|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
IP
|
$118.31
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.73 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Aetna Commercial |
$106.48
|
| Rate for Payer: ASR ASR |
$114.76
|
| Rate for Payer: BCBS Trust/PPO |
$97.16
|
| Rate for Payer: BCN Commercial |
$97.16
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Cofinity Commercial |
$111.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.65
|
| Rate for Payer: Healthscope Commercial |
$114.76
|
| Rate for Payer: Healthscope Whirlpool |
$118.31
|
| Rate for Payer: Mclaren Commercial |
$106.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.56
|
| Rate for Payer: Nomi Health Commercial |
$97.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.11
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
OP
|
$81.59
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.19 |
| Max. Negotiated Rate |
$81.59 |
| Rate for Payer: Aetna Commercial |
$73.43
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: ASR ASR |
$79.14
|
| Rate for Payer: BCBS Complete |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$67.27
|
| Rate for Payer: BCN Commercial |
$67.27
|
| Rate for Payer: Cash Price |
$65.27
|
| Rate for Payer: Cofinity Commercial |
$76.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.27
|
| Rate for Payer: Healthscope Commercial |
$79.14
|
| Rate for Payer: Healthscope Whirlpool |
$81.59
|
| Rate for Payer: Mclaren Commercial |
$73.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.35
|
| Rate for Payer: Nomi Health Commercial |
$66.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.49
|
| Rate for Payer: Priority Health Narrow Network |
$57.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.80
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
IP
|
$81.59
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.19 |
| Max. Negotiated Rate |
$81.59 |
| Rate for Payer: Aetna Commercial |
$73.43
|
| Rate for Payer: ASR ASR |
$79.14
|
| Rate for Payer: BCBS Trust/PPO |
$67.00
|
| Rate for Payer: BCN Commercial |
$67.00
|
| Rate for Payer: Cash Price |
$65.27
|
| Rate for Payer: Cofinity Commercial |
$76.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.27
|
| Rate for Payer: Healthscope Commercial |
$79.14
|
| Rate for Payer: Healthscope Whirlpool |
$81.59
|
| Rate for Payer: Mclaren Commercial |
$73.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.35
|
| Rate for Payer: Nomi Health Commercial |
$66.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.80
|
|
|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
IP
|
$118.31
|
|
| Hospital Charge Code |
27200128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.73 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Aetna Commercial |
$106.48
|
| Rate for Payer: ASR ASR |
$114.76
|
| Rate for Payer: BCBS Trust/PPO |
$97.16
|
| Rate for Payer: BCN Commercial |
$97.16
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Cofinity Commercial |
$111.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.65
|
| Rate for Payer: Healthscope Commercial |
$114.76
|
| Rate for Payer: Healthscope Whirlpool |
$118.31
|
| Rate for Payer: Mclaren Commercial |
$106.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.56
|
| Rate for Payer: Nomi Health Commercial |
$97.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.11
|
|
|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
OP
|
$118.31
|
|
| Hospital Charge Code |
27200128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Aetna Commercial |
$106.48
|
| Rate for Payer: Aetna Medicare |
$43.77
|
| Rate for Payer: ASR ASR |
$114.76
|
| Rate for Payer: BCBS Complete |
$47.32
|
| Rate for Payer: BCBS Trust/PPO |
$97.55
|
| Rate for Payer: BCN Commercial |
$97.55
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Cofinity Commercial |
$111.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.65
|
| Rate for Payer: Healthscope Commercial |
$114.76
|
| Rate for Payer: Healthscope Whirlpool |
$118.31
|
| Rate for Payer: Mclaren Commercial |
$106.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.56
|
| Rate for Payer: Nomi Health Commercial |
$97.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.66
|
| Rate for Payer: Priority Health Narrow Network |
$82.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.11
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
OP
|
$8.02
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$8.02 |
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: Aetna Medicare |
$2.97
|
| Rate for Payer: ASR ASR |
$7.78
|
| Rate for Payer: BCBS Complete |
$3.21
|
| Rate for Payer: BCBS Trust/PPO |
$6.61
|
| Rate for Payer: BCN Commercial |
$6.61
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cofinity Commercial |
$7.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$7.78
|
| Rate for Payer: Healthscope Whirlpool |
$8.02
|
| Rate for Payer: Mclaren Commercial |
$7.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.82
|
| Rate for Payer: Nomi Health Commercial |
$6.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7.03
|
| Rate for Payer: Priority Health Narrow Network |
$5.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.06
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
IP
|
$8.02
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.01 |
| Max. Negotiated Rate |
$8.02 |
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: ASR ASR |
$7.78
|
| Rate for Payer: BCBS Trust/PPO |
$6.59
|
| Rate for Payer: BCN Commercial |
$6.59
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cofinity Commercial |
$7.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$7.78
|
| Rate for Payer: Healthscope Whirlpool |
$8.02
|
| Rate for Payer: Mclaren Commercial |
$7.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.82
|
| Rate for Payer: Nomi Health Commercial |
$6.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.06
