|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna Commercial |
$39.60
|
| Rate for Payer: ASR ASR |
$42.68
|
| Rate for Payer: BCBS Complete |
$17.60
|
| 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: Priority Health HMO/PPO/Tiered Network |
$40.04
|
| Rate for Payer: Priority Health Narrow Network |
$31.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.70 |
| Max. Negotiated Rate |
$31.00 |
| Rate for Payer: Aetna Commercial |
$27.90
|
| Rate for Payer: ASR ASR |
$30.07
|
| Rate for Payer: BCBS Trust/PPO |
$24.03
|
| Rate for Payer: BCN Commercial |
$24.03
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$29.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$31.00
|
| Rate for Payer: Healthscope Whirlpool |
$30.07
|
| Rate for Payer: Mclaren Commercial |
$27.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.28
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$31.00 |
| Rate for Payer: Aetna Commercial |
$27.90
|
| Rate for Payer: ASR ASR |
$30.07
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$24.03
|
| Rate for Payer: BCN Commercial |
$24.03
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$29.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$31.00
|
| Rate for Payer: Healthscope Whirlpool |
$30.07
|
| Rate for Payer: Mclaren Commercial |
$27.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.21
|
| Rate for Payer: Priority Health Narrow Network |
$22.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.28
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,004.99
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$5,004.99 |
| Rate for Payer: Aetna Commercial |
$4,504.49
|
| 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 |
$4,854.84
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,880.37
|
| Rate for Payer: BCN Commercial |
$3,880.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cofinity Commercial |
$4,704.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,003.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$5,004.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,854.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$4,504.49
|
| 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 |
$4,254.24
|
| 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 |
$3,503.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,554.54
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,553.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,404.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,004.99
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,503.49 |
| Max. Negotiated Rate |
$5,004.99 |
| Rate for Payer: Aetna Commercial |
$4,504.49
|
| Rate for Payer: ASR ASR |
$4,854.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,880.37
|
| Rate for Payer: BCN Commercial |
$3,880.37
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cofinity Commercial |
$4,704.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,003.99
|
| Rate for Payer: Healthscope Commercial |
$5,004.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,854.84
|
| Rate for Payer: Mclaren Commercial |
$4,504.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,254.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,503.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,404.39
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: ASR ASR |
$33.64
|
| Rate for Payer: BCBS Trust/PPO |
$26.89
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$57.98 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$8.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.85
|
| Rate for Payer: ASR ASR |
$33.64
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCBS Trust/PPO |
$26.89
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.68
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Mclaren Medicare |
$8.68
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PACE Medicare |
$8.25
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PHP Commercial |
$9.55
|
| Rate for Payer: PHP Medicaid |
$4.75
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.98
|
| Rate for Payer: Priority Health Medicare |
$8.68
|
| Rate for Payer: Priority Health Narrow Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
| Rate for Payer: UHC Medicare Advantage |
$8.94
|
| Rate for Payer: VA VA |
$8.68
|
|
|
HC RENIN
|
Facility
|
OP
|
$40.70
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.03 |
| Max. Negotiated Rate |
$106.72 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$39.48
|
| Rate for Payer: BCBS Complete |
$12.63
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$38.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$40.70
|
| Rate for Payer: Healthscope Whirlpool |
$39.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$36.63
|
| Rate for Payer: Mclaren Medicaid |
$12.03
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Medicaid |
$12.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.72
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$85.38
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.82
|
| Rate for Payer: UHC Medicare Advantage |
$22.65
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC RENIN
|
Facility
|
IP
|
$40.70
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.49 |
| Max. Negotiated Rate |
$40.70 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: ASR ASR |
$39.48
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$38.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Healthscope Commercial |
$40.70
|
| Rate for Payer: Healthscope Whirlpool |
$39.48
|
| Rate for Payer: Mclaren Commercial |
$36.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.82
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.39
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$0.39 |
| Rate for Payer: Aetna Commercial |
$0.35
|
| Rate for Payer: ASR ASR |
$0.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cofinity Commercial |
$0.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.31
|
| Rate for Payer: Healthscope Commercial |
$0.39
|
| Rate for Payer: Healthscope Whirlpool |
$0.38
|
| Rate for Payer: Mclaren Commercial |
$0.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.34
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.39
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.39 |
| Rate for Payer: Aetna Commercial |
$0.35
|
| Rate for Payer: ASR ASR |
$0.38
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cofinity Commercial |
$0.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.31
|
| Rate for Payer: Healthscope Commercial |
$0.39
|
| Rate for Payer: Healthscope Whirlpool |
$0.38
|
| Rate for Payer: Mclaren Commercial |
$0.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.35
|
| Rate for Payer: Priority Health Narrow Network |
$0.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.34
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,550.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$1,550.00 |
| Rate for Payer: Aetna Commercial |
$1,395.00
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$1,503.50
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.72
|
| Rate for Payer: BCN Commercial |
$1,201.72
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,457.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$1,550.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,503.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$1,395.00
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,410.50
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,100.50
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,364.00
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,550.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,085.00 |
| Max. Negotiated Rate |
$1,550.00 |
| Rate for Payer: Aetna Commercial |
$1,395.00
|
| Rate for Payer: ASR ASR |
$1,503.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.72
|
| Rate for Payer: BCN Commercial |
$1,201.72
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,457.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Healthscope Commercial |
$1,550.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,503.50
|
| Rate for Payer: Mclaren Commercial |
$1,395.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,364.00
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,550.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$1,550.00 |
| Rate for Payer: Aetna Commercial |
$1,395.00
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$1,503.50
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.72
|
| Rate for Payer: BCN Commercial |
$1,201.72
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,457.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$1,550.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,503.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$1,395.00
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.73
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$524.58
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,364.00
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,550.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,085.00 |
| Max. Negotiated Rate |
