|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,103.27
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.88 |
| Max. Negotiated Rate |
$1,103.27 |
| Rate for Payer: Aetna Commercial |
$992.94
|
| Rate for Payer: Aetna Medicare |
$177.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: ASR ASR |
$1,070.17
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$855.37
|
| Rate for Payer: BCN Commercial |
$855.37
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cofinity Commercial |
$1,037.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$1,103.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,070.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.12
|
| Rate for Payer: Mclaren Commercial |
$992.94
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.78
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$194.83
|
| Rate for Payer: PHP Medicaid |
$96.88
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.98
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$783.32
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.88
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: VA VA |
$177.12
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
IP
|
$1,103.27
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$772.29 |
| Max. Negotiated Rate |
$1,103.27 |
| Rate for Payer: Aetna Commercial |
$992.94
|
| Rate for Payer: ASR ASR |
$1,070.17
|
| Rate for Payer: BCBS Trust/PPO |
$855.37
|
| Rate for Payer: BCN Commercial |
$855.37
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cofinity Commercial |
$1,037.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.62
|
| Rate for Payer: Healthscope Commercial |
$1,103.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,070.17
|
| Rate for Payer: Mclaren Commercial |
$992.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.88
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
IP
|
$712.41
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.69 |
| Max. Negotiated Rate |
$712.41 |
| Rate for Payer: Aetna Commercial |
$641.17
|
| Rate for Payer: ASR ASR |
$691.04
|
| Rate for Payer: BCBS Trust/PPO |
$552.33
|
| Rate for Payer: BCN Commercial |
$552.33
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cofinity Commercial |
$669.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.93
|
| Rate for Payer: Healthscope Commercial |
$712.41
|
| Rate for Payer: Healthscope Whirlpool |
$691.04
|
| Rate for Payer: Mclaren Commercial |
$641.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.92
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
OP
|
$712.41
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$712.41 |
| Rate for Payer: Aetna Commercial |
$641.17
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$691.04
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$552.33
|
| Rate for Payer: BCN Commercial |
$552.33
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cofinity Commercial |
$669.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$712.41
|
| Rate for Payer: Healthscope Whirlpool |
$691.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$641.17
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.55
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$648.29
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$505.81
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.92
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$503.94
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.12
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$238.83
|
| Rate for Payer: PHP Medicaid |
$118.76
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$591.50
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$461.50
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.00 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: BCBS Trust/PPO |
$503.94
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
IP
|
$2,847.42
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,993.19 |
| Max. Negotiated Rate |
$2,847.42 |
| Rate for Payer: Aetna Commercial |
$2,562.68
|
| Rate for Payer: ASR ASR |
$2,762.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,207.60
|
| Rate for Payer: BCN Commercial |
$2,207.60
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cofinity Commercial |
$2,676.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,277.94
|
| Rate for Payer: Healthscope Commercial |
$2,847.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,762.00
|
| Rate for Payer: Mclaren Commercial |
$2,562.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,420.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,993.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,505.73
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
OP
|
$2,847.42
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$2,847.42 |
| Rate for Payer: Aetna Commercial |
$2,562.68
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$2,762.00
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,207.60
|
| Rate for Payer: BCN Commercial |
$2,207.60
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cofinity Commercial |
$2,676.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,277.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$2,847.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,762.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$2,562.68
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,420.31
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,993.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,591.15
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,021.67
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,505.73
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
IP
|
$448.01
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.61 |
| Max. Negotiated Rate |
$448.01 |
| Rate for Payer: Aetna Commercial |
$403.21
|
| Rate for Payer: ASR ASR |
$434.57
|
| Rate for Payer: BCBS Trust/PPO |
$347.34
|
| Rate for Payer: BCN Commercial |
$347.34
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cofinity Commercial |
$421.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.41
|
| Rate for Payer: Healthscope Commercial |
$448.01
|
| Rate for Payer: Healthscope Whirlpool |
$434.57
|
| Rate for Payer: Mclaren Commercial |
$403.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.25
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
OP
|
$448.01
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$448.01 |
| Rate for Payer: Aetna Commercial |
$403.21
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$434.57
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$347.34
