|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$539.61 |
| Rate for Payer: Aetna Commercial |
$485.65
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$523.42
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$418.36
|
| Rate for Payer: BCN Commercial |
$418.36
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$507.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$539.61
|
| Rate for Payer: Healthscope Whirlpool |
$523.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$485.65
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.05
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$383.12
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.86
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$377.73 |
| Max. Negotiated Rate |
$539.61 |
| Rate for Payer: Aetna Commercial |
$485.65
|
| Rate for Payer: ASR ASR |
$523.42
|
| Rate for Payer: BCBS Trust/PPO |
$418.36
|
| Rate for Payer: BCN Commercial |
$418.36
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$507.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Healthscope Commercial |
$539.61
|
| Rate for Payer: Healthscope Whirlpool |
$523.42
|
| Rate for Payer: Mclaren Commercial |
$485.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.86
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$1,265.00
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$1,265.00 |
| Rate for Payer: Aetna Commercial |
$1,138.50
|
| Rate for Payer: Aetna Commercial |
$2,503.39
|
| Rate for Payer: Aetna Medicare |
$637.31
|
| Rate for Payer: Aetna Medicare |
$637.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: ASR ASR |
$1,227.05
|
| Rate for Payer: ASR ASR |
$2,698.09
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS Trust/PPO |
$980.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.53
|
| Rate for Payer: BCN Commercial |
$2,156.53
|
| Rate for Payer: BCN Commercial |
$980.75
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$2,614.65
|
| Rate for Payer: Cofinity Commercial |
$1,189.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Healthscope Commercial |
$2,781.54
|
| Rate for Payer: Healthscope Commercial |
$1,265.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,698.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$637.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$637.31
|
| Rate for Payer: Mclaren Commercial |
$1,138.50
|
| Rate for Payer: Mclaren Commercial |
$2,503.39
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PHP Commercial |
$701.04
|
| Rate for Payer: PHP Commercial |
$701.04
|
| Rate for Payer: PHP Medicaid |
$348.61
|
| Rate for Payer: PHP Medicaid |
$348.61
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,531.20
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Narrow Network |
$898.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,974.89
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,113.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,447.76
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: VA VA |
$637.31
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,781.54
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,947.08 |
| Max. Negotiated Rate |
$2,781.54 |
| Rate for Payer: Aetna Commercial |
$2,503.39
|
| Rate for Payer: Aetna Commercial |
$1,138.50
|
| Rate for Payer: ASR ASR |
$1,227.05
|
| Rate for Payer: ASR ASR |
$2,698.09
|
| Rate for Payer: BCBS Trust/PPO |
$980.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.53
|
| Rate for Payer: BCN Commercial |
$980.75
|
| Rate for Payer: BCN Commercial |
$2,156.53
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cofinity Commercial |
$1,189.10
|
| Rate for Payer: Cofinity Commercial |
$2,614.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Healthscope Commercial |
$1,265.00
|
| Rate for Payer: Healthscope Commercial |
$2,781.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,698.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.05
|
| Rate for Payer: Mclaren Commercial |
$1,138.50
|
| Rate for Payer: Mclaren Commercial |
$2,503.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,113.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,447.76
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$230.25
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$161.18 |
| Max. Negotiated Rate |
$230.25 |
| Rate for Payer: Aetna Commercial |
$207.22
|
| Rate for Payer: Aetna Commercial |
$896.40
|
| Rate for Payer: ASR ASR |
$966.12
|
| Rate for Payer: ASR ASR |
$223.34
|
| Rate for Payer: BCBS Trust/PPO |
$772.20
|
| Rate for Payer: BCBS Trust/PPO |
$178.51
|
| Rate for Payer: BCN Commercial |
$178.51
|
| Rate for Payer: BCN Commercial |
$772.20
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cofinity Commercial |
$216.44
|
| Rate for Payer: Cofinity Commercial |
$936.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Healthscope Commercial |
$230.25
|
| Rate for Payer: Healthscope Commercial |
$996.00
|
| Rate for Payer: Healthscope Whirlpool |
$966.12
|
