|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.06 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,555.18 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.18
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,044.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,365.19 |
| Max. Negotiated Rate |
$4,984.52 |
| Rate for Payer: Aetna Commercial |
$4,486.07
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$4,834.98
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,864.50
|
| Rate for Payer: BCN Commercial |
$3,864.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$4,685.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$4,984.52
|
| Rate for Payer: Healthscope Whirlpool |
$4,834.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$4,486.07
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,441.80
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,753.44
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,386.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,489.16 |
| Max. Negotiated Rate |
$4,984.52 |
| Rate for Payer: Aetna Commercial |
$4,486.07
|
| Rate for Payer: ASR ASR |
$4,834.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,864.50
|
| Rate for Payer: BCN Commercial |
$3,864.50
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$4,685.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Healthscope Commercial |
$4,984.52
|
| Rate for Payer: Healthscope Whirlpool |
$4,834.98
|
| Rate for Payer: Mclaren Commercial |
$4,486.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,386.38
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,909.37 |
| Max. Negotiated Rate |
$4,363.29 |
| Rate for Payer: Aetna Commercial |
$2,701.79
|
| Rate for Payer: Aetna Medicare |
$3,490.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,363.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,363.29
|
| Rate for Payer: ASR ASR |
$2,911.93
|
| Rate for Payer: BCBS Complete |
$2,005.02
|
| Rate for Payer: BCBS MAPPO |
$3,490.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,327.44
|
| Rate for Payer: BCN Commercial |
$2,327.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,490.63
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,821.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,490.63
|
| Rate for Payer: Healthscope Commercial |
$3,001.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,911.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,490.63
|
| Rate for Payer: Mclaren Commercial |
$2,701.79
|
| Rate for Payer: Mclaren Medicaid |
$1,909.37
|
| Rate for Payer: Mclaren Medicare |
$3,490.63
|
| Rate for Payer: Meridian Medicaid |
$2,005.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,665.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,014.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PACE Medicare |
$3,316.10
|
| Rate for Payer: PACE SWMI |
$3,490.63
|
| Rate for Payer: PHP Commercial |
$3,839.69
|
| Rate for Payer: PHP Medicaid |
$1,909.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,490.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,909.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,731.81
|
| Rate for Payer: Priority Health Medicare |
$3,490.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,131.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,490.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,641.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.35
|
| Rate for Payer: VA VA |
$3,490.63
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,101.39 |
| Max. Negotiated Rate |
$3,001.99 |
| Rate for Payer: Aetna Commercial |
$2,701.79
|
| Rate for Payer: ASR ASR |
$2,911.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,327.44
|
| Rate for Payer: BCN Commercial |
$2,327.44
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,821.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Healthscope Commercial |
$3,001.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,911.93
|
| Rate for Payer: Mclaren Commercial |
$2,701.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,641.75
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,311.53 |
| Max. Negotiated Rate |
$3,302.19 |
| Rate for Payer: Aetna Commercial |
$2,971.97
|
| Rate for Payer: ASR ASR |
$3,203.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,560.19
|
| Rate for Payer: BCN Commercial |
$2,560.19
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$3,104.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Healthscope Commercial |
$3,302.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,203.12
|
| Rate for Payer: Mclaren Commercial |
$2,971.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,905.93
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,311.53 |
| Max. Negotiated Rate |
$9,439.52 |
| Rate for Payer: Aetna Commercial |
$2,971.97
|
| Rate for Payer: Aetna Medicare |
$7,551.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.52
|
| Rate for Payer: ASR ASR |
$3,203.12
|
| Rate for Payer: BCBS Complete |
$4,337.65
|
| Rate for Payer: BCBS MAPPO |
$7,551.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,560.19
|
| Rate for Payer: BCN Commercial |
$2,560.19
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.62
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$3,104.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.62
|
| Rate for Payer: Healthscope Commercial |
$3,302.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,203.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,551.62
|
| Rate for Payer: Mclaren Commercial |
$2,971.97
|
| Rate for Payer: Mclaren Medicaid |
$4,130.74
|
| Rate for Payer: Mclaren Medicare |
$7,551.62
|
| Rate for Payer: Meridian Medicaid |
$4,337.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: PACE Medicare |
$7,174.04
|
| Rate for Payer: PACE SWMI |
$7,551.62
|
| Rate for Payer: PHP Commercial |
$8,306.78
|
| Rate for Payer: PHP Medicaid |
$4,130.74
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,004.99
|
| Rate for Payer: Priority Health Medicare |
$7,551.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,344.55
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,905.93
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.17
|
| Rate for Payer: VA VA |
$7,551.62
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,530.00 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,189.00
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,609.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,661.82 |
| Rate for Payer: Aetna Commercial |
$2,395.64
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$2,581.97
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.71
|
| Rate for Payer: BCN Commercial |
$2,063.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,502.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,661.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,395.64
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,422.26
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,889.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,863.27 |
| Max. Negotiated Rate |
$2,661.82 |
| Rate for Payer: Aetna Commercial |
$2,395.64
|
| Rate for Payer: ASR ASR |
$2,581.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.71
|
| Rate for Payer: BCN Commercial |
$2,063.71
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,502.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Healthscope Commercial |
$2,661.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.97
|
| Rate for Payer: Mclaren Commercial |
$2,395.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.40
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,530.00 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,189.00
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,609.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,500.00 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$4,500.00
