|
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
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,722.84
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,905.99 |
| Max. Negotiated Rate |
$2,722.84 |
| Rate for Payer: Aetna Commercial |
$2,450.56
|
| Rate for Payer: ASR ASR |
$2,641.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.02
|
| Rate for Payer: BCN Commercial |
$2,111.02
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cofinity Commercial |
$2,559.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,178.27
|
| Rate for Payer: Healthscope Commercial |
$2,722.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,641.15
|
| Rate for Payer: Mclaren Commercial |
$2,450.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,314.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,905.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,396.10
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,722.84
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,722.84 |
| Rate for Payer: Aetna Commercial |
$2,450.56
|
| 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 |
$2,641.15
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.02
|
| Rate for Payer: BCN Commercial |
$2,111.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cofinity Commercial |
$2,559.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,178.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,722.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,641.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,450.56
|
| 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 |
$2,314.41
|
| 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 |
$1,905.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,477.78
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,933.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,396.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$844.26
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.98 |
| Max. Negotiated Rate |
$844.26 |
| Rate for Payer: Aetna Commercial |
$759.83
|
| Rate for Payer: ASR ASR |
$818.93
|
| Rate for Payer: BCBS Trust/PPO |
$654.55
|
| Rate for Payer: BCN Commercial |
$654.55
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cofinity Commercial |
$793.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$675.41
|
| Rate for Payer: Healthscope Commercial |
$844.26
|
| Rate for Payer: Healthscope Whirlpool |
$818.93
|
| Rate for Payer: Mclaren Commercial |
$759.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$717.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.95
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$844.26
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,007.19 |
| Rate for Payer: Aetna Commercial |
$759.83
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$818.93
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$654.55
|
| Rate for Payer: BCN Commercial |
$654.55
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cofinity Commercial |
$793.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$675.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$844.26
|
| Rate for Payer: Healthscope Whirlpool |
$818.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$759.83
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$717.62
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.28
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$599.42
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.95
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$170.37
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$170.37 |
| Rate for Payer: Aetna Commercial |
$153.33
|
| Rate for Payer: ASR ASR |
$165.26
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$132.09
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cofinity Commercial |
$160.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.30
|
| Rate for Payer: Healthscope Commercial |
$170.37
|
| Rate for Payer: Healthscope Whirlpool |
$165.26
|
| Rate for Payer: Mclaren Commercial |
$153.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.93
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$170.37
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$298.40 |
| Rate for Payer: Aetna Commercial |
$153.33
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$165.26
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$132.09
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cofinity Commercial |
$160.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$170.37
|
| Rate for Payer: Healthscope Whirlpool |
$165.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$153.33
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.81
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.04
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$120.96
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.93
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$190.11
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$298.40 |
| Rate for Payer: Aetna Commercial |
$171.10
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$184.41
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$147.39
|
| Rate for Payer: BCN Commercial |
$147.39
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$190.11
|
| Rate for Payer: Healthscope Whirlpool |
$184.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$171.10
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.00
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$134.98
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.30
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$190.11
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$133.08 |
| Max. Negotiated Rate |
$190.11 |
| Rate for Payer: Aetna Commercial |
$171.10
|
| Rate for Payer: ASR ASR |
$184.41
|
| Rate for Payer: BCBS Trust/PPO |
$147.39
|
| Rate for Payer: BCN Commercial |
$147.39
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Healthscope Commercial |
$190.11
|
| Rate for Payer: Healthscope Whirlpool |
$184.41
|
| Rate for Payer: Mclaren Commercial |
$171.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.30
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$345.19
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$345.19 |
| Rate for Payer: Aetna Commercial |
$310.67
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$334.83
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$267.63
|
| Rate for Payer: BCN Commercial |
$267.63
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cofinity Commercial |
$324.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$345.19
|
| Rate for Payer: Healthscope Whirlpool |
$334.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$310.67
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.41
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.12
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$245.08
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.77
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$345.19
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$345.19 |
| Rate for Payer: Aetna Commercial |
$310.67
|
| Rate for Payer: ASR ASR |
$334.83
|
| Rate for Payer: BCBS Trust/PPO |
$267.63
|
| Rate for Payer: BCN Commercial |
$267.63
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cofinity Commercial |
$324.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.15
|
| Rate for Payer: Healthscope Commercial |
$345.19
|
| Rate for Payer: Healthscope Whirlpool |
$334.83
|
| Rate for Payer: Mclaren Commercial |
$310.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.77
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$209.17 |
| Rate for Payer: Aetna Commercial |
$188.25
|
| Rate for Payer: ASR ASR |
$202.89
|
| Rate for Payer: BCBS Trust/PPO |
$162.17
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$209.17
|
| Rate for Payer: Healthscope Whirlpool |
