|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$18,046.39
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,534.79 |
| Max. Negotiated Rate |
$18,046.39 |
| Rate for Payer: Aetna Commercial |
$16,241.75
|
| Rate for Payer: ASR ASR |
$17,505.00
|
| Rate for Payer: BCBS Trust/PPO |
$14,819.70
|
| Rate for Payer: BCN Commercial |
$14,819.70
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cofinity Commercial |
$16,963.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,437.11
|
| Rate for Payer: Healthscope Commercial |
$17,505.00
|
| Rate for Payer: Healthscope Whirlpool |
$18,046.39
|
| Rate for Payer: Mclaren Commercial |
$16,241.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,339.43
|
| Rate for Payer: Nomi Health Commercial |
$14,798.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,534.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,880.82
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$28,657.20 |
| Rate for Payer: Aetna Commercial |
$25,791.48
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$27,797.48
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$23,627.86
|
| Rate for Payer: BCN Commercial |
$23,627.86
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Commercial |
$26,937.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$27,797.48
|
| Rate for Payer: Healthscope Whirlpool |
$28,657.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$25,791.48
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Nomi Health Commercial |
$23,498.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25,109.44
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$20,088.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,218.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,492.90 |
| Max. Negotiated Rate |
$28,657.20 |
| Rate for Payer: Aetna Commercial |
$25,791.48
|
| Rate for Payer: ASR ASR |
$27,797.48
|
| Rate for Payer: BCBS Trust/PPO |
$23,533.29
|
| Rate for Payer: BCN Commercial |
$23,533.29
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Commercial |
$26,937.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Healthscope Commercial |
$27,797.48
|
| Rate for Payer: Healthscope Whirlpool |
$28,657.20
|
| Rate for Payer: Mclaren Commercial |
$25,791.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Nomi Health Commercial |
$23,498.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,218.34
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.96
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$12.56
|
| Rate for Payer: ASR ASR |
$13.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$11.46
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.54
|
| Rate for Payer: Healthscope Whirlpool |
$13.96
|
| Rate for Payer: Mclaren Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.96
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$12.56
|
| Rate for Payer: Aetna Medicare |
$5.17
|
| Rate for Payer: ASR ASR |
$13.54
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.51
|
| Rate for Payer: BCN Commercial |
$11.51
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.54
|
| Rate for Payer: Healthscope Whirlpool |
$13.96
|
| Rate for Payer: Mclaren Commercial |
$12.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.23
|
| Rate for Payer: Priority Health Narrow Network |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,628.79
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$5,120.49 |
| Rate for Payer: Aetna Commercial |
$4,165.91
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| 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: ASR ASR |
$4,489.93
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,816.44
|
| Rate for Payer: BCN Commercial |
$3,816.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$3,703.03
|
| Rate for Payer: Cash Price |
$3,703.03
|
| Rate for Payer: Cofinity Commercial |
$4,351.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,703.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$4,489.93
|
| Rate for Payer: Healthscope Whirlpool |
$4,628.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$4,165.91
|
| Rate for Payer: Mclaren Medicaid |
$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 Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,934.47
|
| Rate for Payer: Nomi Health Commercial |
$3,795.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,471.59
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,055.75
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$3,244.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,073.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,628.79
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,471.59 |
| Max. Negotiated Rate |
$4,628.79 |
| Rate for Payer: Aetna Commercial |
$4,165.91
|
| Rate for Payer: ASR ASR |
$4,489.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,801.16
|
| Rate for Payer: BCN Commercial |
$3,801.16
|
| Rate for Payer: Cash Price |
$3,703.03
|
| Rate for Payer: Cofinity Commercial |
$4,351.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,703.03
|
| Rate for Payer: Healthscope Commercial |
$4,489.93
|
| Rate for Payer: Healthscope Whirlpool |
$4,628.79
|
| Rate for Payer: Mclaren Commercial |
$4,165.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,934.47
|
| Rate for Payer: Nomi Health Commercial |
