|
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 |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$1,762.20
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$1,899.26
|
| Rate for Payer: ASR Commercial |
$1,899.26
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.41
|
| Rate for Payer: BCN Commercial |
$1,518.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| 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 |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$1,958.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,899.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$1,762.20
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| 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 |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| 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 |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,372.56
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,723.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
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 HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,873.50
|
| 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 |
$4,174.77
|
| Rate for Payer: ASR Commercial |
$4,174.77
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,524.46
|
| Rate for Payer: BCN Commercial |
$3,336.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,303.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,174.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,873.50
|
| 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 |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$3,529.19
|
| 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 |
$2,797.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,771.07
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,017.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,787.42
|
| 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 IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,123.32
|
| 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 |
$3,366.25
|
| Rate for Payer: ASR Commercial |
$3,366.25
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,841.88
|
| Rate for Payer: BCN Commercial |
$2,690.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,470.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,366.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,123.32
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$2,845.70
|
| 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 |
$2,255.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,040.73
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,432.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,053.92
|
| 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 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 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 |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,141.24
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,230.00
|
| Rate for Payer: ASR Commercial |
$1,230.00
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.40
|
| Rate for Payer: BCN Commercial |
$983.11
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| 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 |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,268.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,141.24
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| 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 |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| 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 |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$888.90
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
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 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 |
$467.55 |
| Max. Negotiated Rate |
$1,650.89 |
| Rate for Payer: Aetna Commercial |
$1,485.80
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,601.36
|
| Rate for Payer: ASR Commercial |
$1,601.36
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.91
|
| Rate for Payer: BCN Commercial |
$1,279.94
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| 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 |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,650.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,485.80
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| 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 |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| 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 |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.27
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
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 INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,149.83 |
| Max. Negotiated Rate |
$4,845.89 |
| Rate for Payer: Aetna Commercial |
$4,361.30
|
| Rate for Payer: ASR ASR |
$4,700.51
|
| Rate for Payer: ASR Commercial |
$4,700.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,948.92
|
| Rate for Payer: BCN Commercial |
$3,757.02
|
| 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: Healthscope Commercial |
$4,845.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,700.51
|
| Rate for Payer: Mclaren Commercial |
$4,361.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,264.38
|
|
|
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 |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$4,361.30
|
| 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 |
$4,700.51
|
| Rate for Payer: ASR Commercial |
$4,700.51
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,968.30
|
| Rate for Payer: BCN Commercial |
$3,757.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| 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 |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$4,845.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,700.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$4,361.30
|
| 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 |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| 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 |
$3,149.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,245.97
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,396.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,264.38
|
| 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 IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,860.88 |
| Rate for Payer: Aetna Commercial |
$4,374.79
|
| 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 |
$4,715.05
|
| Rate for Payer: ASR Commercial |
$4,715.05
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.57
|
| Rate for Payer: BCN Commercial |
$3,768.64
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,569.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,860.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,715.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,374.79
|
| 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 |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| 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 |
$3,159.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,259.10
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,407.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,277.57
|
| 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 IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,159.57 |
| Max. Negotiated Rate |
$4,860.88 |
| Rate for Payer: Aetna Commercial |
$4,374.79
|
| Rate for Payer: ASR ASR |
$4,715.05
|
| Rate for Payer: ASR Commercial |
$4,715.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,961.13
|
| Rate for Payer: BCN Commercial |
$3,768.64
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,569.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Healthscope Commercial |
$4,860.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,715.05
|
| Rate for Payer: Mclaren Commercial |
$4,374.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,277.57
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$4,573.82 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,727.21
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| 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 |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,745.50
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| 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 |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| 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 |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,007.58
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,206.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
| 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 IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,838.87 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$4,379.33
|
| 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 |
$4,719.94
|
| Rate for Payer: ASR Commercial |
