|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.71 |
| Max. Negotiated Rate |
$6,624.17 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,398.04
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,424.53
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,804.10
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,643.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,424.53
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,804.10
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,643.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.71 |
| Max. Negotiated Rate |
$6,624.17 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,398.04
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,424.53
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,804.10
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,643.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.71 |
| Max. Negotiated Rate |
$6,624.17 |
| Rate for Payer: Aetna Commercial |
$5,961.75
|
| Rate for Payer: ASR ASR |
$6,425.44
|
| Rate for Payer: ASR Commercial |
$6,425.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,398.04
|
| Rate for Payer: BCN Commercial |
$5,135.72
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$6,226.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$6,624.17
|
| Rate for Payer: Healthscope Whirlpool |
$6,425.44
|
| Rate for Payer: Mclaren Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,829.27
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.76 |
| Max. Negotiated Rate |
$204.41 |
| Rate for Payer: Aetna Commercial |
$183.97
|
| Rate for Payer: Aetna Medicare |
$102.20
|
| Rate for Payer: ASR ASR |
$198.28
|
| Rate for Payer: ASR Commercial |
$198.28
|
| Rate for Payer: BCBS Complete |
$81.76
|
| Rate for Payer: BCBS Trust/PPO |
$167.39
|
| Rate for Payer: BCN Commercial |
$158.48
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$192.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$204.41
|
| Rate for Payer: Healthscope Whirlpool |
$198.28
|
| Rate for Payer: Mclaren Commercial |
$183.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.10
|
| Rate for Payer: Priority Health Narrow Network |
$143.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.88
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$204.41 |
| Rate for Payer: Aetna Commercial |
$183.97
|
| Rate for Payer: ASR ASR |
$198.28
|
| Rate for Payer: ASR Commercial |
$198.28
|
| Rate for Payer: BCBS Trust/PPO |
$166.57
|
| Rate for Payer: BCN Commercial |
$158.48
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$192.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$204.41
|
| Rate for Payer: Healthscope Whirlpool |
$198.28
|
| Rate for Payer: Mclaren Commercial |
$183.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.88
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,631.20 |
| Max. Negotiated Rate |
$9,078.00 |
| Rate for Payer: Aetna Commercial |
$8,170.20
|
| Rate for Payer: Aetna Medicare |
$4,539.00
|
| Rate for Payer: ASR ASR |
$8,805.66
|
| Rate for Payer: ASR Commercial |
$8,805.66
|
| Rate for Payer: BCBS Complete |
$3,631.20
|
| Rate for Payer: BCBS Trust/PPO |
$7,433.97
|
| Rate for Payer: BCN Commercial |
$7,038.17
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$8,533.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Healthscope Commercial |
$9,078.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,805.66
|
| Rate for Payer: Mclaren Commercial |
$8,170.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: Nomi Health Commercial |
$7,443.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,954.14
|
| Rate for Payer: Priority Health Narrow Network |
$6,363.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,988.64
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,900.70 |
| Max. Negotiated Rate |
$9,078.00 |
| Rate for Payer: Aetna Commercial |
$8,170.20
|
| Rate for Payer: ASR ASR |
$8,805.66
|
| Rate for Payer: ASR Commercial |
$8,805.66
|
| Rate for Payer: BCBS Trust/PPO |
$7,397.66
|
| Rate for Payer: BCN Commercial |
$7,038.17
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$8,533.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Healthscope Commercial |
$9,078.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,805.66
|
| Rate for Payer: Mclaren Commercial |
$8,170.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: Nomi Health Commercial |
$7,443.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,988.64
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.29 |
| Max. Negotiated Rate |
$5,213.75 |
| Rate for Payer: Aetna Commercial |
$298.09
|
| Rate for Payer: Aetna Medicare |
$3,363.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: ASR ASR |
$321.27
|
| Rate for Payer: ASR Commercial |
$321.27
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCBS Trust/PPO |
$271.23
|
| Rate for Payer: BCN Commercial |
$256.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$311.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$331.21
|
| Rate for Payer: Healthscope Whirlpool |
$321.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,363.71
|
| Rate for Payer: Mclaren Commercial |
$298.09
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: Nomi Health Commercial |
$271.59
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,700.08
|
| Rate for Payer: PHP Medicaid |
$1,802.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.21
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health Narrow Network |
$232.18
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Exchange |
$5,213.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP DNSP |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,802.95
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.29 |
| Max. Negotiated Rate |
$331.21 |
| Rate for Payer: Aetna Commercial |
$298.09
|
| Rate for Payer: ASR ASR |
$321.27
|
| Rate for Payer: ASR Commercial |
$321.27
|
| Rate for Payer: BCBS Trust/PPO |
$269.90
|
| Rate for Payer: BCN Commercial |
$256.79
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$311.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Healthscope Commercial |
$331.21
|
| Rate for Payer: Healthscope Whirlpool |
$321.27
|
| Rate for Payer: Mclaren Commercial |
$298.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: Nomi Health Commercial |
$271.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.46
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,368.14 |
| Max. Negotiated Rate |
$3,643.30 |
| Rate for Payer: Aetna Commercial |
$3,278.97
|
| Rate for Payer: ASR ASR |
$3,534.00
|
| Rate for Payer: ASR Commercial |
$3,534.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,968.93
|
| Rate for Payer: BCN Commercial |
$2,824.65
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,424.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,643.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,534.00
|
| Rate for Payer: Mclaren Commercial |
$3,278.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,206.10
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$5,213.75 |
| Rate for Payer: Aetna Commercial |
$3,278.97
|
| Rate for Payer: Aetna Medicare |
$3,363.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: ASR ASR |
$3,534.00
|
| Rate for Payer: ASR Commercial |
$3,534.00
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,983.50
|
| Rate for Payer: BCN Commercial |
$2,824.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,424.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$3,643.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,534.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,363.71
