|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Trust/PPO |
$40.96
|
| Rate for Payer: BCN Commercial |
$40.96
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$28.68
|
| 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 |
$30.91
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$26.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Commercial |
$29.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$30.91
|
| Rate for Payer: Healthscope Whirlpool |
$31.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$28.68
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| 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 |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.90 |
| Max. Negotiated Rate |
$31.87 |
| Rate for Payer: Aetna Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$30.91
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Commercial |
$29.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$30.91
|
| Rate for Payer: Healthscope Whirlpool |
$31.87
|
| Rate for Payer: Mclaren Commercial |
$28.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.05
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$20.65 |
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: ASR ASR |
$20.03
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.96
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$19.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$20.03
|
| Rate for Payer: Healthscope Whirlpool |
$20.65
|
| Rate for Payer: Mclaren Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Nomi Health Commercial |
$16.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.17
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$20.03
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$17.03
|
| Rate for Payer: BCN Commercial |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$19.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$20.03
|
| Rate for Payer: Healthscope Whirlpool |
$20.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$18.59
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Nomi Health Commercial |
$16.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$13,800.60 |
| Rate for Payer: Aetna Commercial |
$12,420.54
|
| Rate for Payer: Aetna Commercial |
$8,280.36
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$8,924.39
|
| Rate for Payer: ASR ASR |
$13,386.58
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$7,585.73
|
| Rate for Payer: BCBS Trust/PPO |
$11,378.59
|
| Rate for Payer: BCN Commercial |
$11,378.59
|
| Rate for Payer: BCN Commercial |
$7,585.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cofinity Commercial |
$12,972.56
|
| Rate for Payer: Cofinity Commercial |
$8,648.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$13,386.58
|
| Rate for Payer: Healthscope Commercial |
$8,924.39
|
| Rate for Payer: Healthscope Whirlpool |
$9,200.40
|
| Rate for Payer: Healthscope Whirlpool |
$13,800.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$8,280.36
|
| Rate for Payer: Mclaren Commercial |
$12,420.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Nomi Health Commercial |
$11,316.49
|
| Rate for Payer: Nomi Health Commercial |
$7,544.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,092.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,061.39
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$9,674.22
|
| Rate for Payer: Priority Health Narrow Network |
$6,449.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,144.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,096.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10,350.45 |
| Max. Negotiated Rate |
$13,800.60 |
| Rate for Payer: Aetna Commercial |
$12,420.54
|
| Rate for Payer: Aetna Commercial |
$8,280.36
|
| Rate for Payer: ASR ASR |
$13,386.58
|
| Rate for Payer: ASR ASR |
$8,924.39
|
| Rate for Payer: BCBS Trust/PPO |
$11,333.05
|
| Rate for Payer: BCBS Trust/PPO |
$7,555.37
|
| Rate for Payer: BCN Commercial |
$11,333.05
|
| Rate for Payer: BCN Commercial |
$7,555.37
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cofinity Commercial |
$8,648.38
|
| Rate for Payer: Cofinity Commercial |
$12,972.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Healthscope Commercial |
$13,386.58
|
| Rate for Payer: Healthscope Commercial |
$8,924.39
|
| Rate for Payer: Healthscope Whirlpool |
$9,200.40
|
| Rate for Payer: Healthscope Whirlpool |
$13,800.60
|
| Rate for Payer: Mclaren Commercial |
$8,280.36
|
| Rate for Payer: Mclaren Commercial |
$12,420.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Nomi Health Commercial |
$7,544.33
|
| Rate for Payer: Nomi Health Commercial |