| Rate for Payer: Healthscope Whirlpool |
$223.34
|
| Rate for Payer: Mclaren Commercial |
$207.22
|
| Rate for Payer: Mclaren Commercial |
$896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$876.48
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$996.00
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$996.00 |
| Rate for Payer: Aetna Commercial |
$896.40
|
| Rate for Payer: Aetna Commercial |
$207.22
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$966.12
|
| Rate for Payer: ASR ASR |
$223.34
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$772.20
|
| Rate for Payer: BCBS Trust/PPO |
$178.51
|
| Rate for Payer: BCN Commercial |
$178.51
|
| Rate for Payer: BCN Commercial |
$772.20
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cofinity Commercial |
$936.24
|
| Rate for Payer: Cofinity Commercial |
$216.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$230.25
|
| Rate for Payer: Healthscope Commercial |
$996.00
|
| Rate for Payer: Healthscope Whirlpool |
$223.34
|
| Rate for Payer: Healthscope Whirlpool |
$966.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$896.40
|
| Rate for Payer: Mclaren Commercial |
$207.22
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$906.36
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$707.16
|
| Rate for Payer: Priority Health Narrow Network |
$163.48
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$876.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.62
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$671.51
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$671.51 |
| Rate for Payer: Aetna Commercial |
$604.36
|
| Rate for Payer: Aetna Commercial |
$1,583.10
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$651.36
|
| Rate for Payer: ASR ASR |
$1,706.23
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$520.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.75
|
| Rate for Payer: BCN Commercial |
$1,363.75
|
| Rate for Payer: BCN Commercial |
$520.62
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cofinity Commercial |
$1,653.46
|
| Rate for Payer: Cofinity Commercial |
$631.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$671.51
|
| Rate for Payer: Healthscope Commercial |
$1,759.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,706.23
|
| Rate for Payer: Healthscope Whirlpool |
$651.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$604.36
|
| Rate for Payer: Mclaren Commercial |
$1,583.10
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,600.69
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$476.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.89
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,547.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.93
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$1,759.00
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,231.30 |
| Max. Negotiated Rate |
$1,759.00 |
| Rate for Payer: Aetna Commercial |
$1,583.10
|
| Rate for Payer: Aetna Commercial |
$604.36
|
| Rate for Payer: ASR ASR |
$1,706.23
|
| Rate for Payer: ASR ASR |
$651.36
|
| Rate for Payer: BCBS Trust/PPO |
$520.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.75
|
| Rate for Payer: BCN Commercial |
$520.62
|
| Rate for Payer: BCN Commercial |
$1,363.75
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$1,653.46
|
| Rate for Payer: Cofinity Commercial |
$631.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Healthscope Commercial |
$671.51
|
| Rate for Payer: Healthscope Commercial |
$1,759.00
|
| Rate for Payer: Healthscope Whirlpool |
$651.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,706.23
|
| Rate for Payer: Mclaren Commercial |
$604.36
|
| Rate for Payer: Mclaren Commercial |
$1,583.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,547.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.93
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$610.46
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$610.46 |
| Rate for Payer: Aetna Commercial |
$549.41
|
| Rate for Payer: Aetna Commercial |
$1,154.70
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$592.15
|
| Rate for Payer: ASR ASR |
$1,244.51
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$994.71
|
| Rate for Payer: BCBS Trust/PPO |
$473.29
|
| Rate for Payer: BCN Commercial |
$994.71
|
| Rate for Payer: BCN Commercial |
$473.29
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cofinity Commercial |
$573.83
|
| Rate for Payer: Cofinity Commercial |
$1,206.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$610.46
|
| Rate for Payer: Healthscope Commercial |
$1,283.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,244.51
|
| Rate for Payer: Healthscope Whirlpool |
$592.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$549.41
|
| Rate for Payer: Mclaren Commercial |
$1,154.70
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,167.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.52
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$433.43
|