|
| Rate for Payer: BCN Commercial |
$347.34
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cofinity Commercial |
$421.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$448.01
|
| Rate for Payer: Healthscope Whirlpool |
$434.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$403.21
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.81
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.69
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$318.09
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.25
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC UNNA BOOT
|
Facility
|
IP
|
$360.06
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
42000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$252.04 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$324.05
|
| Rate for Payer: ASR ASR |
$349.26
|
| Rate for Payer: BCBS Trust/PPO |
$279.15
|
| Rate for Payer: BCN Commercial |
$279.15
|
| Rate for Payer: Cash Price |
$288.05
|
| Rate for Payer: Cofinity Commercial |
$338.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.05
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Healthscope Whirlpool |
$349.26
|
| Rate for Payer: Mclaren Commercial |
$324.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.85
|
|
|
HC UNNA BOOT
|
Facility
|
OP
|
$360.06
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
42000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$324.05
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$349.26
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$279.15
|
| Rate for Payer: BCN Commercial |
$279.15
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$288.05
|
| Rate for Payer: Cash Price |
$288.05
|
| Rate for Payer: Cofinity Commercial |
$338.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Healthscope Whirlpool |
$349.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$324.05
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.05
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.03
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$126.42
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.85
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC UPGRADE PACEMAKER
|
Facility
|
OP
|
$8,845.22
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
36100063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,191.95 |
| Max. Negotiated Rate |
$11,864.60 |
| Rate for Payer: Aetna Commercial |
$7,960.70
|
| Rate for Payer: Aetna Medicare |
$9,491.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
| Rate for Payer: ASR ASR |
$8,579.86
|
| Rate for Payer: BCBS Complete |
$5,452.02
|
| Rate for Payer: BCBS MAPPO |
$9,491.68
|
| Rate for Payer: BCBS Trust/PPO |
$6,857.70
|
| Rate for Payer: BCN Commercial |
$6,857.70
|
| Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
| Rate for Payer: Cash Price |
$7,076.18
|
| Rate for Payer: Cash Price |
$7,076.18
|
| Rate for Payer: Cofinity Commercial |
$8,314.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,076.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
| Rate for Payer: Healthscope Commercial |
$8,845.22
|
| Rate for Payer: Healthscope Whirlpool |
$8,579.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,491.68
|
| Rate for Payer: Mclaren Commercial |
$7,960.70
|
| Rate for Payer: Mclaren Medicaid |
$5,191.95
|
| Rate for Payer: Mclaren Medicare |
$9,491.68
|
| Rate for Payer: Meridian Medicaid |
$5,452.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,518.44
|
| Rate for Payer: PACE Medicare |
$9,017.10
|
| Rate for Payer: PACE SWMI |
$9,491.68
|
| Rate for Payer: PHP Commercial |
$10,440.85
|
| Rate for Payer: PHP Medicaid |
$5,191.95
|
| Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,191.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,049.15
|
| Rate for Payer: Priority Health Medicare |
$9,491.68
|
| Rate for Payer: Priority Health Narrow Network |
$6,280.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,783.79
|
| Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
| Rate for Payer: VA VA |
$9,491.68
|
|
|
HC UPGRADE PACEMAKER
|
Facility
|
IP
|
$8,845.22
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
36100063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,191.65 |
| Max. Negotiated Rate |
$8,845.22 |
| Rate for Payer: Aetna Commercial |
$7,960.70
|
| Rate for Payer: ASR ASR |
$8,579.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,857.70
|
| Rate for Payer: BCN Commercial |
$6,857.70
|
| Rate for Payer: Cash Price |
$7,076.18
|
| Rate for Payer: Cofinity Commercial |
$8,314.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,076.18
|
| Rate for Payer: Healthscope Commercial |
$8,845.22
|
| Rate for Payer: Healthscope Whirlpool |
$8,579.86
|
| Rate for Payer: Mclaren Commercial |
$7,960.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,518.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,191.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,783.79
|
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
IP
|
$4,556.67
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
36100069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,189.67 |
| Max. Negotiated Rate |
$4,556.67 |
| Rate for Payer: Aetna Commercial |
$4,101.00
|
| Rate for Payer: ASR ASR |
$4,419.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,532.79
|
| Rate for Payer: BCN Commercial |
$3,532.79
|
| Rate for Payer: Cash Price |
$3,645.34
|
| Rate for Payer: Cofinity Commercial |
$4,283.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.34
|
| Rate for Payer: Healthscope Commercial |
$4,556.67
|
| Rate for Payer: Healthscope Whirlpool |
$4,419.97
|
| Rate for Payer: Mclaren Commercial |
$4,101.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,873.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,189.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,009.87
|
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
OP
|
$4,556.67
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
36100069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,189.67 |
| Max. Negotiated Rate |
$11,864.60 |
| Rate for Payer: Aetna Commercial |
$4,101.00
|
| Rate for Payer: Aetna Medicare |
$9,491.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
| Rate for Payer: ASR ASR |
$4,419.97
|
| Rate for Payer: BCBS Complete |
$5,452.02
|
| Rate for Payer: BCBS MAPPO |
$9,491.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,532.79
|
| Rate for Payer: BCN Commercial |
$3,532.79
|
| Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
| Rate for Payer: Cash Price |
$3,645.34