|
| Rate for Payer: Mclaren Commercial |
$3,278.97
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,700.08
|
| Rate for Payer: PHP Medicaid |
$1,802.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,192.26
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,553.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,206.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Exchange |
$5,213.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP DNSP |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,802.95
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,368.14 |
| Max. Negotiated Rate |
$3,643.30 |
| Rate for Payer: Aetna Commercial |
$3,278.97
|
| Rate for Payer: ASR ASR |
$3,534.00
|
| Rate for Payer: ASR Commercial |
$3,534.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,968.93
|
| Rate for Payer: BCN Commercial |
$2,824.65
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,424.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,643.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,534.00
|
| Rate for Payer: Mclaren Commercial |
$3,278.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,206.10
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$5,213.75 |
| Rate for Payer: Aetna Commercial |
$3,278.97
|
| Rate for Payer: Aetna Medicare |
$3,363.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: ASR ASR |
$3,534.00
|
| Rate for Payer: ASR Commercial |
$3,534.00
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,983.50
|
| Rate for Payer: BCN Commercial |
$2,824.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,424.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$3,643.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,534.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,363.71
|
| Rate for Payer: Mclaren Commercial |
$3,278.97
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,700.08
|
| Rate for Payer: PHP Medicaid |
$1,802.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,192.26
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,553.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,206.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Exchange |
$5,213.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP DNSP |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,802.95
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$268.26 |
| Rate for Payer: Aetna Commercial |
$241.43
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$260.21
|
| Rate for Payer: ASR Commercial |
$260.21
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$219.68
|
| Rate for Payer: BCN Commercial |
$207.98
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$252.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$268.26
|
| Rate for Payer: Healthscope Whirlpool |
$260.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$241.43
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.05
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$188.05
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$174.37 |
| Max. Negotiated Rate |
$268.26 |
| Rate for Payer: Aetna Commercial |
$241.43
|
| Rate for Payer: ASR ASR |
$260.21
|
| Rate for Payer: ASR Commercial |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$218.61
|
| Rate for Payer: BCN Commercial |
$207.98
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$252.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$268.26
|
| Rate for Payer: Healthscope Whirlpool |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$241.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.07
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.93 |
| Max. Negotiated Rate |
$158.36 |
| Rate for Payer: Aetna Commercial |
$142.52
|
| Rate for Payer: ASR ASR |
$153.61
|
| Rate for Payer: ASR Commercial |
$153.61
|
| Rate for Payer: BCBS Trust/PPO |
$129.05
|
| Rate for Payer: BCN Commercial |
$122.78
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$148.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$158.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.61
|
| Rate for Payer: Mclaren Commercial |
$142.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.36
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.93 |
| Max. Negotiated Rate |
$543.79 |
| Rate for Payer: Aetna Commercial |
$142.52
|
| Rate for Payer: Aetna Medicare |
$350.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: ASR ASR |
$153.61
|
| Rate for Payer: ASR Commercial |
$153.61
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCBS Trust/PPO |
$129.68
|
| Rate for Payer: BCN Commercial |
$122.78
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$148.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$158.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$350.83
|
| Rate for Payer: Mclaren Commercial |
$142.52
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$385.91
|
| Rate for Payer: PHP Medicaid |
$188.04
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.76
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health Narrow Network |
$111.01
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$543.79
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP DNSP |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$42.78
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.77
|
| Rate for Payer: Priority Health Narrow Network |
$36.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Trust/PPO |
$42.57
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$75.12 |
| Max. Negotiated Rate |
$115.57 |
| Rate for Payer: Aetna Commercial |
$104.01
|
| Rate for Payer: ASR ASR |
$112.10
|
| Rate for Payer: ASR Commercial |
$112.10
|
| Rate for Payer: BCBS Trust/PPO |
$94.18
|
| Rate for Payer: BCN Commercial |
$89.60
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$108.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Healthscope Commercial |
$115.57
|
| Rate for Payer: Healthscope Whirlpool |
$112.10
|
| Rate for Payer: Mclaren Commercial |
$104.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: Nomi Health Commercial |
$94.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.70
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$115.57 |
| Rate for Payer: Aetna Commercial |
$104.01
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$112.10
|
| Rate for Payer: ASR Commercial |
$112.10
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$94.64
|
| Rate for Payer: BCN Commercial |
$89.60
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$108.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$115.57
|
| Rate for Payer: Healthscope Whirlpool |
$112.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$104.01
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: Nomi Health Commercial |
$94.77
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.26
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$81.01
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$104.08 |
| Max. Negotiated Rate |
$160.12 |
| Rate for Payer: Aetna Commercial |
$144.11
|
| Rate for Payer: ASR ASR |
$155.32
|
| Rate for Payer: ASR Commercial |
$155.32
|
| Rate for Payer: BCBS Trust/PPO |
$130.48
|
| Rate for Payer: BCN Commercial |
$124.14
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$150.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Healthscope Commercial |
$160.12
|
| Rate for Payer: Healthscope Whirlpool |
$155.32
|
| Rate for Payer: Mclaren Commercial |
$144.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.91
|
|