| Rate for Payer: Priority Health Narrow Network |
$910.93
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,129.04
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$1,283.00
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$898.10 |
| Max. Negotiated Rate |
$1,283.00 |
| Rate for Payer: Aetna Commercial |
$1,154.70
|
| Rate for Payer: Aetna Commercial |
$549.41
|
| Rate for Payer: ASR ASR |
$1,244.51
|
| Rate for Payer: ASR ASR |
$592.15
|
| Rate for Payer: BCBS Trust/PPO |
$473.29
|
| Rate for Payer: BCBS Trust/PPO |
$994.71
|
| Rate for Payer: BCN Commercial |
$473.29
|
| Rate for Payer: BCN Commercial |
$994.71
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,206.02
|
| Rate for Payer: Cofinity Commercial |
$573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Healthscope Commercial |
$1,283.00
|
| Rate for Payer: Healthscope Commercial |
$610.46
|
| Rate for Payer: Healthscope Whirlpool |
$592.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,244.51
|
| Rate for Payer: Mclaren Commercial |
$549.41
|
| Rate for Payer: Mclaren Commercial |
$1,154.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,129.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.20
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
IP
|
$1,174.00
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$821.80 |
| Max. Negotiated Rate |
$1,174.00 |
| Rate for Payer: Aetna Commercial |
$1,056.60
|
| Rate for Payer: Aetna Commercial |
$1,021.73
|
| Rate for Payer: ASR ASR |
$1,138.78
|
| Rate for Payer: ASR ASR |
$1,101.20
|
| Rate for Payer: BCBS Trust/PPO |
$880.17
|
| Rate for Payer: BCBS Trust/PPO |
$910.20
|
| Rate for Payer: BCN Commercial |
$910.20
|
| Rate for Payer: BCN Commercial |
$880.17
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$1,103.56
|
| Rate for Payer: Cofinity Commercial |
$1,067.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.21
|
| Rate for Payer: Healthscope Commercial |
$1,174.00
|
| Rate for Payer: Healthscope Commercial |
$1,135.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,101.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,138.78
|
| Rate for Payer: Mclaren Commercial |
$1,021.73
|
| Rate for Payer: Mclaren Commercial |
$1,056.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$964.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$999.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.12
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,174.00
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$1,174.00 |
| Rate for Payer: Aetna Commercial |
$1,056.60
|
| Rate for Payer: Aetna Commercial |
$1,021.73
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$1,138.78
|
| Rate for Payer: ASR ASR |
$1,101.20
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$910.20
|
| Rate for Payer: BCBS Trust/PPO |
$880.17
|
| Rate for Payer: BCN Commercial |
$880.17
|
| Rate for Payer: BCN Commercial |
$910.20
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$1,103.56
|
| Rate for Payer: Cofinity Commercial |
$1,067.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$1,135.26
|
| Rate for Payer: Healthscope Commercial |
$1,174.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,138.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,101.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$1,021.73
|
| Rate for Payer: Mclaren Commercial |
$1,056.60
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$964.97
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.34
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$806.03
|
| Rate for Payer: Priority Health Narrow Network |
$833.54
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$999.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.12
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
IP
|
$247.86
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$173.50 |
| Max. Negotiated Rate |
$247.86 |
| Rate for Payer: Aetna Commercial |
$223.07
|
| Rate for Payer: Aetna Commercial |
$576.90
|
| Rate for Payer: ASR ASR |
$621.77
|
| Rate for Payer: ASR ASR |
$240.42
|
| Rate for Payer: BCBS Trust/PPO |
$496.97
|
| Rate for Payer: BCBS Trust/PPO |
$192.17
|
| Rate for Payer: BCN Commercial |
$192.17
|
| Rate for Payer: BCN Commercial |
$496.97
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$602.54
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.29
|
| Rate for Payer: Healthscope Commercial |
$641.00
|
| Rate for Payer: Healthscope Commercial |
$247.86
|
| Rate for Payer: Healthscope Whirlpool |
$621.77
|
| Rate for Payer: Healthscope Whirlpool |
$240.42
|
| Rate for Payer: Mclaren Commercial |
$576.90
|
| Rate for Payer: Mclaren Commercial |
$223.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$544.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.12
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$641.00 |
| Rate for Payer: Aetna Commercial |
$576.90
|
| Rate for Payer: Aetna Commercial |
$223.07
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$240.42
|
| Rate for Payer: ASR ASR |