|
| Rate for Payer: Cash Price |
$3,645.34
|
| Rate for Payer: Cofinity Commercial |
$4,283.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
| Rate for Payer: Healthscope Commercial |
$4,556.67
|
| Rate for Payer: Healthscope Whirlpool |
$4,419.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,491.68
|
| Rate for Payer: Mclaren Commercial |
$4,101.00
|
| Rate for Payer: Mclaren Medicaid |
$5,191.95
|
| Rate for Payer: Mclaren Medicare |
$9,491.68
|
| Rate for Payer: Meridian Medicaid |
$5,452.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,873.17
|
| Rate for Payer: PACE Medicare |
$9,017.10
|
| Rate for Payer: PACE SWMI |
$9,491.68
|
| Rate for Payer: PHP Commercial |
$10,440.85
|
| Rate for Payer: PHP Medicaid |
$5,191.95
|
| Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,189.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,146.57
|
| Rate for Payer: Priority Health Medicare |
$9,491.68
|
| Rate for Payer: Priority Health Narrow Network |
$3,235.24
|
| Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,009.87
|
| Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
| Rate for Payer: VA VA |
$9,491.68
|
|
|
HC UREA NITROGEN BUN
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC UREA NITROGEN BUN
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$3.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.27
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.95
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.16
|
| Rate for Payer: Mclaren Medicare |
$3.95
|
| Rate for Payer: Meridian Medicaid |
$2.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: PHP Medicaid |
$2.16
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.95
|
| Rate for Payer: Priority Health Medicare |
$3.95
|
| Rate for Payer: Priority Health Narrow Network |
$14.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$4.07
|
| Rate for Payer: VA VA |
$3.95
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$5.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.95
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: BCBS Complete |
$3.19
|
| Rate for Payer: BCBS MAPPO |
$5.56
|
| Rate for Payer: BCBS Trust/PPO |
$29.97
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$5.56
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.56
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.56
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$3.04
|
| Rate for Payer: Mclaren Medicare |
$5.56
|
| Rate for Payer: Meridian Medicaid |
$3.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.86
|
| Rate for Payer: PACE Medicare |
$5.28
|
| Rate for Payer: PACE SWMI |
$5.56
|
| Rate for Payer: PHP Commercial |
$6.12
|
| Rate for Payer: PHP Medicaid |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.18
|
| Rate for Payer: Priority Health Medicare |
$5.56
|
| Rate for Payer: Priority Health Narrow Network |
$27.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.73
|
| Rate for Payer: VA VA |
$5.56
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$29.97
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC UREAPLASMA PCR
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600301
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$84.27 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| 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 |
$81.74
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$65.33
|
| Rate for Payer: BCN Commercial |
$65.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$84.27
|
| Rate for Payer: Healthscope Whirlpool |
$81.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.63
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.69
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.83
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC UREAPLASMA PCR
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600301
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.99 |
| Max. Negotiated Rate |
$84.27 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| Rate for Payer: ASR ASR |
$81.74
|
| Rate for Payer: BCBS Trust/PPO |
$65.33
|
| Rate for Payer: BCN Commercial |
$65.33
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$84.27
|
| Rate for Payer: Healthscope Whirlpool |
$81.74
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
IP
|
$58.77
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600302
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.14 |
| Max. Negotiated Rate |
$58.77 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: ASR ASR |
$57.01
|
| Rate for Payer: BCBS Trust/PPO |
$45.56
|
| Rate for Payer: BCN Commercial |
$45.56
|
| Rate for Payer: Cash Price |
$47.02
|
| Rate for Payer: Cofinity Commercial |
$55.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.02
|
| Rate for Payer: Healthscope Commercial |
$58.77
|
| Rate for Payer: Healthscope Whirlpool |
$57.01
|
| Rate for Payer: Mclaren Commercial |
$52.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.72
|
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
OP
|
$58.77
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600302
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$58.77 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| 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 |
$57.01
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$45.56
|
| Rate for Payer: BCN Commercial |
$45.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$47.02
|
| Rate for Payer: Cash Price |
$47.02
|
| Rate for Payer: Cofinity Commercial |
$55.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$58.77
|
| Rate for Payer: Healthscope Whirlpool |
$57.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$52.89
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.95
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.48
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$41.73
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.72
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$349.74
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$244.82 |
| Max. Negotiated Rate |
$349.74 |
| Rate for Payer: Aetna Commercial |
$314.77
|
| Rate for Payer: ASR ASR |
$339.25
|
| Rate for Payer: BCBS Trust/PPO |
$271.15
|
| Rate for Payer: BCN Commercial |
$271.15
|
| Rate for Payer: Cash Price |
$279.79
|
| Rate for Payer: Cofinity Commercial |
$328.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.79
|
| Rate for Payer: Healthscope Commercial |
$349.74
|
| Rate for Payer: Healthscope Whirlpool |
$339.25
|
| Rate for Payer: Mclaren Commercial |
$314.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$307.77
|
|