$11,316.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,096.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,144.53
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$640.89 |
| Rate for Payer: Aetna Commercial |
$576.80
|
| Rate for Payer: Aetna Commercial |
$865.20
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$932.49
|
| Rate for Payer: ASR ASR |
$621.66
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$792.62
|
| Rate for Payer: BCBS Trust/PPO |
$528.41
|
| Rate for Payer: BCN Commercial |
$528.41
|
| Rate for Payer: BCN Commercial |
$792.62
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cofinity Commercial |
$602.44
|
| Rate for Payer: Cofinity Commercial |
$903.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$621.66
|
| Rate for Payer: Healthscope Commercial |
$932.49
|
| Rate for Payer: Healthscope Whirlpool |
$961.33
|
| Rate for Payer: Healthscope Whirlpool |
$640.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$865.20
|
| Rate for Payer: Mclaren Commercial |
$576.80
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Nomi Health Commercial |
$788.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$561.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$842.32
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$449.26
|
| Rate for Payer: Priority Health Narrow Network |
$673.89
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$563.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.67 |
| Max. Negotiated Rate |
$640.89 |
| Rate for Payer: Aetna Commercial |
$576.80
|
| Rate for Payer: Aetna Commercial |
$865.20
|
| Rate for Payer: ASR ASR |
$621.66
|
| Rate for Payer: ASR ASR |
$932.49
|
| Rate for Payer: BCBS Trust/PPO |
$526.30
|
| Rate for Payer: BCBS Trust/PPO |
$789.44
|
| Rate for Payer: BCN Commercial |
$526.30
|
| Rate for Payer: BCN Commercial |
$789.44
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Commercial |
$903.65
|
| Rate for Payer: Cofinity Commercial |
$602.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Healthscope Commercial |
$621.66
|
| Rate for Payer: Healthscope Commercial |
$932.49
|
| Rate for Payer: Healthscope Whirlpool |
$961.33
|
| Rate for Payer: Healthscope Whirlpool |
$640.89
|
| Rate for Payer: Mclaren Commercial |
$865.20
|
| Rate for Payer: Mclaren Commercial |
$576.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$788.29
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$563.98
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$772.78
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$579.59 |
| Max. Negotiated Rate |
$772.78 |
| Rate for Payer: Aetna Commercial |
$695.50
|
| Rate for Payer: ASR ASR |
$749.60
|
| Rate for Payer: BCBS Trust/PPO |
$634.61
|
| Rate for Payer: BCN Commercial |
$634.61
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cofinity Commercial |
$726.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.22
|
| Rate for Payer: Healthscope Commercial |
$749.60
|
| Rate for Payer: Healthscope Whirlpool |
$772.78
|
| Rate for Payer: Mclaren Commercial |
$695.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.86
|
| Rate for Payer: Nomi Health Commercial |
$633.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$680.05
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$772.78
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.60 |
| Max. Negotiated Rate |
$1,141.44 |
| Rate for Payer: Aetna Commercial |
$695.50
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$749.60
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$637.16
|
| Rate for Payer: BCN Commercial |
$637.16
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cofinity Commercial |
$726.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$749.60
|
| Rate for Payer: Healthscope Whirlpool |
$772.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$695.50
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.86
|
| Rate for Payer: Nomi Health Commercial |
$633.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.59
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$680.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$277.25
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.94 |
| Max. Negotiated Rate |
$277.25 |
| Rate for Payer: Aetna Commercial |
$249.53
|
| Rate for Payer: ASR ASR |
$268.93
|
| Rate for Payer: BCBS Trust/PPO |
$227.68
|
| Rate for Payer: BCN Commercial |
$227.68
|
| Rate for Payer: Cash Price |
$221.80
|
| Rate for Payer: Cofinity Commercial |
$260.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.80
|
| Rate for Payer: Healthscope Commercial |
$268.93