$3,795.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,471.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,073.34
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
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
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
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 PERFUSION OPEN HEART
|
Facility
|
OP
|
$6,656.19
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,462.79 |
| Max. Negotiated Rate |
$6,656.19 |
| Rate for Payer: Aetna Commercial |
$5,990.57
|
| Rate for Payer: Aetna Medicare |
$2,462.79
|
| Rate for Payer: ASR ASR |
$6,456.50
|
| Rate for Payer: BCBS Complete |
$2,662.48
|
| Rate for Payer: BCBS Trust/PPO |
$5,488.03
|
| Rate for Payer: BCN Commercial |
$5,488.03
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$6,256.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Healthscope Commercial |
$6,456.50
|
| Rate for Payer: Healthscope Whirlpool |
$6,656.19
|
| Rate for Payer: Mclaren Commercial |
$5,990.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,324.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,832.15
|
| Rate for Payer: Priority Health Narrow Network |
$4,665.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,857.45
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
IP
|
$6,656.19
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,992.14 |
| Max. Negotiated Rate |
$6,656.19 |
| Rate for Payer: Aetna Commercial |
$5,990.57
|
| Rate for Payer: ASR ASR |
$6,456.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,466.06
|
| Rate for Payer: BCN Commercial |
$5,466.06
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$6,256.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Healthscope Commercial |
$6,456.50
|
| Rate for Payer: Healthscope Whirlpool |
$6,656.19
|
| Rate for Payer: Mclaren Commercial |
$5,990.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,857.45
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
OP
|
$2,596.18
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,596.18 |
| Rate for Payer: Aetna Commercial |
$2,336.56
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$2,518.29
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.55
|
| Rate for Payer: BCN Commercial |
$2,140.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$2,076.94
|
| Rate for Payer: Cash Price |
$2,076.94
|
| Rate for Payer: Cofinity Commercial |
$2,440.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,076.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$2,518.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$2,336.56
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.75
|
| Rate for Payer: Nomi Health Commercial |
$2,128.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.13
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,058.67
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,646.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,596.18
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,947.13 |
| Max. Negotiated Rate |
$2,596.18 |
| Rate for Payer: Aetna Commercial |
$2,336.56
|
| Rate for Payer: ASR ASR |
$2,518.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,131.98
|
| Rate for Payer: BCN Commercial |
$2,131.98
|
| Rate for Payer: Cash Price |
$2,076.94
|
| Rate for Payer: Cofinity Commercial |
$2,440.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,076.94
|
| Rate for Payer: Healthscope Commercial |
$2,518.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,596.18
|
| Rate for Payer: Mclaren Commercial |
$2,336.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.75
|
| Rate for Payer: Nomi Health Commercial |
$2,128.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.64
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
IP
|
$105.30
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$78.97 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Commercial |
$94.77
|
| Rate for Payer: ASR ASR |
$102.14
|
| Rate for Payer: BCBS Trust/PPO |
$86.47
|
| Rate for Payer: BCN Commercial |
$86.47
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$98.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.24
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Healthscope Whirlpool |
$105.30
|
| Rate for Payer: Mclaren Commercial |
$94.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.50
|
| Rate for Payer: Nomi Health Commercial |
$86.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.66
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$105.30
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Commercial |
$94.77
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$102.14
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$86.82
|
| Rate for Payer: BCN Commercial |
$86.82
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$98.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Healthscope Whirlpool |
$105.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$94.77
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.50
|
| Rate for Payer: Nomi Health Commercial |
$86.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.97
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.26
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$73.82
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