$202.89
|
| Rate for Payer: Mclaren Commercial |
$188.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.07
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$209.17 |
| Rate for Payer: Aetna Commercial |
$188.25
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$202.89
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$162.17
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$209.17
|
| Rate for Payer: Healthscope Whirlpool |
$202.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$188.25
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.41
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$75.53
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.07
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.02 |
| Max. Negotiated Rate |
$140.03 |
| Rate for Payer: Aetna Commercial |
$126.03
|
| Rate for Payer: ASR ASR |
$135.83
|
| Rate for Payer: BCBS Trust/PPO |
$108.57
|
| Rate for Payer: BCN Commercial |
$108.57
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$140.03
|
| Rate for Payer: Healthscope Whirlpool |
$135.83
|
| Rate for Payer: Mclaren Commercial |
$126.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.23
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$140.03 |
| Rate for Payer: Aetna Commercial |
$126.03
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$135.83
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$108.57
|
| Rate for Payer: BCN Commercial |
$108.57
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$140.03
|
| Rate for Payer: Healthscope Whirlpool |
$135.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$126.03
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.41
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$75.53
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.23
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$209.17 |
| Rate for Payer: Aetna Commercial |
$188.25
|
| Rate for Payer: ASR ASR |
$202.89
|
| Rate for Payer: BCBS Trust/PPO |
$162.17
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$209.17
|
| Rate for Payer: Healthscope Whirlpool |
$202.89
|
| Rate for Payer: Mclaren Commercial |
$188.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.07
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$209.17 |
| Rate for Payer: Aetna Commercial |
$188.25
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$202.89
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$162.17
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$209.17
|
| Rate for Payer: Healthscope Whirlpool |
$202.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$188.25
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.34
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$148.51
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.07
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$140.03 |
| Rate for Payer: Aetna Commercial |
$126.03
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$135.83
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$108.57
|
| Rate for Payer: BCN Commercial |
$108.57
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$140.03
|
| Rate for Payer: Healthscope Whirlpool |
$135.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$126.03
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.43
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$99.42
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.23
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.02 |
| Max. Negotiated Rate |
$140.03 |
| Rate for Payer: Aetna Commercial |
$126.03
|
| Rate for Payer: ASR ASR |
$135.83
|
| Rate for Payer: BCBS Trust/PPO |
$108.57
|
| Rate for Payer: BCN Commercial |
$108.57
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$140.03
|
| Rate for Payer: Healthscope Whirlpool |
$135.83
|
| Rate for Payer: Mclaren Commercial |
$126.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.23
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$6,901.00 |
| Rate for Payer: Aetna Commercial |
$6,210.90
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$6,693.97
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,350.35
|
| Rate for Payer: BCN Commercial |
$5,350.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$6,486.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$6,901.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,693.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$6,210.90
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,279.91
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$4,899.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,072.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,830.70 |
| Max. Negotiated Rate |
$6,901.00 |
| Rate for Payer: Aetna Commercial |
$6,210.90
|
| Rate for Payer: ASR ASR |
$6,693.97
|
| Rate for Payer: BCBS Trust/PPO |
$5,350.35
|
| Rate for Payer: BCN Commercial |
$5,350.35
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$6,486.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Healthscope Commercial |
$6,901.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,693.97
|
| Rate for Payer: Mclaren Commercial |
$6,210.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,072.88
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,750.99 |
| Max. Negotiated Rate |
$2,501.42 |
| Rate for Payer: Aetna Commercial |
$2,251.28
|
| Rate for Payer: ASR ASR |
$2,426.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.35
|
| Rate for Payer: BCN Commercial |
$1,939.35
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$2,351.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Healthscope Commercial |
$2,501.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,426.38
|
| Rate for Payer: Mclaren Commercial |
$2,251.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,201.25
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,501.42 |
| Rate for Payer: Aetna Commercial |
$2,251.28
|
| 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 |
$2,426.38
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.35
|
| Rate for Payer: BCN Commercial |
$1,939.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$2,351.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,501.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,426.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,251.28
|
| 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 |
$2,126.21
|
| 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 |
$1,750.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,276.29
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,776.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,201.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$259.34 |
| Max. Negotiated Rate |
$370.48 |
| Rate for Payer: Aetna Commercial |
$333.43
|
| Rate for Payer: ASR ASR |
$359.37
|
| Rate for Payer: BCBS Trust/PPO |
$287.23
|
| Rate for Payer: BCN Commercial |
$287.23
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$348.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$370.48
|
| Rate for Payer: Healthscope Whirlpool |
$359.37
|
| Rate for Payer: Mclaren Commercial |
$333.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.02
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$148.19 |
| Max. Negotiated Rate |
$370.48 |
| Rate for Payer: Aetna Commercial |
$333.43
|
| Rate for Payer: ASR ASR |
$359.37
|
| Rate for Payer: BCBS Complete |
$148.19
|
| Rate for Payer: BCBS Trust/PPO |
$287.23
|
| Rate for Payer: BCN Commercial |
$287.23
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$348.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$370.48
|
| Rate for Payer: Healthscope Whirlpool |
$359.37
|
| Rate for Payer: Mclaren Commercial |
$333.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.14
|
| Rate for Payer: Priority Health Narrow Network |
$263.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.02
|
|