|
| Rate for Payer: Healthscope Whirlpool |
$277.25
|
| Rate for Payer: Mclaren Commercial |
$249.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.66
|
| Rate for Payer: Nomi Health Commercial |
$227.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.98
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$277.25
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.58 |
| Max. Negotiated Rate |
$277.25 |
| Rate for Payer: Aetna Commercial |
$249.53
|
| Rate for Payer: Aetna Medicare |
$102.58
|
| Rate for Payer: ASR ASR |
$268.93
|
| Rate for Payer: BCBS Complete |
$110.90
|
| Rate for Payer: BCBS Trust/PPO |
$228.59
|
| Rate for Payer: BCN Commercial |
$228.59
|
| Rate for Payer: Cash Price |
$221.80
|
| Rate for Payer: Cofinity Commercial |
$260.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.80
|
| Rate for Payer: Healthscope Commercial |
$268.93
|
| Rate for Payer: Healthscope Whirlpool |
$277.25
|
| Rate for Payer: Mclaren Commercial |
$249.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.66
|
| Rate for Payer: Nomi Health Commercial |
$227.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.93
|
| Rate for Payer: Priority Health Narrow Network |
$194.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.98
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$334.65
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$431.27 |
| Rate for Payer: Aetna Commercial |
$301.19
|
| Rate for Payer: Aetna Medicare |
$278.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$347.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$347.80
|
| Rate for Payer: ASR ASR |
$324.61
|
| Rate for Payer: BCBS Complete |
$152.81
|
| Rate for Payer: BCBS MAPPO |
$278.24
|
| Rate for Payer: BCBS Trust/PPO |
$275.92
|
| Rate for Payer: BCN Commercial |
$275.92
|
| Rate for Payer: BCN Medicare Advantage |
$278.24
|
| Rate for Payer: Cash Price |
$267.72
|
| Rate for Payer: Cash Price |
$267.72
|
| Rate for Payer: Cofinity Commercial |
$314.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.24
|
| Rate for Payer: Healthscope Commercial |
$324.61
|
| Rate for Payer: Healthscope Whirlpool |
$334.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.24
|
| Rate for Payer: Mclaren Commercial |
$301.19
|
| Rate for Payer: Mclaren Medicaid |
$278.24
|
| Rate for Payer: Mclaren Medicare |
$278.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.15
|
| Rate for Payer: Meridian Medicaid |
$152.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$319.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.45
|
| Rate for Payer: Nomi Health Commercial |
$274.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.99
|
| Rate for Payer: PACE Medicare |
$264.33
|
| Rate for Payer: PACE SWMI |
$278.24
|
| Rate for Payer: PHP Commercial |
$306.06
|
| Rate for Payer: PHP Medicaid |
$149.14
|
| Rate for Payer: PHP Medicare Advantage |
$278.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$310.97
|
| Rate for Payer: Priority Health Medicare |
$278.24
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: Railroad Medicare Medicare |
$278.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.24
|
| Rate for Payer: UHC Exchange |
$431.27
|
| Rate for Payer: UHC Medicaid |
$145.52
|
| Rate for Payer: UHCCP DNSP |
$278.24
|
| Rate for Payer: UHCCP Medicaid |
$145.52
|
| Rate for Payer: VA VA |
$278.24
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$334.65
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$250.99 |
| Max. Negotiated Rate |
$334.65 |
| Rate for Payer: Aetna Commercial |
$301.19
|
| Rate for Payer: ASR ASR |
$324.61
|
| Rate for Payer: BCBS Trust/PPO |
$274.81
|
| Rate for Payer: BCN Commercial |
$274.81
|
| Rate for Payer: Cash Price |
$267.72
|
| Rate for Payer: Cofinity Commercial |
$314.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.72
|
| Rate for Payer: Healthscope Commercial |
$324.61
|
| Rate for Payer: Healthscope Whirlpool |
$334.65
|
| Rate for Payer: Mclaren Commercial |
$301.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.45
|
| Rate for Payer: Nomi Health Commercial |
$274.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.49
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
IP
|
$202.79
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$152.09 |
| Max. Negotiated Rate |
$202.79 |
| Rate for Payer: Aetna Commercial |
$182.51
|
| Rate for Payer: ASR ASR |
$196.71
|
| Rate for Payer: BCBS Trust/PPO |
$166.53
|
| Rate for Payer: BCN Commercial |
$166.53
|
| Rate for Payer: Cash Price |
$162.23
|
| Rate for Payer: Cofinity Commercial |
$190.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.23