IP
|
$289.51
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$217.13 |
| Max. Negotiated Rate |
$289.51 |
| Rate for Payer: Aetna Commercial |
$260.56
|
| Rate for Payer: ASR ASR |
$280.82
|
| Rate for Payer: BCBS Trust/PPO |
$237.75
|
| Rate for Payer: BCN Commercial |
$237.75
|
| Rate for Payer: Cash Price |
$231.61
|
| Rate for Payer: Cofinity Commercial |
$272.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.61
|
| Rate for Payer: Healthscope Commercial |
$280.82
|
| Rate for Payer: Healthscope Whirlpool |
$289.51
|
| Rate for Payer: Mclaren Commercial |
$260.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.08
|
| Rate for Payer: Nomi Health Commercial |
$237.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.77
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
OP
|
$289.51
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.12 |
| Max. Negotiated Rate |
$289.51 |
| Rate for Payer: Aetna Commercial |
$260.56
|
| Rate for Payer: Aetna Medicare |
$107.12
|
| Rate for Payer: ASR ASR |
$280.82
|
| Rate for Payer: BCBS Complete |
$115.80
|
| Rate for Payer: BCBS Trust/PPO |
$238.70
|
| Rate for Payer: BCN Commercial |
$238.70
|
| Rate for Payer: Cash Price |
$231.61
|
| Rate for Payer: Cofinity Commercial |
$272.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.61
|
| Rate for Payer: Healthscope Commercial |
$280.82
|
| Rate for Payer: Healthscope Whirlpool |
$289.51
|
| Rate for Payer: Mclaren Commercial |
$260.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.08
|
| Rate for Payer: Nomi Health Commercial |
$237.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$253.67
|
| Rate for Payer: Priority Health Narrow Network |
$202.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.77
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
OP
|
$697.98
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.25 |
| Max. Negotiated Rate |
$697.98 |
| Rate for Payer: Aetna Commercial |
$628.18
|
| Rate for Payer: Aetna Medicare |
$258.25
|
| Rate for Payer: ASR ASR |
$677.04
|
| Rate for Payer: BCBS Complete |
$279.19
|
| Rate for Payer: BCBS Trust/PPO |
$575.48
|
| Rate for Payer: BCN Commercial |
$575.48
|
| Rate for Payer: Cash Price |
$558.38
|
| Rate for Payer: Cofinity Commercial |
$656.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.38
|
| Rate for Payer: Healthscope Commercial |
$677.04
|
| Rate for Payer: Healthscope Whirlpool |
$697.98
|
| Rate for Payer: Mclaren Commercial |
$628.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$558.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.28
|
| Rate for Payer: Nomi Health Commercial |
$572.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$611.57
|
| Rate for Payer: Priority Health Narrow Network |
$489.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$614.22
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
IP
|
$697.98
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$523.49 |
| Max. Negotiated Rate |
$697.98 |
| Rate for Payer: Aetna Commercial |
$628.18
|
| Rate for Payer: ASR ASR |
$677.04
|
| Rate for Payer: BCBS Trust/PPO |
$573.18
|
| Rate for Payer: BCN Commercial |
$573.18
|
| Rate for Payer: Cash Price |
$558.38
|
| Rate for Payer: Cofinity Commercial |
$656.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.38
|
| Rate for Payer: Healthscope Commercial |
$677.04
|
| Rate for Payer: Healthscope Whirlpool |
$697.98
|
| Rate for Payer: Mclaren Commercial |
$628.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.28
|
| Rate for Payer: Nomi Health Commercial |
$572.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$614.22
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
OP
|
$976.17
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$217.44 |
| Max. Negotiated Rate |
$976.17 |
| Rate for Payer: Aetna Commercial |
$878.55
|
| Rate for Payer: Aetna Medicare |
$415.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.70
|
| Rate for Payer: ASR ASR |
$946.88
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS MAPPO |
$415.76
|
| Rate for Payer: BCBS Trust/PPO |
$804.85
|
| Rate for Payer: BCN Commercial |
$804.85
|
| Rate for Payer: BCN Medicare Advantage |
$415.76
|
| Rate for Payer: Cash Price |
$780.94
|
| Rate for Payer: Cash Price |
$780.94
|
| Rate for Payer: Cofinity Commercial |
$917.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.76
|
| Rate for Payer: Healthscope Commercial |
$946.88
|
| Rate for Payer: Healthscope Whirlpool |
$976.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$415.76
|
| Rate for Payer: Mclaren Commercial |
$878.55
|
| Rate for Payer: Mclaren Medicaid |
$415.76
|
| Rate for Payer: Mclaren Medicare |
$415.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.55
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$478.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.74
|
| Rate for Payer: Nomi Health Commercial |
$800.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.13
|
| Rate for Payer: PACE Medicare |
$394.97
|
| Rate for Payer: PACE SWMI |
$415.76
|
| Rate for Payer: PHP Commercial |
$457.34
|
| Rate for Payer: PHP Medicaid |
$222.85
|
| Rate for Payer: PHP Medicare Advantage |
$415.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$855.32
|
| Rate for Payer: Priority Health Medicare |
$415.76
|
