|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
IP
|
$1,591.81
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,193.86 |
| Max. Negotiated Rate |
$1,591.81 |
| Rate for Payer: Aetna Commercial |
$1,432.63
|
| Rate for Payer: ASR ASR |
$1,544.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.19
|
| Rate for Payer: BCN Commercial |
$1,307.19
|
| Rate for Payer: Cash Price |
$1,273.45
|
| Rate for Payer: Cofinity Commercial |
$1,496.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.45
|
| Rate for Payer: Healthscope Commercial |
$1,544.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,591.81
|
| Rate for Payer: Mclaren Commercial |
$1,432.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.04
|
| Rate for Payer: Nomi Health Commercial |
$1,305.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,193.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.79
|
|
|
HC PIGWEED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PIGWEED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PI LINKED ANTIGEN
|
Facility
|
IP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$153.71 |
| Max. Negotiated Rate |
$204.94 |
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: ASR ASR |
$198.79
|
| Rate for Payer: BCBS Trust/PPO |
$168.30
|
| Rate for Payer: BCN Commercial |
$168.30
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Healthscope Whirlpool |
$204.94
|
| Rate for Payer: Mclaren Commercial |
$184.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.35
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
OP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.31 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$198.79
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$168.97
|
| Rate for Payer: BCN Commercial |
$168.97
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Healthscope Whirlpool |
$204.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$184.45
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
IP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$153.71 |
| Max. Negotiated Rate |
$204.94 |
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: ASR ASR |
$198.79
|
| Rate for Payer: BCBS Trust/PPO |
$168.30
|
| Rate for Payer: BCN Commercial |
$168.30
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Healthscope Whirlpool |
$204.94
|
| Rate for Payer: Mclaren Commercial |
$184.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.35
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
OP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.31 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$184.45
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$198.79
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$168.97
|
| Rate for Payer: BCN Commercial |
$168.97
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Healthscope Whirlpool |
$204.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$184.45
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
OP
|
$64.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$65.38 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: ASR ASR |
$62.90
|
| Rate for Payer: BCBS Complete |
$25.94
|
| Rate for Payer: BCBS Trust/PPO |
$53.47
|
| Rate for Payer: BCN Commercial |
$53.47
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$60.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.88
|
| Rate for Payer: Healthscope Commercial |
$62.90
|
| Rate for Payer: Healthscope Whirlpool |
$64.85
|
| Rate for Payer: Mclaren Commercial |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.12
|
| Rate for Payer: Nomi Health Commercial |
$53.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.07
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
IP
|
$64.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.64 |
| Max. Negotiated Rate |
$64.85 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: ASR ASR |
$62.90
|
| Rate for Payer: BCBS Trust/PPO |
$53.25
|
| Rate for Payer: BCN Commercial |
$53.25
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$60.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.88
|
| Rate for Payer: Healthscope Commercial |
$62.90
|
| Rate for Payer: Healthscope Whirlpool |
$64.85
|
| Rate for Payer: Mclaren Commercial |
$58.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.12
|
| Rate for Payer: Nomi Health Commercial |
$53.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.07
|
|
|
HC PINWORM EXAM
|
Facility
|
IP
|
$56.60
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.45 |
| Max. Negotiated Rate |
$56.60 |
| Rate for Payer: Aetna Commercial |
$50.94
|
| Rate for Payer: ASR ASR |
$54.90
|
| Rate for Payer: BCBS Trust/PPO |
$46.48
|
| Rate for Payer: BCN Commercial |
$46.48
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.28
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Healthscope Whirlpool |
$56.60
|
| Rate for Payer: Mclaren Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.11
|
| Rate for Payer: Nomi Health Commercial |
$46.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.81
|
|
|
HC PINWORM EXAM
|
Facility
|
OP
|
$56.60
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$56.60 |
| Rate for Payer: Aetna Commercial |
$50.94
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$54.90
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$46.67
|
| Rate for Payer: BCN Commercial |
$46.67
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Healthscope Whirlpool |
$56.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.11
|
| Rate for Payer: Nomi Health Commercial |
$46.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.45
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.67
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$23.74
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP DNSP |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
IP
|
$9,503.13
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,127.35 |
| Max. Negotiated Rate |
