|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
IP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,433.63 |
| Max. Negotiated Rate |
$2,205.59 |
| Rate for Payer: Aetna Commercial |
$1,985.03
|
| Rate for Payer: ASR ASR |
$2,139.42
|
| Rate for Payer: ASR Commercial |
$2,139.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.34
|
| Rate for Payer: BCN Commercial |
$1,709.99
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$2,073.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Healthscope Commercial |
$2,205.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,139.42
|
| Rate for Payer: Mclaren Commercial |
$1,985.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: Nomi Health Commercial |
$1,808.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,940.92
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
OP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,205.59 |
| Rate for Payer: Aetna Commercial |
$1,985.03
|
| Rate for Payer: Aetna Medicare |
$914.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: ASR ASR |
$2,139.42
|
| Rate for Payer: ASR Commercial |
$2,139.42
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,806.16
|
| Rate for Payer: BCN Commercial |
$1,709.99
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$2,073.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$2,205.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,139.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$914.38
|
| Rate for Payer: Mclaren Commercial |
$1,985.03
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: Nomi Health Commercial |
$1,808.58
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,005.82
|
| Rate for Payer: PHP Medicaid |
$490.11
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,932.54
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,546.12
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,940.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,417.29
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP DNSP |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$340.34 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| Rate for Payer: ASR ASR |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Trust/PPO |
$277.34
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.50
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$136.14 |
| Max. Negotiated Rate |
$340.34 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| Rate for Payer: Aetna Medicare |
$170.17
|
| Rate for Payer: ASR ASR |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Complete |
$136.14
|
| Rate for Payer: BCBS Trust/PPO |
$278.70
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.21
|
| Rate for Payer: Priority Health Narrow Network |
$238.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.50
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
IP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$169.87 |
| Max. Negotiated Rate |
$261.34 |
| Rate for Payer: Aetna Commercial |
$235.21
|
| Rate for Payer: ASR ASR |
$253.50
|
| Rate for Payer: ASR Commercial |
$253.50
|
| Rate for Payer: BCBS Trust/PPO |
$212.97
|
| Rate for Payer: BCN Commercial |
$202.62
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$245.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Healthscope Commercial |
$261.34
|
| Rate for Payer: Healthscope Whirlpool |
$253.50
|
| Rate for Payer: Mclaren Commercial |
$235.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: Nomi Health Commercial |
$214.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.98
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
OP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$104.54 |
| Max. Negotiated Rate |
$261.34 |
| Rate for Payer: Aetna Commercial |
$235.21
|
| Rate for Payer: Aetna Medicare |
$130.67
|
| Rate for Payer: ASR ASR |
$253.50
|
| Rate for Payer: ASR Commercial |
$253.50
|
| Rate for Payer: BCBS Complete |
$104.54
|
| Rate for Payer: BCBS Trust/PPO |
$214.01
|
| Rate for Payer: BCN Commercial |
$202.62
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$245.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Healthscope Commercial |
$261.34
|
| Rate for Payer: Healthscope Whirlpool |
$253.50
|
| Rate for Payer: Mclaren Commercial |
$235.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: Nomi Health Commercial |
$214.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.99
|
| Rate for Payer: Priority Health Narrow Network |
$183.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.98
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.48 |
| Max. Negotiated Rate |
$388.71 |
| Rate for Payer: Aetna Commercial |
$349.84
|
| Rate for Payer: Aetna Medicare |
$194.35
|
| Rate for Payer: ASR ASR |
$377.05
|
| Rate for Payer: ASR Commercial |
$377.05
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS Trust/PPO |
$318.31
|
| Rate for Payer: BCN Commercial |
$301.37
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$365.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$388.71
|
| Rate for Payer: Healthscope Whirlpool |
$377.05
|
| Rate for Payer: Mclaren Commercial |
$349.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.59
|
| Rate for Payer: Priority Health Narrow Network |
$272.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.06
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$388.71 |
| Rate for Payer: Aetna Commercial |
$349.84
|
| Rate for Payer: ASR ASR |
$377.05
|
| Rate for Payer: ASR Commercial |
$377.05
|
| Rate for Payer: BCBS Trust/PPO |
$316.76
|
| Rate for Payer: BCN Commercial |
$301.37
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$365.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$388.71
|
| Rate for Payer: Healthscope Whirlpool |
$377.05
|
| Rate for Payer: Mclaren Commercial |
$349.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.06
|
|
|
HC IR GUIDEWIRE
|
Facility
|
IP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Trust/PPO |
$36.46
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC IR GUIDEWIRE
|
Facility
|
OP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Complete |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.20
|
| Rate for Payer: Priority Health Narrow Network |
$31.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$539.87 |
| Rate for Payer: Aetna Commercial |
$437.40
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$471.42
|
| Rate for Payer: ASR Commercial |
$471.42
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$397.99
|
| Rate for Payer: BCN Commercial |
$376.80
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$486.00
|
| Rate for Payer: Healthscope Whirlpool |
$471.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$437.40
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.83
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$340.69
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$427.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$315.90 |
| Max. Negotiated Rate |
$486.00 |
| Rate for Payer: Aetna Commercial |
$437.40
|
| Rate for Payer: ASR ASR |
$471.42
|
| Rate for Payer: ASR Commercial |
$471.42
|
| Rate for Payer: BCBS Trust/PPO |
$396.04
|
| Rate for Payer: BCN Commercial |
$376.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$486.00
|
| Rate for Payer: Healthscope Whirlpool |
$471.42
|
| Rate for Payer: Mclaren Commercial |
$437.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$427.68
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
IP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$825.69 |
| Rate for Payer: Aetna Commercial |
$743.12
|
| Rate for Payer: ASR ASR |
$800.92
|
| Rate for Payer: ASR Commercial |
$800.92
|
| Rate for Payer: BCBS Trust/PPO |
$672.85
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$776.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Healthscope Commercial |
$825.69
|
| Rate for Payer: Healthscope Whirlpool |
$800.92
|
| Rate for Payer: Mclaren Commercial |
$743.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$677.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.61
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
OP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$828.86 |
| Rate for Payer: Aetna Commercial |
$743.12
|
| Rate for Payer: Aetna Medicare |
$534.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: ASR ASR |
$800.92
|
| Rate for Payer: ASR Commercial |
$800.92
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$676.16
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$776.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$825.69
|
| Rate for Payer: Healthscope Whirlpool |
$800.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$534.75
|
| Rate for Payer: Mclaren Commercial |
$743.12
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$677.07
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$588.23
|
| Rate for Payer: PHP Medicaid |
