|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,340.62
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$5,529.67 |
| Rate for Payer: Aetna Commercial |
$3,006.56
|
| 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 |
$3,240.40
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,754.34
|
| Rate for Payer: BCN Commercial |
$2,754.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$2,672.50
|
| Rate for Payer: Cash Price |
$2,672.50
|
| Rate for Payer: Cofinity Commercial |
$3,140.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,672.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,240.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,340.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$3,006.56
|
| 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 |
$2,839.53
|
| Rate for Payer: Nomi Health Commercial |
$2,739.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,505.47
|
| 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 |
$2,927.05
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,341.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,939.75
|
| 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
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,340.62
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,505.47 |
| Max. Negotiated Rate |
$3,340.62 |
| Rate for Payer: Aetna Commercial |
$3,006.56
|
| Rate for Payer: ASR ASR |
$3,240.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,743.32
|
| Rate for Payer: BCN Commercial |
$2,743.32
|
| Rate for Payer: Cash Price |
$2,672.50
|
| Rate for Payer: Cofinity Commercial |
$3,140.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,672.50
|
| Rate for Payer: Healthscope Commercial |
$3,240.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,340.62
|
| Rate for Payer: Mclaren Commercial |
$3,006.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,839.53
|
| Rate for Payer: Nomi Health Commercial |
$2,739.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,505.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,939.75
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,224.00
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$126.61 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Aetna Commercial |
$1,101.60
|
| Rate for Payer: Aetna Medicare |
$452.88
|
| Rate for Payer: ASR ASR |
$1,187.28
|
| Rate for Payer: BCBS Complete |
$489.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.19
|
| Rate for Payer: BCCCP Commercial |
$156.92
|
| Rate for Payer: BCN Commercial |
$1,009.19
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$1,150.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.20
|
| Rate for Payer: Healthscope Commercial |
$1,187.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,224.00
|
| Rate for Payer: Mclaren Commercial |
$1,101.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$979.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.40
|
| Rate for Payer: Nomi Health Commercial |
$1,003.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$158.27
|
| Rate for Payer: Priority Health Narrow Network |
$126.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,077.12
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,224.00
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Aetna Commercial |
$1,101.60
|
| Rate for Payer: ASR ASR |
$1,187.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,005.15
|
| Rate for Payer: BCN Commercial |
$1,005.15
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$1,150.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.20
|
| Rate for Payer: Healthscope Commercial |
$1,187.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,224.00
|
| Rate for Payer: Mclaren Commercial |
$1,101.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.40
|
| Rate for Payer: Nomi Health Commercial |
$1,003.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,077.12
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,791.10
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.69 |
| Max. Negotiated Rate |
$1,791.10 |
| Rate for Payer: Aetna Commercial |
$1,611.99
|
| Rate for Payer: Aetna Medicare |
$662.71
|
| Rate for Payer: ASR ASR |
$1,737.37
|
| Rate for Payer: BCBS Complete |
$716.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.76
|
| Rate for Payer: BCCCP Commercial |
$432.83
|
| Rate for Payer: BCN Commercial |
$1,476.76
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cofinity Commercial |
$1,683.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.88
|
| Rate for Payer: Healthscope Commercial |
$1,737.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,791.10
|
| Rate for Payer: Mclaren Commercial |
$1,611.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,432.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,522.43
|
| Rate for Payer: Nomi Health Commercial |
$1,468.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$204.61
|
| Rate for Payer: Priority Health Narrow Network |
$163.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,576.17
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,791.10
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,343.33 |
| Max. Negotiated Rate |
$1,791.10 |
| Rate for Payer: Aetna Commercial |
$1,611.99
|
| Rate for Payer: ASR ASR |
$1,737.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.85
|
| Rate for Payer: BCN Commercial |
$1,470.85
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cofinity Commercial |
$1,683.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.88
|
| Rate for Payer: Healthscope Commercial |
$1,737.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,791.10
|
| Rate for Payer: Mclaren Commercial |
$1,611.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,522.43
|
| Rate for Payer: Nomi Health Commercial |
$1,468.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,576.17
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,149.22
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,611.91 |
| Max. Negotiated Rate |
$2,149.22 |
| Rate for Payer: Aetna Commercial |
$1,934.30
|
| Rate for Payer: ASR ASR |
$2,084.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.94
|
| Rate for Payer: BCN Commercial |
$1,764.94
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cofinity Commercial |
$2,020.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,719.38
|
| Rate for Payer: Healthscope Commercial |
$2,084.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,149.22
|
| Rate for Payer: Mclaren Commercial |
$1,934.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,826.84
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,611.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,891.31
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,149.22
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.52 |
| Max. Negotiated Rate |
$2,149.22 |
| Rate for Payer: Aetna Commercial |
$1,934.30
|
| Rate for Payer: Aetna Medicare |
$795.21
|
| Rate for Payer: ASR ASR |
$2,084.74
|
| Rate for Payer: BCBS Complete |