$9,503.13 |
| Rate for Payer: Aetna Commercial |
$8,552.82
|
| Rate for Payer: ASR ASR |
$9,218.04
|
| Rate for Payer: BCBS Trust/PPO |
$7,803.97
|
| Rate for Payer: BCN Commercial |
$7,803.97
|
| Rate for Payer: Cash Price |
$7,602.50
|
| Rate for Payer: Cofinity Commercial |
$8,932.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,602.50
|
| Rate for Payer: Healthscope Commercial |
$9,218.04
|
| Rate for Payer: Healthscope Whirlpool |
$9,503.13
|
| Rate for Payer: Mclaren Commercial |
$8,552.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,077.66
|
| Rate for Payer: Nomi Health Commercial |
$7,792.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,127.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,362.75
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,503.13
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,516.16 |
| Max. Negotiated Rate |
$9,503.13 |
| Rate for Payer: Aetna Commercial |
$8,552.82
|
| Rate for Payer: Aetna Medicare |
$3,516.16
|
| Rate for Payer: ASR ASR |
$9,218.04
|
| Rate for Payer: BCBS Complete |
$3,801.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,835.33
|
| Rate for Payer: BCN Commercial |
$7,835.33
|
| Rate for Payer: Cash Price |
$7,602.50
|
| Rate for Payer: Cofinity Commercial |
$8,932.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,602.50
|
| Rate for Payer: Healthscope Commercial |
$9,218.04
|
| Rate for Payer: Healthscope Whirlpool |
$9,503.13
|
| Rate for Payer: Mclaren Commercial |
$8,552.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,602.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,077.66
|
| Rate for Payer: Nomi Health Commercial |
$7,792.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,127.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,326.64
|
| Rate for Payer: Priority Health Narrow Network |
$6,661.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,362.75
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,962.82
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,386.24 |
| Max. Negotiated Rate |
$19,962.82 |
| Rate for Payer: Aetna Commercial |
$17,966.54
|
| Rate for Payer: Aetna Medicare |
$7,386.24
|
| Rate for Payer: ASR ASR |
$19,363.94
|
| Rate for Payer: BCBS Complete |
$7,985.13
|
| Rate for Payer: BCBS Trust/PPO |
$16,459.35
|
| Rate for Payer: BCN Commercial |
$16,459.35
|
| Rate for Payer: Cash Price |
$15,970.26
|
| Rate for Payer: Cofinity Commercial |
$18,765.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,970.26
|
| Rate for Payer: Healthscope Commercial |
$19,363.94
|
| Rate for Payer: Healthscope Whirlpool |
$19,962.82
|
| Rate for Payer: Mclaren Commercial |
$17,966.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,970.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,968.40
|
| Rate for Payer: Nomi Health Commercial |
$16,369.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,972.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,491.42
|
| Rate for Payer: Priority Health Narrow Network |
$13,993.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,567.28
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,962.82
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14,972.11 |
| Max. Negotiated Rate |
$19,962.82 |
| Rate for Payer: Aetna Commercial |
$17,966.54
|
| Rate for Payer: ASR ASR |
$19,363.94
|
| Rate for Payer: BCBS Trust/PPO |
$16,393.47
|
| Rate for Payer: BCN Commercial |
$16,393.47
|
| Rate for Payer: Cash Price |
$15,970.26
|
| Rate for Payer: Cofinity Commercial |
$18,765.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,970.26
|
| Rate for Payer: Healthscope Commercial |
$19,363.94
|
| Rate for Payer: Healthscope Whirlpool |
$19,962.82
|
| Rate for Payer: Mclaren Commercial |
$17,966.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,968.40
|
| Rate for Payer: Nomi Health Commercial |
$16,369.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,972.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,567.28
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PISTACHIO NUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PITOCIN AUGMENTATION
|
Facility
|
OP
|
$484.53
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$179.28 |
| Max. Negotiated Rate |
$484.53 |
| Rate for Payer: Aetna Commercial |
$436.08
|
| Rate for Payer: Aetna Medicare |
$179.28
|
| Rate for Payer: ASR ASR |
$469.99
|
| Rate for Payer: BCBS Complete |
$193.81
|
| Rate for Payer: BCBS Trust/PPO |
$399.49
|
| Rate for Payer: BCN Commercial |
$399.49
|
| Rate for Payer: Cash Price |
$387.62
|
| Rate for Payer: Cofinity Commercial |
$455.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.62
|
| Rate for Payer: Healthscope Commercial |
$469.99
|
| Rate for Payer: Healthscope Whirlpool |
$484.53
|
| Rate for Payer: Mclaren Commercial |
$436.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$387.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$411.85
|
| Rate for Payer: Nomi Health Commercial |
$397.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$424.55
|
| Rate for Payer: Priority Health Narrow Network |
$339.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.39
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
IP
|
$484.53
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$363.40 |
| Max. Negotiated Rate |
$484.53 |
| Rate for Payer: Aetna Commercial |
$436.08
|
| Rate for Payer: ASR ASR |
$469.99
|
| Rate for Payer: BCBS Trust/PPO |
$397.90
|
| Rate for Payer: BCN Commercial |
$397.90
|
| Rate for Payer: Cash Price |
$387.62
|
| Rate for Payer: Cofinity Commercial |
$455.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.62
|
| Rate for Payer: Healthscope Commercial |
$469.99
|
| Rate for Payer: Healthscope Whirlpool |
$484.53
|
| Rate for Payer: Mclaren Commercial |
$436.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$411.85
|
| Rate for Payer: Nomi Health Commercial |
$397.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.39