|
| Rate for Payer: Healthscope Commercial |
$196.71
|
| Rate for Payer: Healthscope Whirlpool |
$202.79
|
| Rate for Payer: Mclaren Commercial |
$182.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.37
|
| Rate for Payer: Nomi Health Commercial |
$166.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.46
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
OP
|
$202.79
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$202.79 |
| Rate for Payer: Aetna Commercial |
$182.51
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$196.71
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$167.20
|
| Rate for Payer: BCN Commercial |
$167.20
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$162.23
|
| Rate for Payer: Cash Price |
$162.23
|
| Rate for Payer: Cofinity Commercial |
$190.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$196.71
|
| Rate for Payer: Healthscope Whirlpool |
$202.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$182.51
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.37
|
| Rate for Payer: Nomi Health Commercial |
$166.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.09
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.95
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$123.96
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
OP
|
$261.02
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$308.28 |
| Rate for Payer: Aetna Commercial |
$234.92
|
| Rate for Payer: Aetna Medicare |
$198.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.61
|
| Rate for Payer: ASR ASR |
$253.19
|
| Rate for Payer: BCBS Complete |
$109.23
|
| Rate for Payer: BCBS MAPPO |
$198.89
|
| Rate for Payer: BCBS Trust/PPO |
$215.21
|
| Rate for Payer: BCN Commercial |
$215.21
|
| Rate for Payer: BCN Medicare Advantage |
$198.89
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$245.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.89
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Healthscope Whirlpool |
$261.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$198.89
|
| Rate for Payer: Mclaren Commercial |
$234.92
|
| Rate for Payer: Mclaren Medicaid |
$198.89
|
| Rate for Payer: Mclaren Medicare |
$198.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.83
|
| Rate for Payer: Meridian Medicaid |
$109.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.87
|
| Rate for Payer: Nomi Health Commercial |
$214.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.76
|
| Rate for Payer: PACE Medicare |
$188.95
|
| Rate for Payer: PACE SWMI |
$198.89
|
| Rate for Payer: PHP Commercial |
$218.78
|
| Rate for Payer: PHP Medicaid |
$106.61
|
| Rate for Payer: PHP Medicare Advantage |
$198.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.71
|
| Rate for Payer: Priority Health Medicare |
$198.89
|
| Rate for Payer: Priority Health Narrow Network |
$182.98
|
| Rate for Payer: Railroad Medicare Medicare |
$198.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.89
|
| Rate for Payer: UHC Exchange |
$308.28
|
| Rate for Payer: UHC Medicaid |
$104.02
|
| Rate for Payer: UHCCP DNSP |
$198.89
|
| Rate for Payer: UHCCP Medicaid |
$104.02
|
| Rate for Payer: VA VA |
$198.89
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
IP
|
$261.02
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.76 |
| Max. Negotiated Rate |
$261.02 |
| Rate for Payer: Aetna Commercial |
$234.92
|
| Rate for Payer: ASR ASR |
$253.19
|
| Rate for Payer: BCBS Trust/PPO |
$214.35
|
| Rate for Payer: BCN Commercial |
$214.35
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$245.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.82
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Healthscope Whirlpool |
$261.02
|
| Rate for Payer: Mclaren Commercial |
$234.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.87
|
| Rate for Payer: Nomi Health Commercial |
$214.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.70
|
|
|
HC NASAL/SINUS ENDSC SURG W/BX POLYPEC/DBRD SPX
|
Facility
|
OP
|
$4,525.74
|
|
|
Service Code
|
CPT 31237
|
| Hospital Charge Code |
76100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$927.54 |
| Max. Negotiated Rate |
$4,525.74 |
| Rate for Payer: Aetna Commercial |
$4,073.17
|
| Rate for Payer: Aetna Medicare |
$1,773.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,216.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,216.88
|
| Rate for Payer: ASR ASR |
$4,389.97
|
| Rate for Payer: BCBS Complete |
$974.01
|
| Rate for Payer: BCBS MAPPO |
$1,773.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,731.47
|
| Rate for Payer: BCN Commercial |