$621.77
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$192.17
|
| Rate for Payer: BCBS Trust/PPO |
$496.97
|
| Rate for Payer: BCN Commercial |
$192.17
|
| Rate for Payer: BCN Commercial |
$496.97
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Cofinity Commercial |
$602.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$641.00
|
| Rate for Payer: Healthscope Commercial |
$247.86
|
| Rate for Payer: Healthscope Whirlpool |
$240.42
|
| Rate for Payer: Healthscope Whirlpool |
$621.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$576.90
|
| Rate for Payer: Mclaren Commercial |
$223.07
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$544.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.68
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.31
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$175.98
|
| Rate for Payer: Priority Health Narrow Network |
$455.11
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.08
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
OP
|
$3,476.48
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$867.59 |
| Max. Negotiated Rate |
$3,476.48 |
| Rate for Payer: Aetna Commercial |
$3,128.83
|
| Rate for Payer: Aetna Medicare |
$1,586.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,982.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,982.60
|
| Rate for Payer: ASR ASR |
$3,372.19
|
| Rate for Payer: BCBS Complete |
$911.04
|
| Rate for Payer: BCBS MAPPO |
$1,586.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,695.31
|
| Rate for Payer: BCN Commercial |
$2,695.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.08
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cofinity Commercial |
$3,267.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,781.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.08
|
| Rate for Payer: Healthscope Commercial |
$3,476.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,372.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,586.08
|
| Rate for Payer: Mclaren Commercial |
$3,128.83
|
| Rate for Payer: Mclaren Medicaid |
$867.59
|
| Rate for Payer: Mclaren Medicare |
$1,586.08
|
| Rate for Payer: Meridian Medicaid |
$911.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,665.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,823.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,955.01
|
| Rate for Payer: PACE Medicare |
$1,506.78
|
| Rate for Payer: PACE SWMI |
$1,586.08
|
| Rate for Payer: PHP Commercial |
$1,744.69
|
| Rate for Payer: PHP Medicaid |
$867.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$867.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,433.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,163.60
|
| Rate for Payer: Priority Health Medicare |
$1,586.08
|
| Rate for Payer: Priority Health Narrow Network |
$2,468.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,586.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,059.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,633.66
|
| Rate for Payer: VA VA |
$1,586.08
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
IP
|
$3,476.48
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,433.54 |
| Max. Negotiated Rate |
$3,476.48 |
| Rate for Payer: Aetna Commercial |
$3,128.83
|
| Rate for Payer: ASR ASR |
$3,372.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,695.31
|
| Rate for Payer: BCN Commercial |
$2,695.31
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cofinity Commercial |
$3,267.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,781.18
|
| Rate for Payer: Healthscope Commercial |
$3,476.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,372.19
|
| Rate for Payer: Mclaren Commercial |
$3,128.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,955.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,433.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,059.30
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
OP
|
$11.22
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$13.41 |
| Rate for Payer: Aetna Commercial |
$10.10
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.41
|
| Rate for Payer: ASR ASR |
$10.88
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: BCBS MAPPO |
$10.73
|
| Rate for Payer: BCBS Trust/PPO |
$8.70
|
| Rate for Payer: BCN Commercial |
$8.70
|
| Rate for Payer: BCN Medicare Advantage |
$10.73
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Commercial |
$10.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.73
|
| Rate for Payer: Healthscope Commercial |
$11.22
|
| Rate for Payer: Healthscope Whirlpool |
$10.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.73
|
| Rate for Payer: Mclaren Commercial |
$10.10
|
| Rate for Payer: Mclaren Medicaid |
$5.87
|
| Rate for Payer: Mclaren Medicare |
$10.73
|
| Rate for Payer: Meridian Medicaid |
$6.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.54
|
| Rate for Payer: PACE Medicare |
$10.19
|
| Rate for Payer: PACE SWMI |
$10.73
|