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Trust/PPO |
$56.65
|
| Rate for Payer: BCN Commercial |
$56.65
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$145.28 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$56.87
|
| Rate for Payer: BCN Commercial |
$56.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.28
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$116.22
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$321.94 |
| Max. Negotiated Rate |
$4,454.85 |
| Rate for Payer: Aetna Commercial |
$1,440.40
|
| Rate for Payer: Aetna Medicare |
$615.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: ASR ASR |
$1,552.43
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.56
|
| Rate for Payer: BCN Commercial |
$1,319.56
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Commercial |
$1,504.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$1,552.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$615.57
|
| Rate for Payer: Mclaren Commercial |
$1,440.40
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$338.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$1,312.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$677.13
|
| Rate for Payer: PHP Medicaid |
$329.95
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,454.85
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,563.88
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$954.13
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP DNSP |
$615.57
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: VA VA |
$615.57
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,200.33 |
| Max. Negotiated Rate |
$1,600.44 |
| Rate for Payer: Aetna Commercial |
$1,440.40
|
| Rate for Payer: ASR ASR |
$1,552.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.28
|
| Rate for Payer: BCN Commercial |
$1,314.28
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Commercial |
$1,504.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Healthscope Commercial |
$1,552.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.44
|
| Rate for Payer: Mclaren Commercial |
$1,440.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$1,312.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.39
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$321.94 |
| Max. Negotiated Rate |
$3,898.00 |
| Rate for Payer: Aetna Commercial |
$1,099.26
|
| Rate for Payer: Aetna Medicare |
$615.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: ASR ASR |
$1,184.76
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.04
|
| Rate for Payer: BCN Commercial |
$1,007.04
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Commercial |
$1,148.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$1,184.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$615.57
|
| Rate for Payer: Mclaren Commercial |
$1,099.26
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$338.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Nomi Health Commercial |
$1,001.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$677.13
|
| Rate for Payer: PHP Medicaid |
$329.95
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,898.00
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,118.40
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,074.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$954.13
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP DNSP |
$615.57
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: VA VA |
$615.57
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$916.05 |
| Max. Negotiated Rate |
$1,221.40 |
| Rate for Payer: Aetna Commercial |
$1,099.26
|
| Rate for Payer: ASR ASR |
$1,184.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.01
|
| Rate for Payer: BCN Commercial |
$1,003.01
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Commercial |
$1,148.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Healthscope Commercial |
$1,184.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.40
|
| Rate for Payer: Mclaren Commercial |
$1,099.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Nomi Health Commercial |
$1,001.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,074.83
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,432.06 |
| Rate for Payer: Aetna Commercial |
$1,288.85
|
| Rate for Payer: Aetna Medicare |
$694.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: ASR ASR |
$1,389.10
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.73
|
| Rate for Payer: BCN Commercial |
$1,180.73
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Commercial |
$1,346.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$1,389.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,432.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$694.79
|
| Rate for Payer: Mclaren Commercial |
$1,288.85
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$381.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Nomi Health Commercial |
$1,174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$764.27
|
| Rate for Payer: PHP Medicaid |
$372.41
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,254.77
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.87
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,260.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Exchange |
$1,076.92
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP DNSP |
$694.79
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: VA VA |
$694.79
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,074.05 |
| Max. Negotiated Rate |
$1,432.06 |
| Rate for Payer: Aetna Commercial |
$1,288.85
|
| Rate for Payer: ASR ASR |
$1,389.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.01
|
| Rate for Payer: BCN Commercial |
$1,176.01
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Commercial |
$1,346.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Healthscope Commercial |