$859.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,772.03
|
| Rate for Payer: BCCCP Commercial |
$171.66
|
| Rate for Payer: BCN Commercial |
$1,772.03
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cofinity Commercial |
$2,020.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,719.38
|
| Rate for Payer: Healthscope Commercial |
$2,084.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,149.22
|
| Rate for Payer: Mclaren Commercial |
$1,934.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,719.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,826.84
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,611.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.40
|
| Rate for Payer: Priority Health Narrow Network |
$127.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,891.31
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,977.05
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$109.43 |
| Max. Negotiated Rate |
$2,977.05 |
| Rate for Payer: Aetna Commercial |
$2,679.34
|
| Rate for Payer: Aetna Medicare |
$1,101.51
|
| Rate for Payer: ASR ASR |
$2,887.74
|
| Rate for Payer: BCBS Complete |
$1,190.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.58
|
| Rate for Payer: BCCCP Commercial |
$266.26
|
| Rate for Payer: BCN Commercial |
$2,454.58
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cofinity Commercial |
$2,798.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.64
|
| Rate for Payer: Healthscope Commercial |
$2,887.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,977.05
|
| Rate for Payer: Mclaren Commercial |
$2,679.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,381.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,530.49
|
| Rate for Payer: Nomi Health Commercial |
$2,441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,232.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$136.78
|
| Rate for Payer: Priority Health Narrow Network |
$109.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,619.80
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,977.05
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,232.79 |
| Max. Negotiated Rate |
$2,977.05 |
| Rate for Payer: Aetna Commercial |
$2,679.34
|
| Rate for Payer: ASR ASR |
$2,887.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,444.75
|
| Rate for Payer: BCN Commercial |
$2,444.75
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cofinity Commercial |
$2,798.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.64
|
| Rate for Payer: Healthscope Commercial |
$2,887.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,977.05
|
| Rate for Payer: Mclaren Commercial |
$2,679.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,530.49
|
| Rate for Payer: Nomi Health Commercial |
$2,441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,232.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,619.80
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,477.77
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,329.99
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,433.44
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.42
|
| Rate for Payer: BCCCP Commercial |
$225.33
|
| Rate for Payer: BCN Commercial |
$1,218.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cofinity Commercial |
$1,389.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,433.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,477.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,329.99
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.10
|
| Rate for Payer: Nomi Health Commercial |
$1,211.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.33
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.02
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$99.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,300.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,477.77
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,108.33 |
| Max. Negotiated Rate |
$1,477.77 |
| Rate for Payer: Aetna Commercial |
$1,329.99
|
| Rate for Payer: ASR ASR |
$1,433.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,213.54
|
| Rate for Payer: BCN Commercial |
$1,213.54
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cofinity Commercial |
$1,389.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.22
|
| Rate for Payer: Healthscope Commercial |
$1,433.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,477.77
|
| Rate for Payer: Mclaren Commercial |
$1,329.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.10
|
| Rate for Payer: Nomi Health Commercial |
$1,211.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,300.44
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,727.59
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,295.69 |
| Max. Negotiated Rate |
$1,727.59 |
| Rate for Payer: Aetna Commercial |
$1,554.83
|
| Rate for Payer: ASR ASR |
$1,675.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,418.70
|
| Rate for Payer: BCN Commercial |
$1,418.70
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cofinity Commercial |
$1,623.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,382.07
|
| Rate for Payer: Healthscope Commercial |
$1,675.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,727.59
|
| Rate for Payer: Mclaren Commercial |
$1,554.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,468.45
|
| Rate for Payer: Nomi Health Commercial |
$1,416.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,520.28
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
OP
|
$1,727.59
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$1,727.59 |
| Rate for Payer: Aetna Commercial |
$1,554.83
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$1,675.76
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.40
|
| Rate for Payer: BCCCP Commercial |
$566.80
|
| Rate for Payer: BCN Commercial |
$1,424.40
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cofinity Commercial |
$1,623.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,382.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,675.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,727.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$1,554.83
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,468.45
|
| Rate for Payer: Nomi Health Commercial |
$1,416.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.69
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.02
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$99.21
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,520.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
IP
|
$2,438.02
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,828.52 |
| Max. Negotiated Rate |
$2,438.02 |
| Rate for Payer: Aetna Commercial |
$2,194.22
|
| Rate for Payer: ASR ASR |
$2,364.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,002.10
|
| Rate for Payer: BCN Commercial |
$2,002.10
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cofinity Commercial |
$2,291.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.42
|
