|
HC PENTAMIDINE THERAPY
|
Facility
|
IP
|
$1,033.55
|
|
|
Service Code
|
CPT 94642
|
| Hospital Charge Code |
41000005
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$671.81 |
| Max. Negotiated Rate |
$1,033.55 |
| Rate for Payer: Aetna Commercial |
$930.20
|
| Rate for Payer: ASR ASR |
$1,002.54
|
| Rate for Payer: ASR Commercial |
$1,002.54
|
| Rate for Payer: BCBS Trust/PPO |
$842.24
|
| Rate for Payer: BCN Commercial |
$801.31
|
| Rate for Payer: Cash Price |
$826.84
|
| Rate for Payer: Cofinity Commercial |
$971.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.84
|
| Rate for Payer: Healthscope Commercial |
$1,033.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.54
|
| Rate for Payer: Mclaren Commercial |
$930.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.52
|
| Rate for Payer: Nomi Health Commercial |
$847.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.52
|
|
|
HC PENTAMIDINE THERAPY
|
Facility
|
OP
|
$1,033.55
|
|
|
Service Code
|
CPT 94642
|
| Hospital Charge Code |
41000005
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$106.81 |
| Max. Negotiated Rate |
$1,033.55 |
| Rate for Payer: Aetna Commercial |
$930.20
|
| Rate for Payer: Aetna Medicare |
$199.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.10
|
| Rate for Payer: ASR ASR |
$1,002.54
|
| Rate for Payer: ASR Commercial |
$1,002.54
|
| Rate for Payer: BCBS Complete |
$112.15
|
| Rate for Payer: BCBS MAPPO |
$199.28
|
| Rate for Payer: BCBS Trust/PPO |
$846.37
|
| Rate for Payer: BCN Commercial |
$801.31
|
| Rate for Payer: BCN Medicare Advantage |
$199.28
|
| Rate for Payer: Cash Price |
$826.84
|
| Rate for Payer: Cash Price |
$826.84
|
| Rate for Payer: Cofinity Commercial |
$971.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.28
|
| Rate for Payer: Healthscope Commercial |
$1,033.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.28
|
| Rate for Payer: Mclaren Commercial |
$930.20
|
| Rate for Payer: Mclaren Medicaid |
$106.81
|
| Rate for Payer: Mclaren Medicare |
$199.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.24
|
| Rate for Payer: Meridian Medicaid |
$112.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.52
|
| Rate for Payer: Nomi Health Commercial |
$847.51
|
| Rate for Payer: PACE Medicare |
$189.32
|
| Rate for Payer: PACE SWMI |
$199.28
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: PHP Medicaid |
$106.81
|
| Rate for Payer: PHP Medicare Advantage |
$199.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.60
|
| Rate for Payer: Priority Health Medicare |
$199.28
|
| Rate for Payer: Priority Health Narrow Network |
$724.52
|
| Rate for Payer: Railroad Medicare Medicare |
$199.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.28
|
| Rate for Payer: UHC Exchange |
$308.88
|
| Rate for Payer: UHC Medicare Advantage |
$199.28
|
| Rate for Payer: UHCCP DNSP |
$199.28
|
| Rate for Payer: UHCCP Medicaid |
$106.81
|
| Rate for Payer: VA VA |
$199.28
|
|
|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$116.02 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Aetna Commercial |
$160.65
|
| Rate for Payer: ASR ASR |
$173.14
|
| Rate for Payer: ASR Commercial |
$173.14
|
| Rate for Payer: BCBS Trust/PPO |
$145.46
|
| Rate for Payer: BCN Commercial |
$138.39
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$167.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.80
|
| Rate for Payer: Healthscope Commercial |
$178.50
|
| Rate for Payer: Healthscope Whirlpool |
$173.14
|
| Rate for Payer: Mclaren Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.72
|
| Rate for Payer: Nomi Health Commercial |
$146.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.08
|
|
|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Aetna Commercial |
$160.65
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: ASR ASR |
$173.14
|
| Rate for Payer: ASR Commercial |
$173.14
|
| Rate for Payer: BCBS Complete |
$71.40
|
| Rate for Payer: BCBS Trust/PPO |
$146.17
|
| Rate for Payer: BCN Commercial |
$138.39
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$167.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.80
|
| Rate for Payer: Healthscope Commercial |
$178.50
|
| Rate for Payer: Healthscope Whirlpool |
$173.14
|
| Rate for Payer: Mclaren Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.72
|
| Rate for Payer: Nomi Health Commercial |
$146.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.40
|
| Rate for Payer: Priority Health Narrow Network |
$125.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.08
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
OP
|
$54.58
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$54.58 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: ASR ASR |
$52.94
|
| Rate for Payer: ASR Commercial |
$52.94
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: BCBS Trust/PPO |
$44.70
|
| Rate for Payer: BCN Commercial |
$42.32
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$51.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$54.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.94
|
| Rate for Payer: Mclaren Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.82
|
| Rate for Payer: Priority Health Narrow Network |
$38.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.03
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
IP
|
$54.58
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$54.58 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: ASR ASR |
