|
HC TENOTOMY
|
Facility
|
OP
|
$2,835.96
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$2,835.96 |
| Rate for Payer: Aetna Commercial |
$2,552.36
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$2,750.88
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,198.72
|
| Rate for Payer: BCN Commercial |
$2,198.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cofinity Commercial |
$2,665.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,268.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$2,835.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,750.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$2,552.36
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,410.57
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,985.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,580.72
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,013.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,495.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,935.83 |
| Max. Negotiated Rate |
$4,194.04 |
| Rate for Payer: Aetna Commercial |
$3,774.64
|
| Rate for Payer: ASR ASR |
$4,068.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,251.64
|
| Rate for Payer: BCN Commercial |
$3,251.64
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$3,942.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Healthscope Commercial |
$4,194.04
|
| Rate for Payer: Healthscope Whirlpool |
$4,068.22
|
| Rate for Payer: Mclaren Commercial |
$3,774.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,690.76
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,677.62 |
| Max. Negotiated Rate |
$4,194.04 |
| Rate for Payer: Aetna Commercial |
$3,774.64
|
| Rate for Payer: ASR ASR |
$4,068.22
|
| Rate for Payer: BCBS Complete |
$1,677.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,251.64
|
| Rate for Payer: BCN Commercial |
$3,251.64
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$3,942.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Healthscope Commercial |
$4,194.04
|
| Rate for Payer: Healthscope Whirlpool |
$4,068.22
|
| Rate for Payer: Mclaren Commercial |
$3,774.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,816.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,977.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,690.76
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,573.80 |
| Max. Negotiated Rate |
$4,406.09 |
| Rate for Payer: Aetna Commercial |
$3,965.48
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$4,273.91
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,416.04
|
| Rate for Payer: BCN Commercial |
$3,416.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$4,141.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$4,406.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,273.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$3,965.48
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,009.54
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$3,128.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,877.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,084.26 |
| Max. Negotiated Rate |
$4,406.09 |
| Rate for Payer: Aetna Commercial |
$3,965.48
|
| Rate for Payer: ASR ASR |
$4,273.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,416.04
|
| Rate for Payer: BCN Commercial |
$3,416.04
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$4,141.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$4,406.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,273.91
|
| Rate for Payer: Mclaren Commercial |
$3,965.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,877.36
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,762.44 |
| Max. Negotiated Rate |
$4,406.09 |
| Rate for Payer: Aetna Commercial |
$3,965.48
|
| Rate for Payer: ASR ASR |
$4,273.91
|
| Rate for Payer: BCBS Complete |
$1,762.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,416.04
|
| Rate for Payer: BCN Commercial |
$3,416.04
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$4,141.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$4,406.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,273.91
|
| Rate for Payer: Mclaren Commercial |
$3,965.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,009.54
|
| Rate for Payer: Priority Health Narrow Network |
$3,128.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,877.36
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.26 |
| Max. Negotiated Rate |
$4,406.09 |
| Rate for Payer: Aetna Commercial |
$3,965.48
|
| Rate for Payer: ASR ASR |
$4,273.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,416.04
|
| Rate for Payer: BCN Commercial |
$3,416.04
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$4,141.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$4,406.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,273.91
|
| Rate for Payer: Mclaren Commercial |
$3,965.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,877.36
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,593.31 |
| Max. Negotiated Rate |
$5,133.30 |
| Rate for Payer: Aetna Commercial |
$4,619.97
|
| Rate for Payer: ASR ASR |
$4,979.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,979.85
|
| Rate for Payer: BCN Commercial |
$3,979.85
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$4,825.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Healthscope Commercial |
$5,133.30
|
| Rate for Payer: Healthscope Whirlpool |
$4,979.30
|
| Rate for Payer: Mclaren Commercial |
$4,619.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,517.30
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,053.32 |
| Max. Negotiated Rate |
$5,133.30 |
| Rate for Payer: Aetna Commercial |
$4,619.97
|
| Rate for Payer: ASR ASR |
$4,979.30
|
| Rate for Payer: BCBS Complete |
$2,053.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,979.85
|
| Rate for Payer: BCN Commercial |
$3,979.85
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$4,825.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Healthscope Commercial |
$5,133.30
|
| Rate for Payer: Healthscope Whirlpool |
$4,979.30
|
| Rate for Payer: Mclaren Commercial |
$4,619.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,671.30
|
| Rate for Payer: Priority Health Narrow Network |
