|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$353.74
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$265.31 |
| Max. Negotiated Rate |
$353.74 |
| Rate for Payer: Aetna Commercial |
$318.37
|
| Rate for Payer: ASR ASR |
$343.13
|
| Rate for Payer: BCBS Trust/PPO |
$290.49
|
| Rate for Payer: BCN Commercial |
$290.49
|
| Rate for Payer: Cash Price |
$282.99
|
| Rate for Payer: Cofinity Commercial |
$332.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.99
|
| Rate for Payer: Healthscope Commercial |
$343.13
|
| Rate for Payer: Healthscope Whirlpool |
$353.74
|
| Rate for Payer: Mclaren Commercial |
$318.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.68
|
| Rate for Payer: Nomi Health Commercial |
$290.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.29
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS 16-30 DAYS
|
Facility
|
OP
|
$117.05
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$105.34
|
| Rate for Payer: Aetna Medicare |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.49
|
| Rate for Payer: ASR ASR |
$113.54
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS MAPPO |
$37.19
|
| Rate for Payer: BCBS Trust/PPO |
$96.51
|
| Rate for Payer: BCN Commercial |
$96.51
|
| Rate for Payer: BCN Medicare Advantage |
$37.19
|
| Rate for Payer: Cash Price |
$93.64
|
| Rate for Payer: Cash Price |
$93.64
|
| Rate for Payer: Cofinity Commercial |
$110.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.19
|
| Rate for Payer: Healthscope Commercial |
$113.54
|
| Rate for Payer: Healthscope Whirlpool |
$117.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.19
|
| Rate for Payer: Mclaren Commercial |
$105.34
|
| Rate for Payer: Mclaren Medicaid |
$37.19
|
| Rate for Payer: Mclaren Medicare |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.05
|
| Rate for Payer: Meridian Medicaid |
$20.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.49
|
| Rate for Payer: Nomi Health Commercial |
$95.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.79
|
| Rate for Payer: PACE Medicare |
$35.33
|
| Rate for Payer: PACE SWMI |
$37.19
|
| Rate for Payer: PHP Commercial |
$40.91
|
| Rate for Payer: PHP Medicaid |
$19.93
|
| Rate for Payer: PHP Medicare Advantage |
$37.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.56
|
| Rate for Payer: Priority Health Medicare |
$37.19
|
| Rate for Payer: Priority Health Narrow Network |
$82.05
|
| Rate for Payer: Railroad Medicare Medicare |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.19
|
| Rate for Payer: UHC Exchange |
$57.64
|
| Rate for Payer: UHC Medicaid |
$19.45
|
| Rate for Payer: UHCCP DNSP |
$37.19
|
| Rate for Payer: UHCCP Medicaid |
$19.45
|
| Rate for Payer: VA VA |
$37.19
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS 16-30 DAYS
|
Facility
|
IP
|
$117.05
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.79 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$105.34
|
| Rate for Payer: ASR ASR |
$113.54
|
| Rate for Payer: BCBS Trust/PPO |
$96.12
|
| Rate for Payer: BCN Commercial |
$96.12
|
| Rate for Payer: Cash Price |
$93.64
|
| Rate for Payer: Cofinity Commercial |
$110.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.64
|
| Rate for Payer: Healthscope Commercial |
$113.54
|
| Rate for Payer: Healthscope Whirlpool |
$117.05
|
| Rate for Payer: Mclaren Commercial |
$105.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.49
|
| Rate for Payer: Nomi Health Commercial |
$95.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.00
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$373.46
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$280.10 |
| Max. Negotiated Rate |
$373.46 |
| Rate for Payer: Aetna Commercial |
$336.11
|
| Rate for Payer: ASR ASR |
$362.26
|
| Rate for Payer: BCBS Trust/PPO |
$306.69
|
| Rate for Payer: BCN Commercial |
$306.69
|
| Rate for Payer: Cash Price |
$298.77
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.77
|
| Rate for Payer: Healthscope Commercial |
$362.26
|
| Rate for Payer: Healthscope Whirlpool |
$373.46
|
| Rate for Payer: Mclaren Commercial |
$336.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.44
|
| Rate for Payer: Nomi Health Commercial |
$306.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.64
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$373.46
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$373.46 |
| Rate for Payer: Aetna Commercial |
$336.11
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.82
|
| Rate for Payer: ASR ASR |
$362.26
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$132.66
|
| Rate for Payer: BCBS Trust/PPO |
$307.92
|
| Rate for Payer: BCN Commercial |
$307.92
|
| Rate for Payer: BCN Medicare Advantage |
$132.66
|
| Rate for Payer: Cash Price |
$298.77
|
| Rate for Payer: Cash Price |
$298.77
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.66
|
| Rate for Payer: Healthscope Commercial |
$362.26
|
| Rate for Payer: Healthscope Whirlpool |
$373.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.66
|
| Rate for Payer: Mclaren Commercial |
$336.11
|
| Rate for Payer: Mclaren Medicaid |
$132.66
|
| Rate for Payer: Mclaren Medicare |
$132.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.29
|
| Rate for Payer: Meridian Medicaid |
$72.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.44
|
| Rate for Payer: Nomi Health Commercial |
$306.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.10
|
| Rate for Payer: PACE Medicare |
