|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,200.63 |
| Rate for Payer: Aetna Commercial |
$839.99
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$905.32
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$723.60
|
| Rate for Payer: BCN Commercial |
$723.60
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$877.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$933.32
|
| Rate for Payer: Healthscope Whirlpool |
$905.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$839.99
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.63
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$960.50
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.32
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$653.32 |
| Max. Negotiated Rate |
$933.32 |
| Rate for Payer: Aetna Commercial |
$839.99
|
| Rate for Payer: ASR ASR |
$905.32
|
| Rate for Payer: BCBS Trust/PPO |
$723.60
|
| Rate for Payer: BCN Commercial |
$723.60
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$877.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Healthscope Commercial |
$933.32
|
| Rate for Payer: Healthscope Whirlpool |
$905.32
|
| Rate for Payer: Mclaren Commercial |
$839.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.32
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$97.04 |
| Max. Negotiated Rate |
$242.60 |
| Rate for Payer: Aetna Commercial |
$218.34
|
| Rate for Payer: ASR ASR |
$235.32
|
| Rate for Payer: BCBS Complete |
$97.04
|
| Rate for Payer: BCBS Trust/PPO |
$188.09
|
| Rate for Payer: BCN Commercial |
$188.09
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$228.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Healthscope Commercial |
$242.60
|
| Rate for Payer: Healthscope Whirlpool |
$235.32
|
| Rate for Payer: Mclaren Commercial |
$218.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.77
|
| Rate for Payer: Priority Health Narrow Network |
$172.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.49
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.82 |
| Max. Negotiated Rate |
$242.60 |
| Rate for Payer: Aetna Commercial |
$218.34
|
| Rate for Payer: ASR ASR |
$235.32
|
| Rate for Payer: BCBS Trust/PPO |
$188.09
|
| Rate for Payer: BCN Commercial |
$188.09
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$228.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Healthscope Commercial |
$242.60
|
| Rate for Payer: Healthscope Whirlpool |
$235.32
|
| Rate for Payer: Mclaren Commercial |
$218.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.49
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,178.10 |
| Max. Negotiated Rate |
$1,683.00 |
| Rate for Payer: Aetna Commercial |
$1,514.70
|
| Rate for Payer: ASR ASR |
$1,632.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.83
|
| Rate for Payer: BCN Commercial |
$1,304.83
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,582.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Healthscope Commercial |
$1,683.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,632.51
|
| Rate for Payer: Mclaren Commercial |
$1,514.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,481.04
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$575.48 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,514.70
|
| 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 |
$1,632.51
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.83
|
| Rate for Payer: BCN Commercial |
$1,304.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,582.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,683.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,632.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,514.70
|
| 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 |
$1,430.55
|
| 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 |
$1,178.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.35
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,481.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,095.00 |
| Rate for Payer: Aetna Commercial |
$3,685.50
|
| 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 |
$3,972.15
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,174.85
|
| Rate for Payer: BCN Commercial |
$3,174.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,849.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,095.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,972.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,685.50
|
| 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 |
$3,480.75
|
| 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 |
$2,866.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,726.45
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,907.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,603.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,866.50 |
| Max. Negotiated Rate |
$4,095.00 |
| Rate for Payer: Aetna Commercial |
$3,685.50
|
| Rate for Payer: ASR ASR |
$3,972.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,174.85
|
| Rate for Payer: BCN Commercial |
$3,174.85
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,849.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$4,095.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,972.15
|
| Rate for Payer: Mclaren Commercial |
$3,685.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,480.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,866.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,603.60
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,555.18 |
| Rate for Payer: Aetna Commercial |
$1,889.86
|
| 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 |
$2,036.85
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.01
|
| Rate for Payer: BCN Commercial |
$1,628.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,973.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,099.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,036.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,889.86
|
| 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 |
$1,784.87
|
| 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 |
$1,469.90
|
| 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 |
$1,847.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,469.90 |
| Max. Negotiated Rate |
$2,099.85 |
| Rate for Payer: Aetna Commercial |
$1,889.86
|
| Rate for Payer: ASR ASR |
$2,036.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.01
|
| Rate for Payer: BCN Commercial |
$1,628.01
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,973.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Healthscope Commercial |
$2,099.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,036.85
|
| Rate for Payer: Mclaren Commercial |
$1,889.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,784.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,847.87
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$111.61
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$175.73 |
| Rate for Payer: Aetna Commercial |
$100.45
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$108.26
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$86.53
|
| Rate for Payer: BCN Commercial |
$86.53
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cofinity Commercial |
$104.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Healthscope Whirlpool |
$108.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$100.45
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.87
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.73
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$140.58
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.22
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
IP
|
$111.61
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.13 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna Commercial |
$100.45
|
| Rate for Payer: ASR ASR |
$108.26
|
| Rate for Payer: BCBS Trust/PPO |
$86.53
|
| Rate for Payer: BCN Commercial |
$86.53
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cofinity Commercial |