| Rate for Payer: PHP Commercial |
$11.80
|
| Rate for Payer: PHP Medicaid |
$5.87
|
| Rate for Payer: PHP Medicare Advantage |
$10.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.21
|
| Rate for Payer: Priority Health Medicare |
$10.73
|
| Rate for Payer: Priority Health Narrow Network |
$7.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.05
|
| Rate for Payer: VA VA |
$10.73
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
IP
|
$11.22
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$11.22 |
| Rate for Payer: Aetna Commercial |
$10.10
|
| Rate for Payer: ASR ASR |
$10.88
|
| Rate for Payer: BCBS Trust/PPO |
$8.70
|
| Rate for Payer: BCN Commercial |
$8.70
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Commercial |
$10.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Healthscope Commercial |
$11.22
|
| Rate for Payer: Healthscope Whirlpool |
$10.88
|
| Rate for Payer: Mclaren Commercial |
$10.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.87
|
|
|
HC ROOM & BOARD PSYCH
|
Facility
|
IP
|
$1,775.22
|
|
| Hospital Charge Code |
12400001
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,242.65 |
| Max. Negotiated Rate |
$1,775.22 |
| Rate for Payer: Aetna Commercial |
$1,597.70
|
| Rate for Payer: ASR ASR |
$1,721.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.33
|
| Rate for Payer: BCN Commercial |
$1,376.33
|
| Rate for Payer: Cash Price |
$1,420.18
|
| Rate for Payer: Cofinity Commercial |
$1,668.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.18
|
| Rate for Payer: Healthscope Commercial |
$1,775.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,721.96
|
| Rate for Payer: Mclaren Commercial |
$1,597.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,562.19
|
|
|
HC ROOM MED SURG
|
Facility
|
IP
|
$3,291.02
|
|
| Hospital Charge Code |
12100001
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,303.71 |
| Max. Negotiated Rate |
$3,291.02 |
| Rate for Payer: Aetna Commercial |
$2,961.92
|
| Rate for Payer: ASR ASR |
$3,192.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,551.53
|
| Rate for Payer: BCN Commercial |
$2,551.53
|
| Rate for Payer: Cash Price |
$2,632.82
|
| Rate for Payer: Cofinity Commercial |
$3,093.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,632.82
|
| Rate for Payer: Healthscope Commercial |
$3,291.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,192.29
|
| Rate for Payer: Mclaren Commercial |
$2,961.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,797.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,303.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,896.10
|
|
|
HC ROOM SCU
|
Facility
|
IP
|
$2,305.94
|
|
| Hospital Charge Code |
20000002
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,614.16 |
| Max. Negotiated Rate |
$2,305.94 |
| Rate for Payer: Aetna Commercial |
$2,075.35
|
| Rate for Payer: ASR ASR |
$2,236.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.80
|
| Rate for Payer: BCN Commercial |
$1,787.80
|
| Rate for Payer: Cash Price |
$1,844.75
|
| Rate for Payer: Cofinity Commercial |
$2,167.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,844.75
|
| Rate for Payer: Healthscope Commercial |
$2,305.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,236.76
|
| Rate for Payer: Mclaren Commercial |
$2,075.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,960.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,614.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,029.23
|
|
|
HC RO OR SSA SJOGRENS AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200162
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
|
|
HC RO OR SSA SJOGRENS AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200162
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.67
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ROPIVACAINE HYDROCHLORIDE 1 MG
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
CPT J2795
|
| Hospital Charge Code |
63600236
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: ASR ASR |
$3.88
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$3.10
|
| Rate for Payer: BCN Commercial |
$3.10
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.20
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Healthscope Whirlpool |
$3.88
|
| Rate for Payer: Mclaren Commercial |
$3.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.64
|
| Rate for Payer: Priority Health Narrow Network |
$2.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.52
|
|
|
HC ROPIVACAINE HYDROCHLORIDE 1 MG
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
CPT J2795
|
| Hospital Charge Code |
63600236
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: ASR ASR |
$3.88
|
| Rate for Payer: BCBS Trust/PPO |
$3.10
|
| Rate for Payer: BCN Commercial |
$3.10
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.20
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Healthscope Whirlpool |
$3.88
|
| Rate for Payer: Mclaren Commercial |
$3.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.52
|
|