$126.03
|
| Rate for Payer: PACE SWMI |
$132.66
|
| Rate for Payer: PHP Commercial |
$145.93
|
| Rate for Payer: PHP Medicaid |
$71.11
|
| Rate for Payer: PHP Medicare Advantage |
$132.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$327.23
|
| Rate for Payer: Priority Health Medicare |
$132.66
|
| Rate for Payer: Priority Health Narrow Network |
$261.80
|
| Rate for Payer: Railroad Medicare Medicare |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.66
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicaid |
$69.38
|
| Rate for Payer: UHCCP DNSP |
$132.66
|
| Rate for Payer: UHCCP Medicaid |
$69.38
|
| Rate for Payer: VA VA |
$132.66
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$675.66
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$249.99 |
| Max. Negotiated Rate |
$675.66 |
| Rate for Payer: Aetna Commercial |
$608.09
|
| Rate for Payer: Aetna Medicare |
$249.99
|
| Rate for Payer: ASR ASR |
$655.39
|
| Rate for Payer: BCBS Complete |
$270.26
|
| Rate for Payer: BCBS Trust/PPO |
$557.08
|
| Rate for Payer: BCN Commercial |
$557.08
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$635.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$655.39
|
| Rate for Payer: Healthscope Whirlpool |
$675.66
|
| Rate for Payer: Mclaren Commercial |
$608.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$592.01
|
| Rate for Payer: Priority Health Narrow Network |
$473.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.58
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$675.66
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.75 |
| Max. Negotiated Rate |
$675.66 |
| Rate for Payer: Aetna Commercial |
$608.09
|
| Rate for Payer: ASR ASR |
$655.39
|
| Rate for Payer: BCBS Trust/PPO |
$554.85
|
| Rate for Payer: BCN Commercial |
$554.85
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$635.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$655.39
|
| Rate for Payer: Healthscope Whirlpool |
$675.66
|
| Rate for Payer: Mclaren Commercial |
$608.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.58
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,289.60
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$2,060.64
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$2,220.91
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,887.78
|
| Rate for Payer: BCN Commercial |
$1,887.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,831.68
|
| Rate for Payer: Cash Price |
$1,831.68
|
| Rate for Payer: Cofinity Commercial |
$2,152.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,831.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$2,220.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,289.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$2,060.64
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,946.16
|
| Rate for Payer: Nomi Health Commercial |
$1,877.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,717.20
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,006.15
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,014.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,289.60
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,717.20 |
| Max. Negotiated Rate |
$2,289.60 |
| Rate for Payer: Aetna Commercial |
$2,060.64
|
| Rate for Payer: ASR ASR |
$2,220.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,880.22
|
| Rate for Payer: BCN Commercial |
$1,880.22
|
| Rate for Payer: Cash Price |
$1,831.68
|
| Rate for Payer: Cofinity Commercial |
$2,152.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,831.68
|
| Rate for Payer: Healthscope Commercial |
$2,220.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,289.60
|
| Rate for Payer: Mclaren Commercial |
$2,060.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,946.16
|
| Rate for Payer: Nomi Health Commercial |
$1,877.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,717.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,014.85
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.65 |
| Max. Negotiated Rate |
$350.20 |
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$287.58
|
| Rate for Payer: BCN Commercial |
$287.58
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$339.69
|
| Rate for Payer: Healthscope Whirlpool |
$350.20
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.67
|
| Rate for Payer: Nomi Health Commercial |
$287.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$689.94 |
| Rate for Payer: Aetna Commercial |
$315.18
|
| Rate for Payer: Aetna Medicare |
$445.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: ASR ASR |
$339.69
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$288.74
|
| Rate for Payer: BCN Commercial |
$288.74
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$329.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$339.69
|
| Rate for Payer: Healthscope Whirlpool |
$350.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$315.18
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$244.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.67
|
| Rate for Payer: Nomi Health Commercial |
$287.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.65
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$489.63
|
| Rate for Payer: PHP Medicaid |
$238.58
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$306.85
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$245.49
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$689.94
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP DNSP |