$1,389.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,432.06
|
| Rate for Payer: Mclaren Commercial |
$1,288.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Nomi Health Commercial |
$1,174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,260.21
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$921.37 |
| Max. Negotiated Rate |
$1,228.49 |
| Rate for Payer: Aetna Commercial |
$1,105.64
|
| Rate for Payer: ASR ASR |
$1,191.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.84
|
| Rate for Payer: BCN Commercial |
$1,008.84
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,154.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Healthscope Commercial |
$1,191.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,228.49
|
| Rate for Payer: Mclaren Commercial |
$1,105.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.07
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,228.49 |
| Rate for Payer: Aetna Commercial |
$1,105.64
|
| Rate for Payer: Aetna Medicare |
$694.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: ASR ASR |
$1,191.64
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.89
|
| Rate for Payer: BCN Commercial |
$1,012.89
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,154.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$1,191.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,228.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$694.79
|
| Rate for Payer: Mclaren Commercial |
$1,105.64
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$381.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$764.27
|
| Rate for Payer: PHP Medicaid |
$372.41
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,076.40
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health Narrow Network |
$861.17
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Exchange |
$1,076.92
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP DNSP |
$694.79
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: VA VA |
$694.79
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,521.24 |
| Rate for Payer: Aetna Commercial |
$1,369.12
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,475.60
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.26
|
| Rate for Payer: BCN Commercial |
$1,254.26
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Commercial |
$1,429.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,475.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$1,369.12
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Nomi Health Commercial |
$1,247.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.02
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.02
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,140.93 |
| Max. Negotiated Rate |
$1,521.24 |
| Rate for Payer: Aetna Commercial |
$1,369.12
|
| Rate for Payer: ASR ASR |
$1,475.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.24
|
| Rate for Payer: BCN Commercial |
$1,249.24
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Commercial |
$1,429.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Healthscope Commercial |
$1,475.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.24
|
| Rate for Payer: Mclaren Commercial |
$1,369.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Nomi Health Commercial |
$1,247.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.69
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$870.61 |
| Max. Negotiated Rate |
$1,160.81 |
| Rate for Payer: Aetna Commercial |
$1,044.73
|
| Rate for Payer: Aetna Commercial |
$696.48
|
| Rate for Payer: ASR ASR |
$1,125.99
|
| Rate for Payer: ASR ASR |
$750.65
|
| Rate for Payer: BCBS Trust/PPO |
$953.26
|
| Rate for Payer: BCBS Trust/PPO |
$635.50
|
| Rate for Payer: BCN Commercial |
$953.26
|
| Rate for Payer: BCN Commercial |
$635.50
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cofinity Commercial |
$727.44
|
| Rate for Payer: Cofinity Commercial |
$1,091.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Healthscope Commercial |
$1,125.99
|
| Rate for Payer: Healthscope Commercial |
$750.65
|
| Rate for Payer: Healthscope Whirlpool |
$773.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,160.81
|
| Rate for Payer: Mclaren Commercial |
$696.48
|
| Rate for Payer: Mclaren Commercial |
$1,044.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Nomi Health Commercial |
$634.57
|
| Rate for Payer: Nomi Health Commercial |
$951.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$681.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.51
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,160.81 |
| Rate for Payer: Aetna Commercial |
$1,044.73
|
| Rate for Payer: Aetna Commercial |
$696.48
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$1,125.99
|
| Rate for Payer: ASR ASR |
$750.65
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$638.06
|
| Rate for Payer: BCBS Trust/PPO |
$957.09
|
| Rate for Payer: BCN Commercial |
$638.06
|
| Rate for Payer: BCN Commercial |
$957.09
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cofinity Commercial |
$1,091.16
|
| Rate for Payer: Cofinity Commercial |
$727.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,125.99
|
| Rate for Payer: Healthscope Commercial |
$750.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,160.81
|
| Rate for Payer: Healthscope Whirlpool |
$773.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$696.48
|
| Rate for Payer: Mclaren Commercial |
$1,044.73
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Nomi Health Commercial |
$634.57
|
| Rate for Payer: Nomi Health Commercial |
$951.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.65
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$518.12
|
| Rate for Payer: Priority Health Narrow Network |
$518.12
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$681.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