$286.63
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.47
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow Network |
$578.81
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$828.86
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP DNSP |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: VA VA |
$534.75
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
OP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$1,762.20
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$1,899.26
|
| Rate for Payer: ASR Commercial |
$1,899.26
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.41
|
| Rate for Payer: BCN Commercial |
$1,518.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,840.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$1,958.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,899.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$1,762.20
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: Nomi Health Commercial |
$1,605.56
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,715.60
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,372.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,723.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
IP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,272.70 |
| Max. Negotiated Rate |
$1,958.00 |
| Rate for Payer: Aetna Commercial |
$1,762.20
|
| Rate for Payer: ASR ASR |
$1,899.26
|
| Rate for Payer: ASR Commercial |
$1,899.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,595.57
|
| Rate for Payer: BCN Commercial |
$1,518.04
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,840.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Healthscope Commercial |
$1,958.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,899.26
|
| Rate for Payer: Mclaren Commercial |
$1,762.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: Nomi Health Commercial |
$1,605.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,723.04
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,873.50
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,174.77
|
| Rate for Payer: ASR Commercial |
$4,174.77
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,524.46
|
| Rate for Payer: BCN Commercial |
$3,336.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$4,045.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,303.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,174.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,873.50
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$3,529.19
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,771.07
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,017.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,787.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
IP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,797.53 |
| Max. Negotiated Rate |
$4,303.89 |
| Rate for Payer: Aetna Commercial |
$3,873.50
|
| Rate for Payer: ASR ASR |
$4,174.77
|
| Rate for Payer: ASR Commercial |
$4,174.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,507.24
|
| Rate for Payer: BCN Commercial |
$3,336.81
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$4,045.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Healthscope Commercial |
$4,303.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,174.77
|
| Rate for Payer: Mclaren Commercial |
$3,873.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$3,529.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,787.42
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
IP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,255.73 |
| Max. Negotiated Rate |
$3,470.36 |
| Rate for Payer: Aetna Commercial |
$3,123.32
|
| Rate for Payer: ASR ASR |
$3,366.25
|
| Rate for Payer: ASR Commercial |
$3,366.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,828.00
|
| Rate for Payer: BCN Commercial |
$2,690.57
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$3,262.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Healthscope Commercial |
$3,470.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,366.25
|
| Rate for Payer: Mclaren Commercial |
$3,123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$2,845.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,053.92
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,123.32
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,366.25
|
| Rate for Payer: ASR Commercial |
$3,366.25
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,841.88
|
| Rate for Payer: BCN Commercial |
$2,690.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$3,262.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,470.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,366.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,123.32
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$2,845.70
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,040.73
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,432.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,053.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
IP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$824.23 |
| Max. Negotiated Rate |
$1,268.04 |
| Rate for Payer: Aetna Commercial |
$1,141.24
|
| Rate for Payer: ASR ASR |
$1,230.00
|
| Rate for Payer: ASR Commercial |
$1,230.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.33
|
| Rate for Payer: BCN Commercial |
$983.11
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cofinity Commercial |
$1,191.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.43
|
| Rate for Payer: Healthscope Commercial |
$1,268.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.00
|
| Rate for Payer: Mclaren Commercial |
$1,141.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: Nomi Health Commercial |
$1,039.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.88
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
OP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,141.24
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,230.00
|
| Rate for Payer: ASR Commercial |
$1,230.00
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.40
|
| Rate for Payer: BCN Commercial |
$983.11
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cofinity Commercial |
$1,191.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,268.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,141.24
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: Nomi Health Commercial |
$1,039.79
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.06
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$888.90
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
IP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,073.08 |
| Max. Negotiated Rate |
$1,650.89 |
| Rate for Payer: Aetna Commercial |
$1,485.80
|
| Rate for Payer: ASR ASR |
$1,601.36
|
| Rate for Payer: ASR Commercial |
$1,601.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.31
|
| Rate for Payer: BCN Commercial |
$1,279.94
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,551.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Healthscope Commercial |
$1,650.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.36
|
| Rate for Payer: Mclaren Commercial |
$1,485.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: Nomi Health Commercial |
$1,353.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.78
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
OP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,650.89 |
| Rate for Payer: Aetna Commercial |
$1,485.80
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,601.36
|
| Rate for Payer: ASR Commercial |
$1,601.36
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.91
|
| Rate for Payer: BCN Commercial |
$1,279.94
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,551.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,650.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,485.80
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: Nomi Health Commercial |
$1,353.73
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,446.51
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.27
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$4,361.30
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$4,700.51
|
| Rate for Payer: ASR Commercial |
$4,700.51
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,968.30
|
| Rate for Payer: BCN Commercial |
$3,757.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$4,555.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$4,845.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,700.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$4,361.30
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,245.97
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,396.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,264.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