$4,719.94
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,984.70
|
| Rate for Payer: BCN Commercial |
$3,772.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,573.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$4,865.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,719.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$4,379.33
|
| 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 |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| 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 |
$3,162.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,263.52
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$3,411.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,282.01
|
| 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 IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,162.85 |
| Max. Negotiated Rate |
$4,865.92 |
| Rate for Payer: Aetna Commercial |
$4,379.33
|
| Rate for Payer: ASR ASR |
$4,719.94
|
| Rate for Payer: ASR Commercial |
$4,719.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,965.24
|
| Rate for Payer: BCN Commercial |
$3,772.55
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,573.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Healthscope Commercial |
$4,865.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,719.94
|
| Rate for Payer: Mclaren Commercial |
$4,379.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,282.01
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,284.22 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$1,778.15
|
| 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 |
$1,916.45
|
| Rate for Payer: ASR Commercial |
$1,916.45
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.92
|
| Rate for Payer: BCN Commercial |
$1,531.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,857.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,975.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,916.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$1,778.15
|
| 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 |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,731.13
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,384.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.63
|
| 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 IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,284.22 |
| Max. Negotiated Rate |
$1,975.72 |
| Rate for Payer: Aetna Commercial |
$1,778.15
|
| Rate for Payer: ASR ASR |
$1,916.45
|
| Rate for Payer: ASR Commercial |
$1,916.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.01
|
| Rate for Payer: BCN Commercial |
$1,531.78
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,857.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Healthscope Commercial |
$1,975.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,916.45
|
| Rate for Payer: Mclaren Commercial |
$1,778.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.63
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,328.67
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,509.79
|
| Rate for Payer: ASR Commercial |
$2,509.79
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,118.83
|
| Rate for Payer: BCN Commercial |
$2,006.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,432.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,587.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,328.67
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,267.09
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,813.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.92
|
| 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 IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,681.82 |
| Max. Negotiated Rate |
$2,587.41 |
| Rate for Payer: Aetna Commercial |
$2,328.67
|
| Rate for Payer: ASR ASR |
$2,509.79
|
| Rate for Payer: ASR Commercial |
$2,509.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.48
|
| Rate for Payer: BCN Commercial |
$2,006.02
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,432.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Healthscope Commercial |
$2,587.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.79
|
| Rate for Payer: Mclaren Commercial |
$2,328.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.92
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.69 |
| Max. Negotiated Rate |
$1,392.83 |
| Rate for Payer: Aetna Commercial |
$1,253.55
|
| Rate for Payer: Aetna Medicare |
$678.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.15
|
| Rate for Payer: ASR ASR |
$1,351.05
|
| Rate for Payer: ASR Commercial |
$1,351.05
|
| Rate for Payer: BCBS Complete |
$381.87
|
| Rate for Payer: BCBS MAPPO |
$678.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.59
|
| Rate for Payer: BCN Commercial |
$1,079.86
|
| Rate for Payer: BCN Medicare Advantage |
$678.52
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.52
|
| Rate for Payer: Healthscope Commercial |
$1,392.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$678.52
|
| Rate for Payer: Mclaren Commercial |
$1,253.55
|
| Rate for Payer: Mclaren Medicaid |
$363.69
|
| Rate for Payer: Mclaren Medicare |
$678.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.45
|
| Rate for Payer: Meridian Medicaid |
$381.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: PACE Medicare |
$644.59
|
| Rate for Payer: PACE SWMI |
$678.52
|
| Rate for Payer: PHP Commercial |
$746.37
|
| Rate for Payer: PHP Medicaid |
$363.69
|
| Rate for Payer: PHP Medicare Advantage |
$678.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.54
|
| Rate for Payer: Priority Health Medicare |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.43
|
| Rate for Payer: Railroad Medicare Medicare |
$678.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,225.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.52
|
| Rate for Payer: UHC Exchange |
$1,051.71
|
| Rate for Payer: UHC Medicare Advantage |
$678.52
|
| Rate for Payer: UHCCP DNSP |
$678.52
|
| Rate for Payer: UHCCP Medicaid |
$363.69
|
| Rate for Payer: VA VA |
$678.52
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$905.34 |
| Max. Negotiated Rate |
$1,392.83 |
| Rate for Payer: Aetna Commercial |
$1,253.55
|
| Rate for Payer: ASR ASR |
$1,351.05
|
| Rate for Payer: ASR Commercial |
$1,351.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.02
|
| Rate for Payer: BCN Commercial |
$1,079.86
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Healthscope Commercial |
$1,392.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.05
|
| Rate for Payer: Mclaren Commercial |
$1,253.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,225.69
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$690.71 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$956.37
|
| Rate for Payer: ASR ASR |
$1,030.75
|
| Rate for Payer: ASR Commercial |
$1,030.75
|
| Rate for Payer: BCBS Trust/PPO |
$865.94
|
| Rate for Payer: BCN Commercial |
$823.86
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$998.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Healthscope Commercial |
$1,062.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.75
|
| Rate for Payer: Mclaren Commercial |
$956.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.11
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.69 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$956.37
|
| Rate for Payer: Aetna Medicare |
$678.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.15
|
| Rate for Payer: ASR ASR |
$1,030.75
|
| Rate for Payer: ASR Commercial |
$1,030.75
|
| Rate for Payer: BCBS Complete |
$381.87
|
| Rate for Payer: BCBS MAPPO |
$678.52
|
| Rate for Payer: BCBS Trust/PPO |
$870.19
|
| Rate for Payer: BCN Commercial |
$823.86
|
| Rate for Payer: BCN Medicare Advantage |
$678.52
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$998.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.52
|
| Rate for Payer: Healthscope Commercial |
$1,062.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$678.52
|
| Rate for Payer: Mclaren Commercial |
$956.37
|
| Rate for Payer: Mclaren Medicaid |
$363.69
|
| Rate for Payer: Mclaren Medicare |
$678.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.45
|
| Rate for Payer: Meridian Medicaid |
$381.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: PACE Medicare |
$644.59
|
| Rate for Payer: PACE SWMI |
$678.52
|
| Rate for Payer: PHP Commercial |
$746.37
|
| Rate for Payer: PHP Medicaid |
$363.69
|
| Rate for Payer: PHP Medicare Advantage |
$678.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.54
|
| Rate for Payer: Priority Health Medicare |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.43
|
| Rate for Payer: Railroad Medicare Medicare |
$678.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.52
|
| Rate for Payer: UHC Exchange |
$1,051.71
|
| Rate for Payer: UHC Medicare Advantage |
$678.52
|
| Rate for Payer: UHCCP DNSP |
$678.52
|
| Rate for Payer: UHCCP Medicaid |
$363.69
|
| Rate for Payer: VA VA |
$678.52
|
|