$104.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.29
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Healthscope Whirlpool |
$108.26
|
| Rate for Payer: Mclaren Commercial |
$100.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.22
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
IP
|
$2,722.84
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETERAL STENT
|
Facility
|
OP
|
$2,722.84
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$952.43
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$666.70 |
| Max. Negotiated Rate |
$2,263.10 |
| Rate for Payer: Aetna Commercial |
$857.19
|
| 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 |
$923.86
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$738.42
|
| Rate for Payer: BCN Commercial |
$738.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cofinity Commercial |
$895.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$952.43
|
| Rate for Payer: Healthscope Whirlpool |
$923.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$857.19
|
| 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 |
$809.57
|
| 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 |
$666.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.71
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$676.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$952.43
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$666.70 |
| Max. Negotiated Rate |
$952.43 |
| Rate for Payer: Aetna Commercial |
$857.19
|
| Rate for Payer: ASR ASR |
$923.86
|
| Rate for Payer: BCBS Trust/PPO |
$738.42
|
| Rate for Payer: BCN Commercial |
$738.42
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cofinity Commercial |
$895.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.94
|
| Rate for Payer: Healthscope Commercial |
$952.43
|
| Rate for Payer: Healthscope Whirlpool |
$923.86
|
| Rate for Payer: Mclaren Commercial |
$857.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$809.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.14
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$906.53
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.14 |
| Max. Negotiated Rate |
$906.53 |
| Rate for Payer: Aetna Commercial |
$815.88
|
| Rate for Payer: Aetna Medicare |
$607.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: ASR ASR |
$879.33
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$702.83
|
| Rate for Payer: BCN Commercial |
$702.83
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cofinity Commercial |
$852.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$906.53
|
| Rate for Payer: Healthscope Whirlpool |
$879.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$607.20
|
| Rate for Payer: Mclaren Commercial |
$815.88
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.55
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$667.92
|
| Rate for Payer: PHP Medicaid |
$332.14
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.94
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$643.64
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$797.75
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$906.53
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.57 |
| Max. Negotiated Rate |
$906.53 |
| Rate for Payer: Aetna Commercial |
$815.88
|
| Rate for Payer: ASR ASR |
$879.33
|
| Rate for Payer: BCBS Trust/PPO |
$702.83
|
| Rate for Payer: BCN Commercial |
$702.83
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cofinity Commercial |
$852.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.22
|
| Rate for Payer: Healthscope Commercial |
$906.53
|
| Rate for Payer: Healthscope Whirlpool |
$879.33
|
| Rate for Payer: Mclaren Commercial |
$815.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$797.75
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,852.25
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,996.58 |
| Max. Negotiated Rate |
$2,852.25 |
| Rate for Payer: Aetna Commercial |
$2,567.02
|
| Rate for Payer: ASR ASR |
$2,766.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,211.35
|
| Rate for Payer: BCN Commercial |
$2,211.35
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cofinity Commercial |
$2,681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,281.80
|
| Rate for Payer: Healthscope Commercial |
$2,852.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,766.68
|
| Rate for Payer: Mclaren Commercial |
$2,567.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,424.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,996.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,509.98
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,852.25
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,852.25 |
| Rate for Payer: Aetna Commercial |
$2,567.02
|
| 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 |
$2,766.68
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,211.35
|
| Rate for Payer: BCN Commercial |
$2,211.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cofinity Commercial |
$2,681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,281.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,852.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,766.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,567.02
|
| 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 |
$2,424.41
|
| 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 |
$1,996.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,595.55
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,025.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,509.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,573.80 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,462.00
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,822.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,740.00 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,473.72
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$4,473.72 |
| Rate for Payer: Aetna Commercial |
$4,026.35
|
| Rate for Payer: Aetna Medicare |
$1,716.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: ASR ASR |
$4,339.51
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,468.48
|
| Rate for Payer: BCN Commercial |
$3,468.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cofinity Commercial |
$4,205.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,578.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$4,473.72
|
| Rate for Payer: Healthscope Whirlpool |
$4,339.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$4,026.35
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,802.66
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: PHP Medicaid |
$938.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,071.09
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,176.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,936.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,473.72
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,131.60 |
| Max. Negotiated Rate |
$4,473.72 |
| Rate for Payer: Aetna Commercial |
$4,026.35
|
| Rate for Payer: ASR ASR |
$4,339.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,468.48
|
| Rate for Payer: BCN Commercial |
$3,468.48
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cofinity Commercial |
$4,205.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,578.98
|
| Rate for Payer: Healthscope Commercial |
$4,473.72
|
| Rate for Payer: Healthscope Whirlpool |
$4,339.51
|
| Rate for Payer: Mclaren Commercial |
$4,026.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,802.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,936.87
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna Commercial |
$39.60
|
| Rate for Payer: ASR ASR |
$42.68
|
| Rate for Payer: BCBS Trust/PPO |
$34.11
|
| Rate for Payer: BCN Commercial |
$34.11
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$41.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$44.00
|
| Rate for Payer: Healthscope Whirlpool |
$42.68
|
| Rate for Payer: Mclaren Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
|
