|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| 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: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| 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 |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| 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 PITOCIN AUGMENTATION
|
Facility
|
IP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$308.77 |
| Max. Negotiated Rate |
$475.03 |
| Rate for Payer: Aetna Commercial |
$427.53
|
| Rate for Payer: ASR ASR |
$460.78
|
| Rate for Payer: ASR Commercial |
$460.78
|
| Rate for Payer: BCBS Trust/PPO |
$387.10
|
| Rate for Payer: BCN Commercial |
$368.29
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$446.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Healthscope Commercial |
$475.03
|
| Rate for Payer: Healthscope Whirlpool |
$460.78
|
| Rate for Payer: Mclaren Commercial |
$427.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: Nomi Health Commercial |
$389.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$418.03
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
OP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$190.01 |
| Max. Negotiated Rate |
$475.03 |
| Rate for Payer: Aetna Commercial |
$427.53
|
| Rate for Payer: Aetna Medicare |
$237.52
|
| Rate for Payer: ASR ASR |
$460.78
|
| Rate for Payer: ASR Commercial |
$460.78
|
| Rate for Payer: BCBS Complete |
$190.01
|
| Rate for Payer: BCBS Trust/PPO |
$389.00
|
| Rate for Payer: BCN Commercial |
$368.29
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$446.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Healthscope Commercial |
$475.03
|
| Rate for Payer: Healthscope Whirlpool |
$460.78
|
| Rate for Payer: Mclaren Commercial |
$427.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: Nomi Health Commercial |
$389.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.22
|
| Rate for Payer: Priority Health Narrow Network |
$333.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$418.03
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$21.83 |
| Rate for Payer: Aetna Commercial |
$19.65
|
| Rate for Payer: ASR ASR |
$21.18
|
| Rate for Payer: ASR Commercial |
$21.18
|
| Rate for Payer: BCBS Trust/PPO |
$17.79
|
| Rate for Payer: BCN Commercial |
$16.92
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$21.83
|
| Rate for Payer: Healthscope Whirlpool |
$21.18
|
| Rate for Payer: Mclaren Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.21
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$189.95 |
| Rate for Payer: Aetna Commercial |
$19.65
|
| 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 |
$21.18
|
| Rate for Payer: ASR Commercial |
$21.18
|
| Rate for Payer: BCBS Complete |
$3.10
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$17.88
|
| Rate for Payer: BCN Commercial |
$16.92
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$21.83
|
| Rate for Payer: Healthscope Whirlpool |
$21.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.50
|
| Rate for Payer: Mclaren Commercial |
$19.65
|
| Rate for Payer: Mclaren Medicaid |
$2.95
|
| 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 |
$3.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| 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 |
$2.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.95
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$151.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.50
|
| Rate for Payer: UHC Exchange |
$8.52
|
| Rate for Payer: UHC Medicare Advantage |
$5.50
|
| Rate for Payer: UHCCP DNSP |
$5.50
|
| Rate for Payer: UHCCP Medicaid |
$2.95
|
| Rate for Payer: VA VA |
$5.50
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
OP
|
$3,683.04
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,393.98 |
| Max. Negotiated Rate |
$9,476.05 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| Rate for Payer: Aetna Medicare |
$6,113.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: ASR ASR |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,016.04
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$6,724.94
|
| Rate for Payer: PHP Medicaid |
$3,276.88
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,227.08
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,581.81
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Exchange |
$9,476.05
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP DNSP |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,276.88
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
IP
|
$3,683.04
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,393.98 |
| Max. Negotiated Rate |
$3,683.04 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| Rate for Payer: ASR ASR |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,001.31
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,683.04
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| 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 |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,016.04
