|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,077.02 |
| Max. Negotiated Rate |
$2,769.36 |
| Rate for Payer: Aetna Commercial |
$2,492.42
|
| Rate for Payer: ASR ASR |
$2,686.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,274.20
|
| Rate for Payer: BCN Commercial |
$2,274.20
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Commercial |
$2,603.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Healthscope Commercial |
$2,686.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,769.36
|
| Rate for Payer: Mclaren Commercial |
$2,492.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Nomi Health Commercial |
$2,270.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,437.04
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Aetna Commercial |
$2,492.42
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$2,686.28
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,283.34
|
| Rate for Payer: BCN Commercial |
$2,283.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Commercial |
$2,603.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,686.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,769.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$2,492.42
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Nomi Health Commercial |
$2,270.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,426.51
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,941.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,437.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
OP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$516.66 |
| Max. Negotiated Rate |
$1,396.37 |
| Rate for Payer: Aetna Commercial |
$1,256.73
|
| Rate for Payer: Aetna Medicare |
$516.66
|
| Rate for Payer: ASR ASR |
$1,354.48
|
| Rate for Payer: BCBS Complete |
$558.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.31
|
| Rate for Payer: BCN Commercial |
$1,151.31
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Commercial |
$1,312.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,354.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,396.37
|
| Rate for Payer: Mclaren Commercial |
$1,256.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,117.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Nomi Health Commercial |
$1,145.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,223.50
|
| Rate for Payer: Priority Health Narrow Network |
$978.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,228.81
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
IP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,047.28 |
| Max. Negotiated Rate |
$1,396.37 |
| Rate for Payer: Aetna Commercial |
$1,256.73
|
| Rate for Payer: ASR ASR |
$1,354.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,146.70
|
| Rate for Payer: BCN Commercial |
$1,146.70
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Commercial |
$1,312.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,354.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,396.37
|
| Rate for Payer: Mclaren Commercial |
$1,256.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Nomi Health Commercial |
$1,145.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,228.81
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
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 SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
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
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,901.50 |
| Max. Negotiated Rate |
$5,202.00 |
| Rate for Payer: Aetna Commercial |
$4,681.80
|
| Rate for Payer: ASR ASR |
$5,045.94
|
| Rate for Payer: BCBS Trust/PPO |
$4,271.88
|
| Rate for Payer: BCN Commercial |
$4,271.88
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Commercial |
$4,889.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Commercial |
$5,045.94
|
| Rate for Payer: Healthscope Whirlpool |
$5,202.00
|
| Rate for Payer: Mclaren Commercial |
$4,681.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$4,265.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,577.76
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$5,202.00 |
| Rate for Payer: Aetna Commercial |
$4,681.80
|
| Rate for Payer: Aetna Medicare |
$2,055.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: ASR ASR |
$5,045.94
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,289.05
|
| Rate for Payer: BCN Commercial |
$4,289.05
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Commercial |
$4,889.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$5,045.94
|
| Rate for Payer: Healthscope Whirlpool |
$5,202.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,055.86
|
| Rate for Payer: Mclaren Commercial |
$4,681.80
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$1,129.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$4,265.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,261.45
|
| Rate for Payer: PHP Medicaid |
$1,101.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,557.99
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,646.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,577.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$3,186.58
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP DNSP |
$2,055.86
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.63 |
| Max. Negotiated Rate |
$1,147.51 |
| Rate for Payer: Aetna Commercial |
$1,032.76
|
| Rate for Payer: ASR ASR |
$1,113.08
|
| Rate for Payer: BCBS Trust/PPO |
$942.34
|
| Rate for Payer: BCN Commercial |
$942.34
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Commercial |
$1,078.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Healthscope Commercial |
$1,113.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,147.51
|
| Rate for Payer: Mclaren Commercial |
$1,032.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$940.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,009.81
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,147.51 |
| Rate for Payer: Aetna Commercial |
$1,032.76
|
| Rate for Payer: Aetna Medicare |
$625.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: ASR ASR |
$1,113.08
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$946.12
|
| Rate for Payer: BCN Commercial |
$946.12
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Commercial |
$1,078.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,113.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,147.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$1,032.76
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$343.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$940.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$687.55
|
| Rate for Payer: PHP Medicaid |