$52.94
|
| Rate for Payer: ASR Commercial |
$52.94
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.32
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$51.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$54.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.94
|
| Rate for Payer: Mclaren Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.03
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
OP
|
$5,164.84
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$4,648.36
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$5,009.89
|
| Rate for Payer: ASR Commercial |
$5,009.89
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,229.49
|
| Rate for Payer: BCN Commercial |
$4,004.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cofinity Commercial |
$4,854.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,131.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$5,164.84
|
| Rate for Payer: Healthscope Whirlpool |
$5,009.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$4,648.36
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,390.11
|
| Rate for Payer: Nomi Health Commercial |
$4,235.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,357.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,525.43
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,620.55
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,545.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
IP
|
$5,164.84
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,357.15 |
| Max. Negotiated Rate |
$5,164.84 |
| Rate for Payer: Aetna Commercial |
$4,648.36
|
| Rate for Payer: ASR ASR |
$5,009.89
|
| Rate for Payer: ASR Commercial |
$5,009.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,208.83
|
| Rate for Payer: BCN Commercial |
$4,004.30
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cofinity Commercial |
$4,854.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,131.87
|
| Rate for Payer: Healthscope Commercial |
$5,164.84
|
| Rate for Payer: Healthscope Whirlpool |
$5,009.89
|
| Rate for Payer: Mclaren Commercial |
$4,648.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,390.11
|
| Rate for Payer: Nomi Health Commercial |
$4,235.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,357.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,545.06
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.34 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: ASR Commercial |
$70.65
|
| Rate for Payer: BCBS Trust/PPO |
$59.35
|
| Rate for Payer: BCN Commercial |
$56.47
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$72.83
|
| Rate for Payer: Healthscope Whirlpool |
$70.65
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: ASR Commercial |
$70.65
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$59.64
|
| Rate for Payer: BCN Commercial |
$56.47
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$72.83
|
| Rate for Payer: Healthscope Whirlpool |
$70.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.81
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$51.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
OP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,446.59 |
| Max. Negotiated Rate |
$14,101.06 |
| Rate for Payer: Aetna Commercial |
$12,690.95
|
| Rate for Payer: Aetna Medicare |
$6,430.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,037.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,037.75
|
| Rate for Payer: ASR ASR |
$13,678.03
|
| Rate for Payer: ASR Commercial |
$13,678.03
|
| Rate for Payer: BCBS Complete |
$3,618.92
|
| Rate for Payer: BCBS MAPPO |
$6,430.20
|
| Rate for Payer: BCBS Trust/PPO |
$11,547.36
|
| Rate for Payer: BCN Commercial |
$10,932.55
|
| Rate for Payer: BCN Medicare Advantage |
$6,430.20
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$13,255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,430.20
|
| Rate for Payer: Healthscope Commercial |
$14,101.06
|
| Rate for Payer: Healthscope Whirlpool |
$13,678.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,430.20
|
| Rate for Payer: Mclaren Commercial |
$12,690.95
|
| Rate for Payer: Mclaren Medicaid |
$3,446.59
|
| Rate for Payer: Mclaren Medicare |
$6,430.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,751.71
|
| Rate for Payer: Meridian Medicaid |
$3,618.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,394.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: Nomi Health Commercial |
$11,562.87
|
| Rate for Payer: PACE Medicare |
$6,108.69
|
| Rate for Payer: PACE SWMI |
$6,430.20
|
| Rate for Payer: PHP Commercial |
$7,073.22
|
| Rate for Payer: PHP Medicaid |
$3,446.59
|
| Rate for Payer: PHP Medicare Advantage |
$6,430.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,446.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,355.35
|
| Rate for Payer: Priority Health Medicare |
$6,430.20
|
| Rate for Payer: Priority Health Narrow Network |
$9,884.84
|
| Rate for Payer: Railroad Medicare Medicare |
$6,430.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,408.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,430.20
|
| Rate for Payer: UHC Exchange |
$9,966.81
|
| Rate for Payer: UHC Medicare Advantage |
$6,430.20
|
| Rate for Payer: UHCCP DNSP |
$6,430.20
|
| Rate for Payer: UHCCP Medicaid |
$3,446.59
|
| Rate for Payer: VA VA |
$6,430.20
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
IP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,165.69 |