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| 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 |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| 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 |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,227.08
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,581.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
| 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 PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,683.04
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,393.98 |
| Max. Negotiated Rate |
$3,683.04 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| Rate for Payer: ASR ASR |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,001.31
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,181.54
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,068.00 |
| Max. Negotiated Rate |
$3,181.54 |
| Rate for Payer: Aetna Commercial |
$2,863.39
|
| Rate for Payer: ASR ASR |
$3,086.09
|
| Rate for Payer: ASR Commercial |
$3,086.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,592.64
|
| Rate for Payer: BCN Commercial |
$2,466.65
|
| Rate for Payer: Cash Price |
$2,545.23
|
| Rate for Payer: Cofinity Commercial |
$2,990.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,545.23
|
| Rate for Payer: Healthscope Commercial |
$3,181.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,086.09
|
| Rate for Payer: Mclaren Commercial |
$2,863.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,704.31
|
| Rate for Payer: Nomi Health Commercial |
$2,608.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,068.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,799.76
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,181.54
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$2,863.39
|
| 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 |
$3,086.09
|
| Rate for Payer: ASR Commercial |
$3,086.09
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,605.36
|
| Rate for Payer: BCN Commercial |
$2,466.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$2,545.23
|
| Rate for Payer: Cash Price |
$2,545.23
|
| Rate for Payer: Cofinity Commercial |
$2,990.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,545.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$3,181.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,086.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$2,863.39
|
| 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 |
$2,704.31
|
| Rate for Payer: Nomi Health Commercial |
$2,608.86
|
| 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 |
$2,068.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,787.67
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,230.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,799.76
|
| 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 PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,165.71
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.84 |
| Max. Negotiated Rate |
$1,165.71 |
| Rate for Payer: Aetna Commercial |
$1,049.14
|
| Rate for Payer: Aetna Medicare |
$582.86
|
| Rate for Payer: ASR ASR |
$1,130.74
|
| Rate for Payer: ASR Commercial |
$1,130.74
|
| Rate for Payer: BCBS Complete |
$466.28
|
| Rate for Payer: BCBS Trust/PPO |
$954.60
|
| Rate for Payer: BCCCP Commercial |
$156.92
|
| Rate for Payer: BCN Commercial |
$903.77
|
| Rate for Payer: Cash Price |
$932.57
|
| Rate for Payer: Cash Price |
$932.57
|
| Rate for Payer: Cofinity Commercial |
$1,095.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.57
|
| Rate for Payer: Healthscope Commercial |
$1,165.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,130.74
|
| Rate for Payer: Mclaren Commercial |
$1,049.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.85
|
| Rate for Payer: Nomi Health Commercial |
$955.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.55
|
| Rate for Payer: Priority Health Narrow Network |
$114.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.82
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,165.71
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.71 |
| Max. Negotiated Rate |
$1,165.71 |
| Rate for Payer: Aetna Commercial |
$1,049.14
|
| Rate for Payer: ASR ASR |
$1,130.74
|
| Rate for Payer: ASR Commercial |
$1,130.74
|
| Rate for Payer: BCBS Trust/PPO |
$949.94
|
| Rate for Payer: BCN Commercial |
$903.77
|
| Rate for Payer: Cash Price |
$932.57
|
| Rate for Payer: Cofinity Commercial |
$1,095.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.57
|
| Rate for Payer: Healthscope Commercial |
$1,165.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,130.74
|
| Rate for Payer: Mclaren Commercial |
$1,049.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.85
|
| Rate for Payer: Nomi Health Commercial |
$955.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.82
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,755.98
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,141.39 |
| Max. Negotiated Rate |
$1,755.98 |
| Rate for Payer: Aetna Commercial |
$1,580.38
|
| Rate for Payer: ASR ASR |
$1,703.30
|
| Rate for Payer: ASR Commercial |
$1,703.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,430.95
|
| Rate for Payer: BCN Commercial |
$1,361.41
|
| Rate for Payer: Cash Price |