$3,644.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,517.30
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,664.59
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,565.21 |
| Max. Negotiated Rate |
$3,664.59 |
| Rate for Payer: Aetna Commercial |
$3,298.13
|
| Rate for Payer: ASR ASR |
$3,554.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,841.16
|
| Rate for Payer: BCN Commercial |
$2,841.16
|
| Rate for Payer: Cash Price |
$2,931.67
|
| Rate for Payer: Cofinity Commercial |
$3,444.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.67
|
| Rate for Payer: Healthscope Commercial |
$3,664.59
|
| Rate for Payer: Healthscope Whirlpool |
$3,554.65
|
| Rate for Payer: Mclaren Commercial |
$3,298.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,114.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,224.84
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,664.59
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,465.84 |
| Max. Negotiated Rate |
$3,664.59 |
| Rate for Payer: Aetna Commercial |
$3,298.13
|
| Rate for Payer: ASR ASR |
$3,554.65
|
| Rate for Payer: BCBS Complete |
$1,465.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,841.16
|
| Rate for Payer: BCN Commercial |
$2,841.16
|
| Rate for Payer: Cash Price |
$2,931.67
|
| Rate for Payer: Cofinity Commercial |
$3,444.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.67
|
| Rate for Payer: Healthscope Commercial |
$3,664.59
|
| Rate for Payer: Healthscope Whirlpool |
$3,554.65
|
| Rate for Payer: Mclaren Commercial |
$3,298.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,114.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,334.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,601.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,224.84
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,500.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,400.01 |
| Max. Negotiated Rate |
$3,500.03 |
| Rate for Payer: Aetna Commercial |
$3,150.03
|
| Rate for Payer: ASR ASR |
$3,395.03
|
| Rate for Payer: BCBS Complete |
$1,400.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.57
|
| Rate for Payer: BCN Commercial |
$2,713.57
|
| Rate for Payer: Cash Price |
$2,800.02
|
| Rate for Payer: Cofinity Commercial |
$3,290.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.02
|
| Rate for Payer: Healthscope Commercial |
$3,500.03
|
| Rate for Payer: Healthscope Whirlpool |
$3,395.03
|
| Rate for Payer: Mclaren Commercial |
$3,150.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,185.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,485.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,080.03
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,500.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,450.02 |
| Max. Negotiated Rate |
$3,500.03 |
| Rate for Payer: Aetna Commercial |
$3,150.03
|
| Rate for Payer: ASR ASR |
$3,395.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.57
|
| Rate for Payer: BCN Commercial |
$2,713.57
|
| Rate for Payer: Cash Price |
$2,800.02
|
| Rate for Payer: Cofinity Commercial |
$3,290.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.02
|
| Rate for Payer: Healthscope Commercial |
$3,500.03
|
| Rate for Payer: Healthscope Whirlpool |
$3,395.03
|
| Rate for Payer: Mclaren Commercial |
$3,150.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,080.03
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
OP
|
$4,731.68
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,892.67 |
| Max. Negotiated Rate |
$4,731.68 |
| Rate for Payer: Aetna Commercial |
$4,258.51
|
| Rate for Payer: ASR ASR |
$4,589.73
|
| Rate for Payer: BCBS Complete |
$1,892.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,668.47
|
| Rate for Payer: BCN Commercial |
$3,668.47
|
| Rate for Payer: Cash Price |
$3,785.34
|
| Rate for Payer: Cofinity Commercial |
$4,447.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,785.34
|
| Rate for Payer: Healthscope Commercial |
$4,731.68
|
| Rate for Payer: Healthscope Whirlpool |
$4,589.73
|
| Rate for Payer: Mclaren Commercial |
$4,258.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,021.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,312.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,305.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,359.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,163.88
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
IP
|
$4,731.68
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,312.18 |
| Max. Negotiated Rate |
$4,731.68 |
| Rate for Payer: Aetna Commercial |
$4,258.51
|
| Rate for Payer: ASR ASR |
$4,589.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,668.47
|
| Rate for Payer: BCN Commercial |
$3,668.47
|
| Rate for Payer: Cash Price |
$3,785.34
|
| Rate for Payer: Cofinity Commercial |
$4,447.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,785.34
|
| Rate for Payer: Healthscope Commercial |
$4,731.68
|
| Rate for Payer: Healthscope Whirlpool |
$4,589.73
|
| Rate for Payer: Mclaren Commercial |
$4,258.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,021.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,312.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,163.88
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
IP
|
$2,175.64
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,522.95 |
| Max. Negotiated Rate |
$2,175.64 |
| Rate for Payer: Aetna Commercial |
$1,958.08
|
| Rate for Payer: ASR ASR |
$2,110.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.77
|
| Rate for Payer: BCN Commercial |
$1,686.77
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cofinity Commercial |
$2,045.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.51
|
| Rate for Payer: Healthscope Commercial |
$2,175.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,110.37
|
| Rate for Payer: Mclaren Commercial |
$1,958.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.56
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
OP
|
$2,175.64
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$2,175.64 |
| Rate for Payer: Aetna Commercial |
$1,958.08
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$2,110.37
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.77
|
| Rate for Payer: BCN Commercial |