$445.12
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: VA VA |
$445.12
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.84 |
| Max. Negotiated Rate |
$1,144.44 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| Rate for Payer: Aetna Medicare |
$445.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: ASR ASR |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$943.59
|
| Rate for Payer: BCN Commercial |
$943.59
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$1,075.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$1,110.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,144.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$244.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$489.63
|
| Rate for Payer: PHP Medicaid |
$238.58
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$207.30
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$165.84
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$689.94
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP DNSP |
$445.12
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: VA VA |
$445.12
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.33 |
| Max. Negotiated Rate |
$1,144.44 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| Rate for Payer: ASR ASR |
$1,110.11
|
| Rate for Payer: BCBS Trust/PPO |
$939.81
|
| Rate for Payer: BCN Commercial |
$939.81
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$1,075.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,110.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,144.44
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.11 |
| Max. Negotiated Rate |
$364.14 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: ASR ASR |
$353.22
|
| Rate for Payer: BCBS Trust/PPO |
$299.03
|
| Rate for Payer: BCN Commercial |
$299.03
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$353.22
|
| Rate for Payer: Healthscope Whirlpool |
$364.14
|
| Rate for Payer: Mclaren Commercial |
$327.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$298.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.44
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$364.14 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$353.22
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$300.23
|
| Rate for Payer: BCN Commercial |
$300.23
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$353.22
|
| Rate for Payer: Healthscope Whirlpool |
$364.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$327.73
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$298.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$3,014.28 |
| Rate for Payer: Aetna Commercial |
$1,966.43
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$2,119.37
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.47
|
| Rate for Payer: BCN Commercial |
$1,801.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$2,053.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,119.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,014.28
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,411.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,922.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,638.69 |
| Max. Negotiated Rate |
$2,184.92 |
| Rate for Payer: Aetna Commercial |
$1,966.43
|
| Rate for Payer: ASR ASR |
$2,119.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,794.26
|
| Rate for Payer: BCN Commercial |
$1,794.26
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$2,053.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$2,119.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.92
|
| Rate for Payer: Mclaren Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,922.73
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$5,185.89 |
| Rate for Payer: Aetna Commercial |
$4,667.30
|
| Rate for Payer: Aetna Medicare |
$2,765.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: ASR ASR |
$5,030.31
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,275.77
|
| Rate for Payer: BCN Commercial |
$4,275.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Commercial |
$4,874.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$5,030.31
|
| Rate for Payer: Healthscope Whirlpool |
$5,185.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$4,667.30
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$1,518.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Nomi Health Commercial |
$4,252.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,042.25
|
| Rate for Payer: PHP Medicaid |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,060.21
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$3,248.17
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,563.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Exchange |
$4,286.80
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP DNSP |
$2,765.68
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,889.42 |
| Max. Negotiated Rate |
$5,185.89 |
| Rate for Payer: Aetna Commercial |
$4,667.30
|
| Rate for Payer: ASR ASR |
$5,030.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,258.65
|
| Rate for Payer: BCN Commercial |
$4,258.65
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Commercial |
$4,874.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Healthscope Commercial |
$5,030.31
|
| Rate for Payer: Healthscope Whirlpool |
$5,185.89
|
| Rate for Payer: Mclaren Commercial |
$4,667.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Nomi Health Commercial |