$1,404.78
|
| Rate for Payer: Cofinity Commercial |
$1,650.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,404.78
|
| Rate for Payer: Healthscope Commercial |
$1,755.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,703.30
|
| Rate for Payer: Mclaren Commercial |
$1,580.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,492.58
|
| Rate for Payer: Nomi Health Commercial |
$1,439.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,545.26
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,755.98
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.47 |
| Max. Negotiated Rate |
$1,755.98 |
| Rate for Payer: Aetna Commercial |
$1,580.38
|
| Rate for Payer: Aetna Medicare |
$877.99
|
| Rate for Payer: ASR ASR |
$1,703.30
|
| Rate for Payer: ASR Commercial |
$1,703.30
|
| Rate for Payer: BCBS Complete |
$702.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,437.97
|
| Rate for Payer: BCCCP Commercial |
$432.83
|
| Rate for Payer: BCN Commercial |
$1,361.41
|
| Rate for Payer: Cash Price |
$1,404.78
|
| Rate for Payer: Cash Price |
$1,404.78
|
| Rate for Payer: Cofinity Commercial |
$1,650.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,404.78
|
| Rate for Payer: Healthscope Commercial |
$1,755.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,703.30
|
| Rate for Payer: Mclaren Commercial |
$1,580.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,492.58
|
| Rate for Payer: Nomi Health Commercial |
$1,439.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.59
|
| Rate for Payer: Priority Health Narrow Network |
$148.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,545.26
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,107.08
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$2,107.08 |
| Rate for Payer: Aetna Commercial |
$1,896.37
|
| Rate for Payer: Aetna Medicare |
$1,053.54
|
| Rate for Payer: ASR ASR |
$2,043.87
|
| Rate for Payer: ASR Commercial |
$2,043.87
|
| Rate for Payer: BCBS Complete |
$842.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.49
|
| Rate for Payer: BCCCP Commercial |
$171.66
|
| Rate for Payer: BCN Commercial |
$1,633.62
|
| Rate for Payer: Cash Price |
$1,685.66
|
| Rate for Payer: Cash Price |
$1,685.66
|
| Rate for Payer: Cofinity Commercial |
$1,980.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,685.66
|
| Rate for Payer: Healthscope Commercial |
$2,107.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,043.87
|
| Rate for Payer: Mclaren Commercial |
$1,896.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,791.02
|
| Rate for Payer: Nomi Health Commercial |
$1,727.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.58
|
| Rate for Payer: Priority Health Narrow Network |
$115.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,854.23
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,107.08
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,369.60 |
| Max. Negotiated Rate |
$2,107.08 |
| Rate for Payer: Aetna Commercial |
$1,896.37
|
| Rate for Payer: ASR ASR |
$2,043.87
|
| Rate for Payer: ASR Commercial |
$2,043.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,717.06
|
| Rate for Payer: BCN Commercial |
$1,633.62
|
| Rate for Payer: Cash Price |
$1,685.66
|
| Rate for Payer: Cofinity Commercial |
$1,980.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,685.66
|
| Rate for Payer: Healthscope Commercial |
$2,107.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,043.87
|
| Rate for Payer: Mclaren Commercial |
$1,896.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,791.02
|
| Rate for Payer: Nomi Health Commercial |
$1,727.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,854.23
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,918.68
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$2,918.68 |
| Rate for Payer: Aetna Commercial |
$2,626.81
|
| Rate for Payer: Aetna Medicare |
$1,459.34
|
| Rate for Payer: ASR ASR |
$2,831.12
|
| Rate for Payer: ASR Commercial |
$2,831.12
|
| Rate for Payer: BCBS Complete |
$1,167.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,390.11
|
| Rate for Payer: BCCCP Commercial |
$266.26
|
| Rate for Payer: BCN Commercial |
$2,262.85
|
| Rate for Payer: Cash Price |
$2,334.94
|
| Rate for Payer: Cash Price |
$2,334.94
|
| Rate for Payer: Cofinity Commercial |
$2,743.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,334.94
|
| Rate for Payer: Healthscope Commercial |
$2,918.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,831.12
|
| Rate for Payer: Mclaren Commercial |
$2,626.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,480.88
|
| Rate for Payer: Nomi Health Commercial |
$2,393.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.07
|
| Rate for Payer: Priority Health Narrow Network |
$99.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,568.44
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,918.68
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,897.14 |
| Max. Negotiated Rate |
$2,918.68 |
| Rate for Payer: Aetna Commercial |
$2,626.81
|
| Rate for Payer: ASR ASR |
$2,831.12
|
| Rate for Payer: ASR Commercial |
$2,831.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,378.43
|