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$22.27 |
| Rate for Payer: Aetna Commercial |
$20.04
|
| Rate for Payer: ASR ASR |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$18.29
|
| Rate for Payer: BCN Commercial |
$18.29
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$20.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Healthscope Whirlpool |
$22.27
|
| Rate for Payer: Mclaren Commercial |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.60
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$209.42 |
| Rate for Payer: Aetna Commercial |
$20.04
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$21.60
|
| Rate for Payer: BCBS Complete |
$3.02
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$18.36
|
| Rate for Payer: BCN Commercial |
$18.36
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$20.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Healthscope Whirlpool |
$22.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.50
|
| Rate for Payer: Mclaren Commercial |
$20.04
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Mclaren Medicare |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.78
|
| Rate for Payer: Meridian Medicaid |
$3.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.70
|
| Rate for Payer: PACE Medicare |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.50
|
| Rate for Payer: PHP Commercial |
$6.05
|
| Rate for Payer: PHP Medicaid |
$2.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.42
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$167.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.50
|
| Rate for Payer: UHC Exchange |
$8.53
|
| Rate for Payer: UHC Medicaid |
$2.88
|
| Rate for Payer: UHCCP DNSP |
$5.50
|
| Rate for Payer: UHCCP Medicaid |
$2.88
|
| Rate for Payer: VA VA |
$5.50
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,817.53 |
| Max. Negotiated Rate |
$3,756.70 |
| Rate for Payer: Aetna Commercial |
$3,381.03
|
| Rate for Payer: ASR ASR |
$3,644.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,085.00
|
| Rate for Payer: BCN Commercial |
$3,085.00
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,531.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,644.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,756.70
|
| Rate for Payer: Mclaren Commercial |
$3,381.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,305.90
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,633.45 |
| Max. Negotiated Rate |
$9,998.34 |
| Rate for Payer: Aetna Commercial |
$3,381.03
|
| Rate for Payer: Aetna Medicare |
$6,450.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,063.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,063.18
|
| Rate for Payer: ASR ASR |
$3,644.00
|
| Rate for Payer: BCBS Complete |
$3,542.64
|
| Rate for Payer: BCBS MAPPO |
$6,450.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.40
|
| Rate for Payer: BCN Commercial |
$3,097.40
|
| Rate for Payer: BCN Medicare Advantage |
$6,450.54
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,531.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,450.54
|
| Rate for Payer: Healthscope Commercial |
$3,644.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,756.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,450.54
|
| Rate for Payer: Mclaren Commercial |
$3,381.03
|
| Rate for Payer: Mclaren Medicaid |
$6,450.54
|
| Rate for Payer: Mclaren Medicare |
$6,450.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,773.07
|
| Rate for Payer: Meridian Medicaid |
$3,542.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,418.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,095.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Medicare |
$6,128.01
|
| Rate for Payer: PACE SWMI |
$6,450.54
|
| Rate for Payer: PHP Commercial |
$7,095.59
|
| Rate for Payer: PHP Medicaid |
$3,457.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,450.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,373.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,291.62
|
| Rate for Payer: Priority Health Medicare |
$6,450.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,633.45
|
| Rate for Payer: Railroad Medicare Medicare |
$6,450.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,305.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,450.54
|
| Rate for Payer: UHC Exchange |
$9,998.34
|
| Rate for Payer: UHC Medicaid |
$3,373.63
|
| Rate for Payer: UHCCP DNSP |
$6,450.54
|
| Rate for Payer: UHCCP Medicaid |
$3,373.63
|
| Rate for Payer: VA VA |
$6,450.54
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,817.53 |
| Max. Negotiated Rate |
$3,756.70 |
| Rate for Payer: Aetna Commercial |
$3,381.03
|
| Rate for Payer: ASR ASR |
$3,644.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,085.00
|
| Rate for Payer: BCN Commercial |
$3,085.00
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,531.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,644.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,756.70
|
| Rate for Payer: Mclaren Commercial |
$3,381.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,305.90
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$5,529.67 |
| Rate for Payer: Aetna Commercial |
$3,381.03
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$3,644.00
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.40
|
| Rate for Payer: BCN Commercial |
$3,097.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,531.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,644.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,756.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$3,381.03
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,291.62
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,633.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,305.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Exchange |
$5,529.67
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