| Rate for Payer: Healthscope Commercial |
$2,364.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,438.02
|
| Rate for Payer: Mclaren Commercial |
$2,194.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,072.32
|
| Rate for Payer: Nomi Health Commercial |
$1,999.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,145.46
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
OP
|
$2,438.02
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$2,438.02 |
| Rate for Payer: Aetna Commercial |
$2,194.22
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$2,364.88
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,010.15
|
| Rate for Payer: BCCCP Commercial |
$240.24
|
| Rate for Payer: BCN Commercial |
$2,010.15
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cofinity Commercial |
$2,291.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$2,364.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,438.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$2,194.22
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,072.32
|
| Rate for Payer: Nomi Health Commercial |
$1,999.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.52
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.02
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$99.21
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,145.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
OP
|
$2,002.24
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$2,002.24 |
| Rate for Payer: Aetna Commercial |
$1,802.02
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$1,942.17
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.85
|
| Rate for Payer: BCCCP Commercial |
$330.02
|
| Rate for Payer: BCN Commercial |
$1,650.85
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cofinity Commercial |
$1,882.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,942.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$1,802.02
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,701.90
|
| Rate for Payer: Nomi Health Commercial |
$1,641.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.02
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$99.21
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,761.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
IP
|
$2,002.24
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,501.68 |
| Max. Negotiated Rate |
$2,002.24 |
| Rate for Payer: Aetna Commercial |
$1,802.02
|
| Rate for Payer: ASR ASR |
$1,942.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.24
|
| Rate for Payer: BCN Commercial |
$1,644.24
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cofinity Commercial |
$1,882.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.79
|
| Rate for Payer: Healthscope Commercial |
$1,942.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.24
|
| Rate for Payer: Mclaren Commercial |
$1,802.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,701.90
|
| Rate for Payer: Nomi Health Commercial |
$1,641.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,761.97
|
|
|
HC PLACEMENT FIDUCIAL MARKERS
|
Facility
|
IP
|
$1,092.42
|
|
| Hospital Charge Code |
36000120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$819.32 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: BCBS Trust/PPO |
$897.10
|
| Rate for Payer: BCN Commercial |
$897.10
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,059.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,092.42
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC PLACEMENT FIDUCIAL MARKERS
|
Facility
|
OP
|
$1,092.42
|
|
| Hospital Charge Code |
36000120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$404.20 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$404.20
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS Trust/PPO |
$900.70
|
| Rate for Payer: BCN Commercial |
$900.70
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,059.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,092.42
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$957.18
|
| Rate for Payer: Priority Health Narrow Network |
$765.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC PLACEMENT OF BAKRI BALLOON
|
Facility
|
OP
|
$510.33
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000013
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$510.33 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$495.02
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$420.77
|
| Rate for Payer: BCN Commercial |
$420.77
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$479.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$495.02
|
| Rate for Payer: Healthscope Whirlpool |
$510.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$459.30
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$447.15
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$357.74
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC PLACEMENT OF BAKRI BALLOON
|
Facility
|
IP
|
$510.33
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000013
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$382.75 |
| Max. Negotiated Rate |
$510.33 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: ASR ASR |
$495.02
|
| Rate for Payer: BCBS Trust/PPO |
$419.08
|
| Rate for Payer: BCN Commercial |
$419.08
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$479.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$495.02
|
| Rate for Payer: Healthscope Whirlpool |
$510.33
|
| Rate for Payer: Mclaren Commercial |
$459.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.09
|
|
|
HC PLACEMENT OF JADA SYSTEM
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000012
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC PLACEMENT OF JADA SYSTEM
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000012
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,101.11
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$5,681.21
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
OP
|
$7,411.20
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,742.14 |
| Max. Negotiated Rate |
$7,411.20 |
| Rate for Payer: Aetna Commercial |
$6,670.08
|
| Rate for Payer: Aetna Medicare |
$2,742.14
|
| Rate for Payer: ASR ASR |
$7,188.86
|
| Rate for Payer: BCBS Complete |
$2,964.48
|
| Rate for Payer: BCBS Trust/PPO |
$6,110.53
|
| Rate for Payer: BCN Commercial |
$6,110.53
|
| Rate for Payer: Cash Price |
$5,928.96
|
| Rate for Payer: Cofinity Commercial |
$6,966.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,928.96
|
| Rate for Payer: Healthscope Commercial |
$7,188.86
|
| Rate for Payer: Healthscope Whirlpool |
$7,411.20
|
| Rate for Payer: Mclaren Commercial |
$6,670.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,928.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,299.52
|
| Rate for Payer: Nomi Health Commercial |
$6,077.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,558.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,493.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,195.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,521.86
|
|