$3,731.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,773.50
|
| Rate for Payer: Cash Price |
$3,620.59
|
| Rate for Payer: Cash Price |
$3,620.59
|
| Rate for Payer: Cofinity Commercial |
$4,254.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,620.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,773.50
|
| Rate for Payer: Healthscope Commercial |
$4,389.97
|
| Rate for Payer: Healthscope Whirlpool |
$4,525.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,773.50
|
| Rate for Payer: Mclaren Commercial |
$4,073.17
|
| Rate for Payer: Mclaren Medicaid |
$1,773.50
|
| Rate for Payer: Mclaren Medicare |
$1,773.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,862.17
|
| Rate for Payer: Meridian Medicaid |
$974.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,039.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,950.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,846.88
|
| Rate for Payer: Nomi Health Commercial |
$3,711.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,394.30
|
| Rate for Payer: PACE Medicare |
$1,684.83
|
| Rate for Payer: PACE SWMI |
$1,773.50
|
| Rate for Payer: PHP Commercial |
$1,950.85
|
| Rate for Payer: PHP Medicaid |
$950.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,773.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$927.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,965.45
|
| Rate for Payer: Priority Health Medicare |
$1,773.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,172.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,773.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,982.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,773.50
|
| Rate for Payer: UHC Exchange |
$2,748.93
|
| Rate for Payer: UHC Medicaid |
$927.54
|
| Rate for Payer: UHCCP DNSP |
$1,773.50
|
| Rate for Payer: UHCCP Medicaid |
$927.54
|
| Rate for Payer: VA VA |
$1,773.50
|
|
|
HC NASAL/SINUS ENDSC SURG W/BX POLYPEC/DBRD SPX
|
Facility
|
IP
|
$4,525.74
|
|
|
Service Code
|
CPT 31237
|
| Hospital Charge Code |
76100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,394.30 |
| Max. Negotiated Rate |
$4,525.74 |
| Rate for Payer: Aetna Commercial |
$4,073.17
|
| Rate for Payer: ASR ASR |
$4,389.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,716.54
|
| Rate for Payer: BCN Commercial |
$3,716.54
|
| Rate for Payer: Cash Price |
$3,620.59
|
| Rate for Payer: Cofinity Commercial |
$4,254.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,620.59
|
| Rate for Payer: Healthscope Commercial |
$4,389.97
|
| Rate for Payer: Healthscope Whirlpool |
$4,525.74
|
| Rate for Payer: Mclaren Commercial |
$4,073.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,846.88
|
| Rate for Payer: Nomi Health Commercial |
$3,711.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,394.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,982.65
|
|
|
HC NASAL/SINUS ENDSC SURG W/CONTROL NASAL HEMRR
|
Facility
|
IP
|
$4,078.98
|
|
|
Service Code
|
CPT 31238
|
| Hospital Charge Code |
76100533
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,059.24 |
| Max. Negotiated Rate |
$4,078.98 |
| Rate for Payer: Aetna Commercial |
$3,671.08
|
| Rate for Payer: ASR ASR |
$3,956.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,349.66
|
| Rate for Payer: BCN Commercial |
$3,349.66
|
| Rate for Payer: Cash Price |
$3,263.18
|
| Rate for Payer: Cofinity Commercial |
$3,834.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,263.18
|
| Rate for Payer: Healthscope Commercial |
$3,956.61
|
| Rate for Payer: Healthscope Whirlpool |
$4,078.98
|
| Rate for Payer: Mclaren Commercial |
$3,671.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,467.13
|
| Rate for Payer: Nomi Health Commercial |
$3,344.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,059.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,589.50
|
|
|
HC NASAL/SINUS ENDSC SURG W/CONTROL NASAL HEMRR
|
Facility
|
OP
|
$4,078.98
|
|
|
Service Code
|
CPT 31238
|
| Hospital Charge Code |
76100533
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$927.54 |
| Max. Negotiated Rate |
$4,078.98 |
| Rate for Payer: Aetna Commercial |
$3,671.08
|
| Rate for Payer: Aetna Medicare |
$1,773.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,216.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,216.88
|
| Rate for Payer: ASR ASR |
$3,956.61
|
| Rate for Payer: BCBS Complete |
$974.01
|
| Rate for Payer: BCBS MAPPO |
$1,773.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,363.12
|
| Rate for Payer: BCN Commercial |
$3,363.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,773.50
|
