|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
IP
|
$603.90
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$452.93 |
| Max. Negotiated Rate |
$603.90 |
| Rate for Payer: Aetna Commercial |
$543.51
|
| Rate for Payer: ASR ASR |
$585.78
|
| Rate for Payer: BCBS Trust/PPO |
$495.92
|
| Rate for Payer: BCN Commercial |
$495.92
|
| Rate for Payer: Cash Price |
$483.12
|
| Rate for Payer: Cofinity Commercial |
$567.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.12
|
| Rate for Payer: Healthscope Commercial |
$585.78
|
| Rate for Payer: Healthscope Whirlpool |
$603.90
|
| Rate for Payer: Mclaren Commercial |
$543.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.32
|
| Rate for Payer: Nomi Health Commercial |
$495.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$531.43
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
IP
|
$728.76
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$546.57 |
| Max. Negotiated Rate |
$728.76 |
| Rate for Payer: Aetna Commercial |
$655.88
|
| Rate for Payer: ASR ASR |
$706.90
|
| Rate for Payer: BCBS Trust/PPO |
$598.46
|
| Rate for Payer: BCN Commercial |
$598.46
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$685.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.01
|
| Rate for Payer: Healthscope Commercial |
$706.90
|
| Rate for Payer: Healthscope Whirlpool |
$728.76
|
| Rate for Payer: Mclaren Commercial |
$655.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.45
|
| Rate for Payer: Nomi Health Commercial |
$597.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$641.31
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
OP
|
$728.76
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$50.35 |
| Max. Negotiated Rate |
$728.76 |
| Rate for Payer: Aetna Commercial |
$655.88
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$706.90
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$600.86
|
| Rate for Payer: BCCCP Commercial |
$50.35
|
| Rate for Payer: BCN Commercial |
$600.86
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$685.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$706.90
|
| Rate for Payer: Healthscope Whirlpool |
$728.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$655.88
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.45
|
| Rate for Payer: Nomi Health Commercial |
$597.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.57
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$570.17
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$456.14
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$641.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MANGANESE BLOOD
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
30100770
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Trust/PPO |
$156.03
|
| Rate for Payer: BCN Commercial |
$156.03
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$184.30
|
| Rate for Payer: Healthscope Whirlpool |
$190.00
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
|
|
HC MANGANESE BLOOD
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
30100770
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare |
$26.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.31
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Complete |
$14.64
|
| Rate for Payer: BCBS MAPPO |
$26.65
|
| Rate for Payer: BCBS Trust/PPO |
$156.66
|
| Rate for Payer: BCN Commercial |
$156.66
|
| Rate for Payer: BCN Medicare Advantage |
$26.65
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.65
|
| Rate for Payer: Healthscope Commercial |
$184.30
|
| Rate for Payer: Healthscope Whirlpool |
$190.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.65
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Mclaren Medicaid |
$26.65
|
| Rate for Payer: Mclaren Medicare |
$26.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.98
|
| Rate for Payer: Meridian Medicaid |
$14.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE Medicare |
$25.32
|
| Rate for Payer: PACE SWMI |
$26.65
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Medicaid |
$14.28
|
| Rate for Payer: PHP Medicare Advantage |
$26.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$166.48
|
| Rate for Payer: Priority Health Medicare |
$26.65
|
| Rate for Payer: Priority Health Narrow Network |
$133.19
|
| Rate for Payer: Railroad Medicare Medicare |
$26.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.65
|
| Rate for Payer: UHC Exchange |
$41.31
|
| Rate for Payer: UHC Medicaid |
$13.94
|
| Rate for Payer: UHCCP DNSP |
$26.65
|
| Rate for Payer: UHCCP Medicaid |
$13.94
|
| Rate for Payer: VA VA |
$26.65
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$85.83
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna Commercial |
$77.25
|
| Rate for Payer: Aetna Medicare |
$31.76
|
| Rate for Payer: ASR ASR |
$83.26
|
| Rate for Payer: BCBS Complete |
$34.33
|
| Rate for Payer: BCBS Trust/PPO |
$70.77
|
| Rate for Payer: BCN Commercial |
$70.77
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Healthscope Commercial |
$83.26
|
| Rate for Payer: Healthscope Whirlpool |
$85.83
|
| Rate for Payer: Mclaren Commercial |
$77.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: Nomi Health Commercial |
$70.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$75.20
|
| Rate for Payer: Priority Health Narrow Network |
$60.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.53
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$85.83
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.37 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna Commercial |
$77.25
|
| Rate for Payer: ASR ASR |
$83.26
|
| Rate for Payer: BCBS Trust/PPO |
$70.48
|
| Rate for Payer: BCN Commercial |
$70.48
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Healthscope Commercial |
$83.26
|
| Rate for Payer: Healthscope Whirlpool |
$85.83
|
| Rate for Payer: Mclaren Commercial |
$77.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: Nomi Health Commercial |
$70.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.53
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$4,036.75
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,431.24
|
| Rate for Payer: BCN Commercial |
$3,431.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,036.75
|