|
| Rate for Payer: ASR ASR |
$4,850.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.50
|
| Rate for Payer: BCN Commercial |
$3,876.50
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,700.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Healthscope Commercial |
$5,000.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,850.00
|
| Rate for Payer: Mclaren Commercial |
$4,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,400.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$4,500.00
|
| Rate for Payer: Aetna Medicare |
$1,620.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: ASR ASR |
$4,850.00
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.50
|
| Rate for Payer: BCN Commercial |
$3,876.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,700.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$5,000.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,850.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$4,500.00
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,783.08
|
| Rate for Payer: PHP Medicaid |
$886.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,550.00
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,550.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,400.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,102.95
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$772.06 |
| Max. Negotiated Rate |
$1,102.95 |
| Rate for Payer: Aetna Commercial |
$992.66
|
| Rate for Payer: ASR ASR |
$1,069.86
|
| Rate for Payer: BCBS Trust/PPO |
$855.12
|
| Rate for Payer: BCN Commercial |
$855.12
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cofinity Commercial |
$1,036.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.36
|
| Rate for Payer: Healthscope Commercial |
$1,102.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,069.86
|
| Rate for Payer: Mclaren Commercial |
$992.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.60
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,102.95
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,102.95 |
| Rate for Payer: Aetna Commercial |
$992.66
|
| Rate for Payer: Aetna Medicare |
$558.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: ASR ASR |
$1,069.86
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$855.12
|
| Rate for Payer: BCN Commercial |
$855.12
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cofinity Commercial |
$1,036.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$1,102.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,069.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$992.66
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.51
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$614.24
|
| Rate for Payer: PHP Medicaid |
$305.44
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.68
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$783.09
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.60
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,228.27
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,259.79 |
| Max. Negotiated Rate |
$3,228.27 |
| Rate for Payer: Aetna Commercial |
$2,905.44
|
| Rate for Payer: ASR ASR |
$3,131.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,502.88
|
| Rate for Payer: BCN Commercial |
$2,502.88
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cofinity Commercial |
$3,034.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.62
|
| Rate for Payer: Healthscope Commercial |
$3,228.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,131.42
|
| Rate for Payer: Mclaren Commercial |
$2,905.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,744.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.88
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,228.27
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,905.44
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$3,131.42
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,502.88
|
| Rate for Payer: BCN Commercial |
$2,502.88
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cofinity Commercial |
$3,034.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,228.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,131.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,905.44
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,744.03
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,937.73
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,292.07
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$964.69 |
| Rate for Payer: Aetna Commercial |
$868.22
|
| Rate for Payer: Aetna Medicare |
$558.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: ASR ASR |
$935.75
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$747.92
|
| Rate for Payer: BCN Commercial |
$747.92
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$906.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$964.69
|
| Rate for Payer: Healthscope Whirlpool |
$935.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$868.22
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$614.24
|
| Rate for Payer: PHP Medicaid |
$305.44
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.87
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$684.93
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$848.93
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$675.28 |
| Max. Negotiated Rate |
$964.69 |
| Rate for Payer: Aetna Commercial |
$868.22
|
| Rate for Payer: ASR ASR |
$935.75
|
| Rate for Payer: BCBS Trust/PPO |
$747.92
|
| Rate for Payer: BCN Commercial |
$747.92
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$906.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$964.69
|
| Rate for Payer: Healthscope Whirlpool |
$935.75
|
| Rate for Payer: Mclaren Commercial |
$868.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$848.93
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$532.68
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.73 |
| Max. Negotiated Rate |
$532.68 |
| Rate for Payer: Aetna Commercial |
$479.41
|
| Rate for Payer: Aetna Medicare |
$354.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: ASR ASR |
$516.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$412.99
|
| Rate for Payer: BCN Commercial |
$412.99
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$532.68
|
| Rate for Payer: Healthscope Whirlpool |
$516.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.16
|
| Rate for Payer: Mclaren Commercial |
$479.41
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$389.58
|
| Rate for Payer: PHP Medicaid |
$193.73
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.74
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$378.20
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.76
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: VA VA |
$354.16
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$532.68
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.88 |
| Max. Negotiated Rate |
$532.68 |
| Rate for Payer: Aetna Commercial |
$479.41
|
| Rate for Payer: ASR ASR |
$516.70
|
| Rate for Payer: BCBS Trust/PPO |
$412.99
|
| Rate for Payer: BCN Commercial |
$412.99
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Healthscope Commercial |
$532.68
|
| Rate for Payer: Healthscope Whirlpool |
$516.70
|
| Rate for Payer: Mclaren Commercial |
$479.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.76
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.50 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| Rate for Payer: ASR ASR |
$247.35
|
| Rate for Payer: BCBS Trust/PPO |
$197.70
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$255.00
|
| Rate for Payer: Healthscope Whirlpool |
$247.35
|
| Rate for Payer: Mclaren Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.40
|
|