| Rate for Payer: Cash Price |
$3,263.18
|
| Rate for Payer: Cash Price |
$3,263.18
|
| Rate for Payer: Cofinity Commercial |
$3,834.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,263.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,773.50
|
| Rate for Payer: Healthscope Commercial |
$3,956.61
|
| Rate for Payer: Healthscope Whirlpool |
$4,078.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,773.50
|
| Rate for Payer: Mclaren Commercial |
$3,671.08
|
| Rate for Payer: Mclaren Medicaid |
$1,773.50
|
| Rate for Payer: Mclaren Medicare |
$1,773.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,862.17
|
| Rate for Payer: Meridian Medicaid |
$974.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,039.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,950.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,467.13
|
| Rate for Payer: Nomi Health Commercial |
$3,344.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,059.24
|
| Rate for Payer: PACE Medicare |
$1,684.83
|
| Rate for Payer: PACE SWMI |
$1,773.50
|
| Rate for Payer: PHP Commercial |
$1,950.85
|
| Rate for Payer: PHP Medicaid |
$950.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,773.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$927.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,574.00
|
| Rate for Payer: Priority Health Medicare |
$1,773.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,859.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,773.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,589.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,773.50
|
| Rate for Payer: UHC Exchange |
$2,748.93
|
| Rate for Payer: UHC Medicaid |
$927.54
|
| Rate for Payer: UHCCP DNSP |
$1,773.50
|
| Rate for Payer: UHCCP Medicaid |
$927.54
|
| Rate for Payer: VA VA |
$1,773.50
|
|
|
HC NASOPHARYNGOSCOPY
|
Facility
|
OP
|
$261.02
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
76100177
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$308.28 |
| Rate for Payer: Aetna Commercial |
$234.92
|
| Rate for Payer: Aetna Medicare |
$198.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.61
|
| Rate for Payer: ASR ASR |
$253.19
|
| Rate for Payer: BCBS Complete |
$109.23
|
| Rate for Payer: BCBS MAPPO |
$198.89
|
| Rate for Payer: BCBS Trust/PPO |
$215.21
|
| Rate for Payer: BCN Commercial |
$215.21
|
| Rate for Payer: BCN Medicare Advantage |
$198.89
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$245.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.89
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Healthscope Whirlpool |
$261.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$198.89
|
| Rate for Payer: Mclaren Commercial |
$234.92
|
| Rate for Payer: Mclaren Medicaid |
$198.89
|
| Rate for Payer: Mclaren Medicare |
$198.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.83
|
| Rate for Payer: Meridian Medicaid |
$109.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.87
|
| Rate for Payer: Nomi Health Commercial |
$214.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.76
|
| Rate for Payer: PACE Medicare |
$188.95
|
| Rate for Payer: PACE SWMI |
$198.89
|
| Rate for Payer: PHP Commercial |
$218.78
|
| Rate for Payer: PHP Medicaid |
$106.61
|
| Rate for Payer: PHP Medicare Advantage |
$198.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.71
|
| Rate for Payer: Priority Health Medicare |
$198.89
|
| Rate for Payer: Priority Health Narrow Network |
$182.98
|
| Rate for Payer: Railroad Medicare Medicare |
$198.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.89
|
| Rate for Payer: UHC Exchange |
$308.28
|
| Rate for Payer: UHC Medicaid |
$104.02
|
| Rate for Payer: UHCCP DNSP |
$198.89
|
| Rate for Payer: UHCCP Medicaid |
$104.02
|
| Rate for Payer: VA VA |
$198.89
|
|
|
HC NASOPHARYNGOSCOPY
|
Facility
|
IP
|
$261.02
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
76100177
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.76 |
| Max. Negotiated Rate |
$261.02 |
| Rate for Payer: Aetna Commercial |
$234.92
|
| Rate for Payer: ASR ASR |
$253.19
|
| Rate for Payer: BCBS Trust/PPO |
$214.35
|
| Rate for Payer: BCN Commercial |
$214.35
|
| Rate for Payer: Cash Price |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$245.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.82
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Healthscope Whirlpool |
$261.02
|
| Rate for Payer: Mclaren Commercial |
$234.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.87
|
| Rate for Payer: Nomi Health Commercial |
$214.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.70
|
|