| Rate for Payer: Healthscope Whirlpool |
$4,161.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$3,412.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,646.39
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,917.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,121.20 |
| Max. Negotiated Rate |
$4,161.60 |
| Rate for Payer: Aetna Commercial |
$3,745.44
|
| Rate for Payer: ASR ASR |
$4,036.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,417.51
|
| Rate for Payer: BCN Commercial |
$3,417.51
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,911.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$4,036.75
|
| Rate for Payer: Healthscope Whirlpool |
$4,161.60
|
| Rate for Payer: Mclaren Commercial |
$3,745.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$3,412.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,662.21
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$504.07
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$504.07 |
| Rate for Payer: Aetna Commercial |
$453.66
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$488.95
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$415.61
|
| Rate for Payer: BCN Commercial |
$415.61
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$403.26
|
| Rate for Payer: Cash Price |
$403.26
|
| Rate for Payer: Cofinity Commercial |
$473.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$488.95
|
| Rate for Payer: Healthscope Whirlpool |
$504.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$453.66
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.46
|
| Rate for Payer: Nomi Health Commercial |
$413.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.05
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$441.67
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$353.35
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$443.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$504.07
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.05 |
| Max. Negotiated Rate |
$504.07 |
| Rate for Payer: Aetna Commercial |
$453.66
|
| Rate for Payer: ASR ASR |
$488.95
|
| Rate for Payer: BCBS Trust/PPO |
$413.94
|
| Rate for Payer: BCN Commercial |
$413.94
|
| Rate for Payer: Cash Price |
$403.26
|
| Rate for Payer: Cofinity Commercial |
$473.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.26
|
| Rate for Payer: Healthscope Commercial |
$488.95
|
| Rate for Payer: Healthscope Whirlpool |
$504.07
|
| Rate for Payer: Mclaren Commercial |
$453.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.46
|
| Rate for Payer: Nomi Health Commercial |
$413.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$443.58
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,522.83
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,142.12 |
| Max. Negotiated Rate |
$1,522.83 |
| Rate for Payer: Aetna Commercial |
$1,370.55
|
| Rate for Payer: ASR ASR |
$1,477.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.55
|
| Rate for Payer: BCN Commercial |
$1,250.55
|
| Rate for Payer: Cash Price |
$1,218.26
|
| Rate for Payer: Cofinity Commercial |
$1,431.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.26
|
| Rate for Payer: Healthscope Commercial |
$1,477.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,522.83
|
| Rate for Payer: Mclaren Commercial |
$1,370.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,294.41
|
| Rate for Payer: Nomi Health Commercial |
$1,248.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,142.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.09
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,522.83
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,522.83 |
| Rate for Payer: Aetna Commercial |
$1,370.55
|
| Rate for Payer: Aetna Medicare |
$694.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: ASR ASR |
$1,477.15
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,255.57
|
| Rate for Payer: BCN Commercial |
$1,255.57
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$1,218.26
|
| Rate for Payer: Cash Price |
$1,218.26
|
| Rate for Payer: Cofinity Commercial |
$1,431.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$1,477.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,522.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$694.79
|
| Rate for Payer: Mclaren Commercial |
$1,370.55
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$381.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,294.41
|
| Rate for Payer: Nomi Health Commercial |
$1,248.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,142.12
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$764.27
|
| Rate for Payer: PHP Medicaid |
$372.41
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,334.30
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Exchange |
$1,076.92
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP DNSP |
$694.79
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: VA VA |
$694.79
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,179.81
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$884.86 |
| Max. Negotiated Rate |
$1,179.81 |
| Rate for Payer: Aetna Commercial |
$1,061.83
|
| Rate for Payer: ASR ASR |
$1,144.42
|
| Rate for Payer: BCBS Trust/PPO |
$968.86
|
| Rate for Payer: BCN Commercial |
$968.86
|
| Rate for Payer: Cash Price |
$943.85
|
| Rate for Payer: Cofinity Commercial |
$1,109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$943.85
|
| Rate for Payer: Healthscope Commercial |
$1,144.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,179.81
|
| Rate for Payer: Mclaren Commercial |
$1,061.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,002.84
|
| Rate for Payer: Nomi Health Commercial |
$967.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.23
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,179.81
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$436.53 |
| Max. Negotiated Rate |
$1,179.81 |
| Rate for Payer: Aetna Commercial |
$1,061.83
|
| Rate for Payer: Aetna Medicare |
$436.53
|
| Rate for Payer: ASR ASR |
$1,144.42
|
| Rate for Payer: BCBS Complete |
$471.92
|
| Rate for Payer: BCBS Trust/PPO |
$972.75
|
| Rate for Payer: BCN Commercial |
$972.75
|
| Rate for Payer: Cash Price |
$943.85
|
| Rate for Payer: Cofinity Commercial |