| Max. Negotiated Rate |
$14,101.06 |
| Rate for Payer: Aetna Commercial |
$12,690.95
|
| Rate for Payer: ASR ASR |
$13,678.03
|
| Rate for Payer: ASR Commercial |
$13,678.03
|
| Rate for Payer: BCBS Trust/PPO |
$11,490.95
|
| Rate for Payer: BCN Commercial |
$10,932.55
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$13,255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Healthscope Commercial |
$14,101.06
|
| Rate for Payer: Healthscope Whirlpool |
$13,678.03
|
| Rate for Payer: Mclaren Commercial |
$12,690.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: Nomi Health Commercial |
$11,562.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,408.93
|
|
|
HC PERCLOSE
|
Facility
|
OP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.89 |
| Max. Negotiated Rate |
$1,052.23 |
| Rate for Payer: Aetna Commercial |
$947.01
|
| Rate for Payer: Aetna Medicare |
$526.12
|
| Rate for Payer: ASR ASR |
$1,020.66
|
| Rate for Payer: ASR Commercial |
$1,020.66
|
| Rate for Payer: BCBS Complete |
$420.89
|
| Rate for Payer: BCBS Trust/PPO |
$861.67
|
| Rate for Payer: BCN Commercial |
$815.79
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$989.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Healthscope Commercial |
$1,052.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,020.66
|
| Rate for Payer: Mclaren Commercial |
$947.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: Nomi Health Commercial |
$862.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.96
|
| Rate for Payer: Priority Health Narrow Network |
$737.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$925.96
|
|
|
HC PERCLOSE
|
Facility
|
IP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$683.95 |
| Max. Negotiated Rate |
$1,052.23 |
| Rate for Payer: Aetna Commercial |
$947.01
|
| Rate for Payer: ASR ASR |
$1,020.66
|
| Rate for Payer: ASR Commercial |
$1,020.66
|
| Rate for Payer: BCBS Trust/PPO |
$857.46
|
| Rate for Payer: BCN Commercial |
$815.79
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$989.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Healthscope Commercial |
$1,052.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,020.66
|
| Rate for Payer: Mclaren Commercial |
$947.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: Nomi Health Commercial |
$862.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$925.96
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,231.07 |
| Max. Negotiated Rate |
$6,509.34 |
| Rate for Payer: Aetna Commercial |
$5,858.41
|
| Rate for Payer: ASR ASR |
$6,314.06
|
| Rate for Payer: ASR Commercial |
$6,314.06
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.46
|
| Rate for Payer: BCN Commercial |
$5,046.69
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$6,118.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$6,509.34
|
| Rate for Payer: Healthscope Whirlpool |
$6,314.06
|
| Rate for Payer: Mclaren Commercial |
$5,858.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,728.22
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,994.22 |
| Max. Negotiated Rate |
$8,658.67 |
| Rate for Payer: Aetna Commercial |
$5,858.41
|
| Rate for Payer: Aetna Medicare |
$5,586.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: ASR ASR |
$6,314.06
|
| Rate for Payer: ASR Commercial |
$6,314.06
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,330.50
|
| Rate for Payer: BCN Commercial |
$5,046.69
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$6,118.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$6,509.34
|
| Rate for Payer: Healthscope Whirlpool |
$6,314.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,586.24
|
| Rate for Payer: Mclaren Commercial |
$5,858.41
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$6,144.86
|
| Rate for Payer: PHP Medicaid |
$2,994.22
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,703.48
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,563.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,728.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$8,658.67
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP DNSP |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: VA VA |
$5,586.24
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,692.54 |
| Rate for Payer: Aetna Commercial |
$15,923.29
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$17,161.76
|
| Rate for Payer: ASR Commercial |
$17,161.76
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$14,488.42
|
| Rate for Payer: BCN Commercial |
$13,717.03
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$16,630.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$17,692.54
|
| Rate for Payer: Healthscope Whirlpool |
$17,161.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$15,923.29
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: Nomi Health Commercial |
$14,507.88
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,502.20
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$12,402.47
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,569.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,500.15 |
| Max. Negotiated Rate |
$17,692.54 |
| Rate for Payer: Aetna Commercial |
$15,923.29
|
| Rate for Payer: ASR ASR |
$17,161.76
|
| Rate for Payer: ASR Commercial |
$17,161.76
|
| Rate for Payer: BCBS Trust/PPO |
$14,417.65
|
| Rate for Payer: BCN Commercial |
$13,717.03