$1,686.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cofinity Commercial |
$2,045.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$2,175.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,110.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$1,958.08
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.29
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,979.83
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$25.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Complete |
$14.63
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.47
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$13.93
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Medicaid |
$14.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.02
|
| Rate for Payer: PHP Medicaid |
$13.93
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.20
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$68.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Medicare Advantage |
$26.23
|
| Rate for Payer: VA VA |
$25.47
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
IP
|
$43.91
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$43.91 |
| Rate for Payer: Aetna Commercial |
$39.52
|
| Rate for Payer: ASR ASR |
$42.59
|
| Rate for Payer: BCBS Trust/PPO |
$34.04
|
| Rate for Payer: BCN Commercial |
$34.04
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.13
|
| Rate for Payer: Healthscope Commercial |
$43.91
|
| Rate for Payer: Healthscope Whirlpool |
$42.59
|
| Rate for Payer: Mclaren Commercial |
$39.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.64
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
OP
|
$43.91
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna Commercial |
$39.52
|
| Rate for Payer: Aetna Medicare |
$25.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: ASR ASR |
$42.59
|
| Rate for Payer: BCBS Complete |
$14.63
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$34.04
|
| Rate for Payer: BCN Commercial |
$34.04
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$43.91
|
| Rate for Payer: Healthscope Whirlpool |
$42.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.47
|
| Rate for Payer: Mclaren Commercial |
$39.52
|
| Rate for Payer: Mclaren Medicaid |
$13.93
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Medicaid |
$14.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.32
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.02
|
| Rate for Payer: PHP Medicaid |
$13.93
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.20
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$68.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.64
|
| Rate for Payer: UHC Medicare Advantage |
$26.23
|
| Rate for Payer: VA VA |
$25.47
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: ASR ASR |
$77.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.02
|
| Rate for Payer: BCN Commercial |
$62.02
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$75.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$80.00
|
| Rate for Payer: Healthscope Whirlpool |
$77.60
|
| Rate for Payer: Mclaren Commercial |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.40
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$51.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.10
|
| Rate for Payer: ASR ASR |
$77.60
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$51.28
|
| Rate for Payer: BCBS Trust/PPO |
$62.02
|
| Rate for Payer: BCN Commercial |
$62.02
|
| Rate for Payer: BCN Medicare Advantage |
$51.28
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$75.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.28
|
| Rate for Payer: Healthscope Commercial |
$80.00
|
| Rate for Payer: Healthscope Whirlpool |
$77.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.28
|
| Rate for Payer: Mclaren Commercial |
$72.00
|
| Rate for Payer: Mclaren Medicaid |
$28.05
|
| Rate for Payer: Mclaren Medicare |
$51.28
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PACE Medicare |
$48.72
|
| Rate for Payer: PACE SWMI |
$51.28
|
| Rate for Payer: PHP Commercial |
$56.41
|
| Rate for Payer: PHP Medicaid |
$28.05
|
| Rate for Payer: PHP Medicare Advantage |
$51.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.80
|
| Rate for Payer: Priority Health Medicare |
$51.28
|
| Rate for Payer: Priority Health Narrow Network |
$56.80
|
| Rate for Payer: Railroad Medicare Medicare |
$51.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$52.82
|
| Rate for Payer: VA VA |
$51.28
|
|
|
HC TESTOSTERONE LEVEL
|
Facility
|
IP
|
$85.13
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100430
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.59 |
| Max. Negotiated Rate |
$85.13 |
| Rate for Payer: Aetna Commercial |
$76.62
|
| Rate for Payer: ASR ASR |
$82.58
|
| Rate for Payer: BCBS Trust/PPO |
$66.00
|
| Rate for Payer: BCN Commercial |
$66.00
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$80.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Healthscope Commercial |
$85.13
|
| Rate for Payer: Healthscope Whirlpool |
$82.58
|
| Rate for Payer: Mclaren Commercial |
$76.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.91
|
|
|
HC TESTOSTERONE LEVEL
|
Facility
|
OP
|
$85.13
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100430
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$85.13 |
| Rate for Payer: Aetna Commercial |
$76.62
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: ASR ASR |
$82.58
|
| Rate for Payer: BCBS Complete |
$14.83
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$66.00
|
| Rate for Payer: BCN Commercial |
$66.00
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$80.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$85.13
|
| Rate for Payer: Healthscope Whirlpool |
$82.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.81
|
| Rate for Payer: Mclaren Commercial |
$76.62
|
| Rate for Payer: Mclaren Medicaid |
$14.12
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Medicaid |
$14.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.36
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$28.39
|
| Rate for Payer: PHP Medicaid |
$14.12
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.91
|
| Rate for Payer: UHC Medicare Advantage |
$26.58
|
| Rate for Payer: VA VA |
$25.81
|
|