| Rate for Payer: BCN Commercial |
$2,262.85
|
| Rate for Payer: Cash Price |
$2,334.94
|
| Rate for Payer: Cofinity Commercial |
$2,743.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,334.94
|
| Rate for Payer: Healthscope Commercial |
$2,918.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,831.12
|
| Rate for Payer: Mclaren Commercial |
$2,626.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,480.88
|
| Rate for Payer: Nomi Health Commercial |
$2,393.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,568.44
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,448.79
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$941.71 |
| Max. Negotiated Rate |
$1,448.79 |
| Rate for Payer: Aetna Commercial |
$1,303.91
|
| Rate for Payer: ASR ASR |
$1,405.33
|
| Rate for Payer: ASR Commercial |
$1,405.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.62
|
| Rate for Payer: BCN Commercial |
$1,123.25
|
| Rate for Payer: Cash Price |
$1,159.03
|
| Rate for Payer: Cofinity Commercial |
$1,361.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.03
|
| Rate for Payer: Healthscope Commercial |
$1,448.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.33
|
| Rate for Payer: Mclaren Commercial |
$1,303.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.47
|
| Rate for Payer: Nomi Health Commercial |
$1,188.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.94
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,448.79
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,303.91
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,405.33
|
| Rate for Payer: ASR Commercial |
$1,405.33
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.41
|
| Rate for Payer: BCCCP Commercial |
$225.33
|
| Rate for Payer: BCN Commercial |
$1,123.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,159.03
|
| Rate for Payer: Cash Price |
$1,159.03
|
| Rate for Payer: Cofinity Commercial |
$1,361.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,448.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,303.91
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.47
|
| Rate for Payer: Nomi Health Commercial |
$1,188.01
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.49
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$89.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,693.72
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,100.92 |
| Max. Negotiated Rate |
$1,693.72 |
| Rate for Payer: Aetna Commercial |
$1,524.35
|
| Rate for Payer: ASR ASR |
$1,642.91
|
| Rate for Payer: ASR Commercial |
$1,642.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.21
|
| Rate for Payer: BCN Commercial |
$1,313.14
|
| Rate for Payer: Cash Price |
$1,354.98
|
| Rate for Payer: Cofinity Commercial |
$1,592.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.98
|
| Rate for Payer: Healthscope Commercial |
$1,693.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,642.91
|
| Rate for Payer: Mclaren Commercial |
$1,524.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.66
|
| Rate for Payer: Nomi Health Commercial |
$1,388.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,490.47
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
OP
|
$1,693.72
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$1,693.72 |
| Rate for Payer: Aetna Commercial |
$1,524.35
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,642.91
|
| Rate for Payer: ASR Commercial |
$1,642.91
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.99
|
| Rate for Payer: BCCCP Commercial |
$566.80
|
| Rate for Payer: BCN Commercial |
$1,313.14
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$1,354.98
|
| Rate for Payer: Cash Price |
$1,354.98
|
| Rate for Payer: Cofinity Commercial |
$1,592.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,693.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,642.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$1,524.35
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.66
|
| Rate for Payer: Nomi Health Commercial |
$1,388.85
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.49
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$89.99
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,490.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
IP
|
$2,390.22
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,553.64 |
| Max. Negotiated Rate |
$2,390.22 |
| Rate for Payer: Aetna Commercial |
$2,151.20
|
| Rate for Payer: ASR ASR |
$2,318.51
|
| Rate for Payer: ASR Commercial |
$2,318.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,947.79
|
| Rate for Payer: BCN Commercial |
$1,853.14
|
| Rate for Payer: Cash Price |
$1,912.18
|
| Rate for Payer: Cofinity Commercial |
$2,246.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,912.18
|
| Rate for Payer: Healthscope Commercial |
$2,390.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,318.51
|
| Rate for Payer: Mclaren Commercial |
$2,151.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,031.69
|
| Rate for Payer: Nomi Health Commercial |
$1,959.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,553.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,103.39
|
|