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$16,630.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Healthscope Commercial |
$17,692.54
|
| Rate for Payer: Healthscope Whirlpool |
$17,161.76
|
| Rate for Payer: Mclaren Commercial |
$15,923.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: Nomi Health Commercial |
$14,507.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,569.44
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,261.94 |
| Max. Negotiated Rate |
$28,095.29 |
| Rate for Payer: Aetna Commercial |
$25,285.76
|
| Rate for Payer: ASR ASR |
$27,252.43
|
| Rate for Payer: ASR Commercial |
$27,252.43
|
| Rate for Payer: BCBS Trust/PPO |
$22,894.85
|
| Rate for Payer: BCN Commercial |
$21,782.28
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$26,409.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Healthscope Commercial |
$28,095.29
|
| Rate for Payer: Healthscope Whirlpool |
$27,252.43
|
| Rate for Payer: Mclaren Commercial |
$25,285.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: Nomi Health Commercial |
$23,038.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,723.86
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$28,095.29 |
| Rate for Payer: Aetna Commercial |
$25,285.76
|
| Rate for Payer: Aetna Medicare |
$17,593.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: ASR ASR |
$27,252.43
|
| Rate for Payer: ASR Commercial |
$27,252.43
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$23,007.23
|
| Rate for Payer: BCN Commercial |
$21,782.28
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$26,409.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$28,095.29
|
| Rate for Payer: Healthscope Whirlpool |
$27,252.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$25,285.76
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: Nomi Health Commercial |
$23,038.14
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$19,353.00
|
| Rate for Payer: PHP Medicaid |
$9,430.19
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,617.09
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$19,694.80
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,723.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$27,270.14
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP DNSP |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.48 |
| Max. Negotiated Rate |
$13.69 |
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: Aetna Medicare |
$6.84
|
| Rate for Payer: ASR ASR |
$13.28
|
| Rate for Payer: ASR Commercial |
$13.28
|
| Rate for Payer: BCBS Complete |
$5.48
|
| Rate for Payer: BCBS Trust/PPO |
$11.21
|
| Rate for Payer: BCN Commercial |
$10.61
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$12.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$13.69
|
| Rate for Payer: Healthscope Whirlpool |
$13.28
|
| Rate for Payer: Mclaren Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$9.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.05
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$13.69 |
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: ASR ASR |
$13.28
|
| Rate for Payer: ASR Commercial |
$13.28
|
| Rate for Payer: BCBS Trust/PPO |
$11.16
|
| Rate for Payer: BCN Commercial |
$10.61
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$12.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$13.69
|
| Rate for Payer: Healthscope Whirlpool |
$13.28
|
| Rate for Payer: Mclaren Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.05
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,703.14 |
| Max. Negotiated Rate |
$4,925.12 |
| Rate for Payer: Aetna Commercial |
$4,084.23
|
| Rate for Payer: Aetna Medicare |
$3,177.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: ASR ASR |
$4,401.89
|
| Rate for Payer: ASR Commercial |
$4,401.89
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,716.19
|
| Rate for Payer: BCN Commercial |
$3,518.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$4,265.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$4,538.03
|
| Rate for Payer: Healthscope Whirlpool |
$4,401.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,177.50
|
| Rate for Payer: Mclaren Commercial |
$4,084.23
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: Nomi Health Commercial |
$3,721.18
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$3,495.25
|
| Rate for Payer: PHP Medicaid |
$1,703.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,976.22
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,181.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,993.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,925.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP DNSP |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,949.72 |
| Max. Negotiated Rate |
$4,538.03 |
| Rate for Payer: Aetna Commercial |
$4,084.23
|
| Rate for Payer: ASR ASR |
$4,401.89
|
| Rate for Payer: ASR Commercial |
$4,401.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,698.04
|
| Rate for Payer: BCN Commercial |
$3,518.33
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$4,265.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Healthscope Commercial |
$4,538.03
|
| Rate for Payer: Healthscope Whirlpool |
$4,401.89
|
| Rate for Payer: Mclaren Commercial |
$4,084.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: Nomi Health Commercial |
$3,721.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,993.47
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