| Rate for Payer: Priority Health Narrow Network |
$684.30
|
| Rate for Payer: Railroad Medicare Medicare |
$415.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$415.76
|
| Rate for Payer: UHC Exchange |
$644.43
|
| Rate for Payer: UHC Medicaid |
$217.44
|
| Rate for Payer: UHCCP DNSP |
$415.76
|
| Rate for Payer: UHCCP Medicaid |
$217.44
|
| Rate for Payer: VA VA |
$415.76
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
IP
|
$976.17
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$732.13 |
| Max. Negotiated Rate |
$976.17 |
| Rate for Payer: Aetna Commercial |
$878.55
|
| Rate for Payer: ASR ASR |
$946.88
|
| Rate for Payer: BCBS Trust/PPO |
$801.63
|
| Rate for Payer: BCN Commercial |
$801.63
|
| Rate for Payer: Cash Price |
$780.94
|
| Rate for Payer: Cofinity Commercial |
$917.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.94
|
| Rate for Payer: Healthscope Commercial |
$946.88
|
| Rate for Payer: Healthscope Whirlpool |
$976.17
|
| Rate for Payer: Mclaren Commercial |
$878.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.74
|
| Rate for Payer: Nomi Health Commercial |
$800.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.03
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
IP
|
$721.55
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$541.16 |
| Max. Negotiated Rate |
$721.55 |
| Rate for Payer: Aetna Commercial |
$649.39
|
| Rate for Payer: ASR ASR |
$699.90
|
| Rate for Payer: BCBS Trust/PPO |
$592.54
|
| Rate for Payer: BCN Commercial |
$592.54
|
| Rate for Payer: Cash Price |
$577.24
|
| Rate for Payer: Cofinity Commercial |
$678.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.24
|
| Rate for Payer: Healthscope Commercial |
$699.90
|
| Rate for Payer: Healthscope Whirlpool |
$721.55
|
| Rate for Payer: Mclaren Commercial |
$649.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.32
|
| Rate for Payer: Nomi Health Commercial |
$591.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$541.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$634.96
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
OP
|
$721.55
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$266.97 |
| Max. Negotiated Rate |
$721.55 |
| Rate for Payer: Aetna Commercial |
$649.39
|
| Rate for Payer: Aetna Medicare |
$266.97
|
| Rate for Payer: ASR ASR |
$699.90
|
| Rate for Payer: BCBS Complete |
$288.62
|
| Rate for Payer: BCBS Trust/PPO |
$594.92
|
| Rate for Payer: BCN Commercial |
$594.92
|
| Rate for Payer: Cash Price |
$577.24
|
| Rate for Payer: Cofinity Commercial |
$678.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.24
|
| Rate for Payer: Healthscope Commercial |
$699.90
|
| Rate for Payer: Healthscope Whirlpool |
$721.55
|
| Rate for Payer: Mclaren Commercial |
$649.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$577.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.32
|
| Rate for Payer: Nomi Health Commercial |
$591.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$541.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$632.22
|
| Rate for Payer: Priority Health Narrow Network |
$505.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$634.96
|
|
|
HC PERITONEOGRAM
|
Facility
|
OP
|
$580.04
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$843.90 |
| Rate for Payer: Aetna Commercial |
$522.04
|
| Rate for Payer: Aetna Medicare |
$544.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: ASR ASR |
$562.64
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$478.24
|
| Rate for Payer: BCN Commercial |
$478.24
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$464.03
|
| Rate for Payer: Cash Price |
$464.03
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$562.64
|
| Rate for Payer: Healthscope Whirlpool |
$580.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$544.45
|
| Rate for Payer: Mclaren Commercial |
$522.04
|
| Rate for Payer: Mclaren Medicaid |
$544.45
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.03
|
| Rate for Payer: Nomi Health Commercial |
$475.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.03
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$598.89
|
| Rate for Payer: PHP Medicaid |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$508.23
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health Narrow Network |
$406.61
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$510.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$843.90
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP DNSP |
$544.45
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: VA VA |
$544.45
|
|
|
HC PERITONEOGRAM
|
Facility
|
IP
|
$580.04
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$435.03 |
| Max. Negotiated Rate |
$580.04 |
| Rate for Payer: Aetna Commercial |
$522.04
|
| Rate for Payer: ASR ASR |
$562.64
|
| Rate for Payer: BCBS Trust/PPO |
$476.33
|
| Rate for Payer: BCN Commercial |
$476.33
|
| Rate for Payer: Cash Price |
$464.03
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.03
|
| Rate for Payer: Healthscope Commercial |
$562.64
|
| Rate for Payer: Healthscope Whirlpool |
$580.04
|
| Rate for Payer: Mclaren Commercial |
$522.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.03
|
| Rate for Payer: Nomi Health Commercial |
$475.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$510.44
|
|