$1,109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$943.85
|
| Rate for Payer: Healthscope Commercial |
$1,144.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,179.81
|
| Rate for Payer: Mclaren Commercial |
$1,061.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$943.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,002.84
|
| Rate for Payer: Nomi Health Commercial |
$967.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,033.75
|
| Rate for Payer: Priority Health Narrow Network |
$827.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.23
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: Aetna Medicare |
$3.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.75
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Complete |
$2.09
|
| Rate for Payer: BCBS MAPPO |
$3.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.95
|
| Rate for Payer: BCN Commercial |
$38.95
|
| Rate for Payer: BCN Medicare Advantage |
$3.80
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.80
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.80
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$3.80
|
| Rate for Payer: Mclaren Medicare |
$3.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.99
|
| Rate for Payer: Meridian Medicaid |
$2.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$3.61
|
| Rate for Payer: PACE SWMI |
$3.80
|
| Rate for Payer: PHP Commercial |
$4.18
|
| Rate for Payer: PHP Medicaid |
$2.04
|
| Rate for Payer: PHP Medicare Advantage |
$3.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.11
|
| Rate for Payer: Priority Health Medicare |
$3.80
|
| Rate for Payer: Priority Health Narrow Network |
$9.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.80
|
| Rate for Payer: UHC Exchange |
$5.89
|
| Rate for Payer: UHC Medicaid |
$1.99
|
| Rate for Payer: UHCCP DNSP |
$3.80
|
| Rate for Payer: UHCCP Medicaid |
$1.99
|
| Rate for Payer: VA VA |
$3.80
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.79
|
| Rate for Payer: BCN Commercial |
$38.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,292.96
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,328.40 |
| Max. Negotiated Rate |
$6,292.96 |
| Rate for Payer: Aetna Commercial |
$5,663.66
|
| Rate for Payer: Aetna Medicare |
$2,328.40
|
| Rate for Payer: ASR ASR |
$6,104.17
|
| Rate for Payer: BCBS Complete |
$2,517.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,188.55
|
| Rate for Payer: BCN Commercial |
$5,188.55
|
| Rate for Payer: Cash Price |
$5,034.37
|
| Rate for Payer: Cofinity Commercial |
$5,915.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,034.37
|
| Rate for Payer: Healthscope Commercial |
$6,104.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,292.96
|
| Rate for Payer: Mclaren Commercial |
$5,663.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,034.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,349.02
|
| Rate for Payer: Nomi Health Commercial |
$5,160.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,719.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,513.89
|
| Rate for Payer: Priority Health Narrow Network |
$4,411.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,537.80
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,292.96
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,719.72 |
| Max. Negotiated Rate |
$6,292.96 |
| Rate for Payer: Aetna Commercial |
$5,663.66
|
| Rate for Payer: ASR ASR |
$6,104.17
|
| Rate for Payer: BCBS Trust/PPO |
$5,167.78
|
| Rate for Payer: BCN Commercial |
$5,167.78
|
| Rate for Payer: Cash Price |
$5,034.37
|
| Rate for Payer: Cofinity Commercial |
$5,915.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,034.37
|
| Rate for Payer: Healthscope Commercial |
$6,104.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,292.96
|
| Rate for Payer: Mclaren Commercial |
$5,663.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,349.02
|
| Rate for Payer: Nomi Health Commercial |
$5,160.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,719.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,537.80
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,486.04
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,659.83 |
| Max. Negotiated Rate |
$4,486.04 |
| Rate for Payer: Aetna Commercial |
$4,037.44
|
| Rate for Payer: Aetna Medicare |
$1,659.83
|
| Rate for Payer: ASR ASR |
$4,351.46
|
| Rate for Payer: BCBS Complete |
$1,794.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,698.74
|
| Rate for Payer: BCN Commercial |
$3,698.74
|
| Rate for Payer: Cash Price |
$3,588.83
|
| Rate for Payer: Cofinity Commercial |
$4,216.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.83
|
| Rate for Payer: Healthscope Commercial |
$4,351.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,486.04
|
| Rate for Payer: Mclaren Commercial |
$4,037.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,588.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,813.13
|
| Rate for Payer: Nomi Health Commercial |
$3,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,364.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,930.67
|
| Rate for Payer: Priority Health Narrow Network |
$3,144.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,947.72
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,486.04
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,364.53 |
| Max. Negotiated Rate |
$4,486.04 |
| Rate for Payer: Aetna Commercial |
$4,037.44
|
| Rate for Payer: ASR ASR |
$4,351.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,683.94
|
| Rate for Payer: BCN Commercial |
$3,683.94
|
| Rate for Payer: Cash Price |
$3,588.83
|
| Rate for Payer: Cofinity Commercial |
$4,216.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.83
|
| Rate for Payer: Healthscope Commercial |
$4,351.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,486.04
|
| Rate for Payer: Mclaren Commercial |
$4,037.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,813.13
|
| Rate for Payer: Nomi Health Commercial |
$3,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,364.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,947.72
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,101.11
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,681.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