$4,252.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,563.58
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,411.35 |
| Max. Negotiated Rate |
$3,215.13 |
| Rate for Payer: Aetna Commercial |
$2,893.62
|
| Rate for Payer: ASR ASR |
$3,118.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.26
|
| Rate for Payer: BCN Commercial |
$2,640.26
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Commercial |
$3,022.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Healthscope Commercial |
$3,118.68
|
| Rate for Payer: Healthscope Whirlpool |
$3,215.13
|
| Rate for Payer: Mclaren Commercial |
$2,893.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Nomi Health Commercial |
$2,636.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,829.31
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,947.40 |
| Max. Negotiated Rate |
$5,771.46 |
| Rate for Payer: Aetna Commercial |
$2,893.62
|
| Rate for Payer: Aetna Medicare |
$3,723.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: ASR ASR |
$3,118.68
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,650.87
|
| Rate for Payer: BCN Commercial |
$2,650.87
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Commercial |
$3,022.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$3,118.68
|
| Rate for Payer: Healthscope Whirlpool |
$3,215.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,723.52
|
| Rate for Payer: Mclaren Commercial |
$2,893.62
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$2,044.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Nomi Health Commercial |
$2,636.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$4,095.87
|
| Rate for Payer: PHP Medicaid |
$1,995.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,817.10
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,253.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,829.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Exchange |
$5,771.46
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP DNSP |
$3,723.52
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: VA VA |
$3,723.52
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,652.48 |
| Max. Negotiated Rate |
$3,536.64 |
| Rate for Payer: Aetna Commercial |
$3,182.98
|
| Rate for Payer: ASR ASR |
$3,430.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.29
|
| Rate for Payer: BCN Commercial |
$2,904.29
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Commercial |
$3,324.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Healthscope Commercial |
$3,430.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,536.64
|
| Rate for Payer: Mclaren Commercial |
$3,182.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Nomi Health Commercial |
$2,900.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,112.24
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,479.18 |
| Max. Negotiated Rate |
$12,780.73 |
| Rate for Payer: Aetna Commercial |
$3,182.98
|
| Rate for Payer: Aetna Medicare |
$8,245.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: ASR ASR |
$3,430.54
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,915.96
|
| Rate for Payer: BCN Commercial |
$2,915.96
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Commercial |
$3,324.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$3,430.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,536.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,245.63
|
| Rate for Payer: Mclaren Commercial |
$3,182.98
|
| Rate for Payer: Mclaren Medicaid |
$8,245.63
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$4,528.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Nomi Health Commercial |
$2,900.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$9,070.19
|
| Rate for Payer: PHP Medicaid |
$4,419.66
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,098.80
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,479.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,112.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Exchange |
$12,780.73
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP DNSP |
$8,245.63
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: VA VA |
$8,245.63
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,164.37 |
| Max. Negotiated Rate |
$8,219.16 |
| Rate for Payer: Aetna Commercial |
$7,397.24
|
| Rate for Payer: ASR ASR |
$7,972.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,749.57
|
| Rate for Payer: BCN Commercial |
$6,749.57
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,726.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,972.59
|
| Rate for Payer: Healthscope Whirlpool |
$8,219.16
|
| Rate for Payer: Mclaren Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,232.86
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,219.16 |
| Rate for Payer: Aetna Commercial |
$7,397.24
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$7,972.59
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,776.70
|
| Rate for Payer: BCN Commercial |
$6,776.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,726.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,972.59
|
| Rate for Payer: Healthscope Whirlpool |
$8,219.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,397.24
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,201.63
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,761.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,232.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