$1,550.00 |
| Rate for Payer: Aetna Commercial |
$1,395.00
|
| Rate for Payer: ASR ASR |
$1,503.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.72
|
| Rate for Payer: BCN Commercial |
$1,201.72
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,457.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Healthscope Commercial |
$1,550.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,503.50
|
| Rate for Payer: Mclaren Commercial |
$1,395.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,364.00
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,630.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$1,630.00 |
| Rate for Payer: Aetna Commercial |
$1,467.00
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$1,581.10
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.74
|
| Rate for Payer: BCN Commercial |
$1,263.74
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,532.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,304.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$1,630.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,581.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$1,467.00
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,385.50
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.73
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$524.58
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,434.40
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,630.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,141.00 |
| Max. Negotiated Rate |
$1,630.00 |
| Rate for Payer: Aetna Commercial |
$1,467.00
|
| Rate for Payer: ASR ASR |
$1,581.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.74
|
| Rate for Payer: BCN Commercial |
$1,263.74
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,532.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,304.00
|
| Rate for Payer: Healthscope Commercial |
$1,630.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,581.10
|
| Rate for Payer: Mclaren Commercial |
$1,467.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,385.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,434.40
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,048.38
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,048.38 |
| Rate for Payer: Aetna Commercial |
$943.54
|
| 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 |
$1,016.93
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$812.81
|
| Rate for Payer: BCN Commercial |
$812.81
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$985.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$1,048.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$943.54
|
| 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 |
$891.12
|
| 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 |
$733.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.03
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$744.35
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.57
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,048.38
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$733.87 |
| Max. Negotiated Rate |
$1,048.38 |
| Rate for Payer: Aetna Commercial |
$943.54
|
| Rate for Payer: ASR ASR |
$1,016.93
|
| Rate for Payer: BCBS Trust/PPO |
$812.81
|
| Rate for Payer: BCN Commercial |
$812.81
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$985.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Healthscope Commercial |
$1,048.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.93
|
| Rate for Payer: Mclaren Commercial |
$943.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$891.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.57
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,132.31
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$4,132.31 |
| Rate for Payer: Aetna Commercial |
$3,719.08
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$4,008.34
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.78
|
| Rate for Payer: BCN Commercial |
$3,203.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,884.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$4,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,008.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$3,719.08
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,558.13
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,046.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,636.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,132.31
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,892.62 |
| Max. Negotiated Rate |
$4,132.31 |
| Rate for Payer: Aetna Commercial |
$3,719.08
|
| Rate for Payer: ASR ASR |
$4,008.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.78
|
| Rate for Payer: BCN Commercial |
$3,203.78
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,884.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Healthscope Commercial |
$4,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,008.34
|
| Rate for Payer: Mclaren Commercial |
$3,719.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,636.43
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,207.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$4,207.79 |
| Rate for Payer: Aetna Commercial |
$3,787.01
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$4,081.56
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,262.30
|
| Rate for Payer: BCN Commercial |
$3,262.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cofinity Commercial |
$3,955.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,366.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$4,207.79
|
| Rate for Payer: Healthscope Whirlpool |
$4,081.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$3,787.01
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,576.62
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,945.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,829.09
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,987.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,702.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,207.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,945.45 |
| Max. Negotiated Rate |
$4,207.79 |
| Rate for Payer: Aetna Commercial |
$3,787.01
|
| Rate for Payer: ASR ASR |
$4,081.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,262.30
|
| Rate for Payer: BCN Commercial |
$3,262.30
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cofinity Commercial |
$3,955.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,366.23
|
| Rate for Payer: Healthscope Commercial |
$4,207.79
|
| Rate for Payer: Healthscope Whirlpool |
$4,081.56
|
| Rate for Payer: Mclaren Commercial |
$3,787.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,576.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,945.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,702.86
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,789.72
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,909.37 |
| Max. Negotiated Rate |
$4,789.72 |
| Rate for Payer: Aetna Commercial |
$4,310.75
|
| 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 |
$4,646.03
|
| Rate for Payer: BCBS Complete |
$2,005.02
|
| Rate for Payer: BCBS MAPPO |
$3,490.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,713.47
|
| Rate for Payer: BCN Commercial |
$3,713.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,490.63
|
| Rate for Payer: Cash Price |
$3,831.78
|
| Rate for Payer: Cash Price |
$3,831.78
|
| Rate for Payer: Cofinity Commercial |
$4,502.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,831.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,490.63
|
| Rate for Payer: Healthscope Commercial |
$4,789.72
|
| Rate for Payer: Healthscope Whirlpool |
$4,646.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,490.63
|
| Rate for Payer: Mclaren Commercial |
$4,310.75
|
| 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 |
$4,071.26
|
| 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 |
$3,352.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,358.65
|
| Rate for Payer: Priority Health Medicare |
$3,490.63
|
| Rate for Payer: Priority Health Narrow Network |
$3,400.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,490.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,214.95
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.35
|
| Rate for Payer: VA VA |
$3,490.63
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,789.72
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,352.80 |
| Max. Negotiated Rate |
$4,789.72 |
| Rate for Payer: Aetna Commercial |
$4,310.75
|
| Rate for Payer: ASR ASR |
$4,646.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,713.47
|
| Rate for Payer: BCN Commercial |
$3,713.47
|
| Rate for Payer: Cash Price |
$3,831.78
|
| Rate for Payer: Cofinity Commercial |
$4,502.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,831.78
|
| Rate for Payer: Healthscope Commercial |
$4,789.72
|
| Rate for Payer: Healthscope Whirlpool |
$4,646.03
|
| Rate for Payer: Mclaren Commercial |
$4,310.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,071.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,214.95
|
|
