Payer: BCBS MAPPO |
$218.59
|
| Rate for Payer: BCBS Trust/PPO |
$878.78
|
| Rate for Payer: BCN Commercial |
$831.99
|
| Rate for Payer: BCN Medicare Advantage |
$218.59
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cofinity Commercial |
$1,008.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.59
|
| Rate for Payer: Healthscope Commercial |
$1,073.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,040.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.59
|
| Rate for Payer: Mclaren Commercial |
$965.81
|
| Rate for Payer: Mclaren Medicaid |
$117.16
|
| Rate for Payer: Mclaren Medicare |
$218.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.52
|
| Rate for Payer: Meridian Medicaid |
$123.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.15
|
| Rate for Payer: Nomi Health Commercial |
$879.96
|
| Rate for Payer: PACE Medicare |
$207.66
|
| Rate for Payer: PACE SWMI |
$218.59
|
| Rate for Payer: PHP Commercial |
$240.45
|
| Rate for Payer: PHP Medicaid |
$117.16
|
| Rate for Payer: PHP Medicare Advantage |
$218.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.27
|
| Rate for Payer: Priority Health Medicare |
$218.59
|
| Rate for Payer: Priority Health Narrow Network |
$752.26
|
| Rate for Payer: Railroad Medicare Medicare |
$218.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$944.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.59
|
| Rate for Payer: UHC Exchange |
$338.81
|
| Rate for Payer: UHC Medicare Advantage |
$218.59
|
| Rate for Payer: UHCCP DNSP |
$218.59
|
| Rate for Payer: UHCCP Medicaid |
$117.16
|
| Rate for Payer: VA VA |
$218.59
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,073.12
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$697.53 |
| Max. Negotiated Rate |
$1,073.12 |
| Rate for Payer: Aetna Commercial |
$965.81
|
| Rate for Payer: ASR ASR |
$1,040.93
|
| Rate for Payer: ASR Commercial |
$1,040.93
|
| Rate for Payer: BCBS Trust/PPO |
$874.49
|
| Rate for Payer: BCN Commercial |
$831.99
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cofinity Commercial |
$1,008.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.50
|
| Rate for Payer: Healthscope Commercial |
$1,073.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,040.93
|
| Rate for Payer: Mclaren Commercial |
$965.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.15
|
| Rate for Payer: Nomi Health Commercial |
$879.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$944.35
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,148.49
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,046.52 |
| Max. Negotiated Rate |
$3,148.49 |
| Rate for Payer: Aetna Commercial |
$2,833.64
|
| Rate for Payer: ASR ASR |
$3,054.04
|
| Rate for Payer: ASR Commercial |
$3,054.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,565.70
|
| Rate for Payer: BCN Commercial |
$2,441.02
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cofinity Commercial |
$2,959.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,518.79
|
| Rate for Payer: Healthscope Commercial |
$3,148.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,054.04
|
| Rate for Payer: Mclaren Commercial |
$2,833.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,676.22
|
| Rate for Payer: Nomi Health Commercial |
$2,581.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,770.67
|
|