$335.03
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,005.45
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$804.40
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,009.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$968.83
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP DNSP |
$625.05
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,022.83
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,257.94
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,769.25
|
| Rate for Payer: BCN Commercial |
$2,769.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Commercial |
$3,157.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,257.94
|
| Rate for Payer: Healthscope Whirlpool |
$3,358.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,022.83
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$2,754.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,942.89
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,354.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,955.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,519.03 |
| Max. Negotiated Rate |
$3,358.70 |
| Rate for Payer: Aetna Commercial |
$3,022.83
|
| Rate for Payer: ASR ASR |
$3,257.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.16
|
| Rate for Payer: BCN Commercial |
$2,758.16
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Commercial |
$3,157.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Healthscope Commercial |
$3,257.94
|
| Rate for Payer: Healthscope Whirlpool |
$3,358.70
|
| Rate for Payer: Mclaren Commercial |
$3,022.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$2,754.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,955.66
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$752.75 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Trust/PPO |
$824.21
|
| Rate for Payer: BCN Commercial |
$824.21
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,003.66 |
| Rate for Payer: Aetna Commercial |
$903.29
|
| Rate for Payer: Aetna Medicare |
$625.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: ASR ASR |
$973.55
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$827.52
|
| Rate for Payer: BCN Commercial |
$827.52
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$943.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$973.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,003.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$903.29
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$343.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$687.55
|
| Rate for Payer: PHP Medicaid |
$335.03
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$879.41
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$703.57
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$968.83
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP DNSP |
$625.05
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$689.94 |
| Rate for Payer: Aetna Commercial |
$498.78
|
| 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 |
$537.57
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$456.94
|
| Rate for Payer: BCN Commercial |
$456.94
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$520.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$537.57
|
| Rate for Payer: Healthscope Whirlpool |
$554.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$498.78
|
| 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 |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| 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 |
$485.59
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$388.49
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.70
|
| 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 W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$415.65 |
| Max. Negotiated Rate |
$554.20 |
| Rate for Payer: Aetna Commercial |
$498.78
|
| Rate for Payer: ASR ASR |
$537.57
|
| Rate for Payer: BCBS Trust/PPO |
$455.11
|
| Rate for Payer: BCN Commercial |
$455.11
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$520.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$537.57
|
| Rate for Payer: Healthscope Whirlpool |
$554.20
|
| Rate for Payer: Mclaren Commercial |
$498.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.70
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.97 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Trust/PPO |
$217.86
|
| Rate for Payer: BCN Commercial |
$217.86
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: Aetna Medicare |
$98.16
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Complete |
$106.12
|
| Rate for Payer: BCBS Trust/PPO |
$218.74
|
| Rate for Payer: BCN Commercial |
$218.74
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$152.55
|
| Rate for Payer: Priority Health Narrow Network |
$122.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Aetna Commercial |
$2,549.57
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$2,747.86
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,335.68
|
| Rate for Payer: BCN Commercial |
$2,335.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Commercial |
$2,662.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,747.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,832.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$2,549.57
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Nomi Health Commercial |
$2,322.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,482.14
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,985.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,492.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,124.64 |
| Max. Negotiated Rate |
$2,832.85 |
| Rate for Payer: Aetna Commercial |
$2,549.57
|
| Rate for Payer: ASR ASR |
$2,747.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,326.34
|
| Rate for Payer: BCN Commercial |
$2,326.34
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Commercial |
$2,662.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Healthscope Commercial |
$2,747.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,832.85
|
| Rate for Payer: Mclaren Commercial |
$2,549.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Nomi Health Commercial |
$2,322.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,492.91
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$658.78 |
| Max. Negotiated Rate |
$878.37 |
| Rate for Payer: Aetna Commercial |
$790.53
|
| Rate for Payer: ASR ASR |
$852.02
|
| Rate for Payer: BCBS Trust/PPO |
$721.32
|
| Rate for Payer: BCN Commercial |
$721.32
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Commercial |
$825.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Healthscope Commercial |
$852.02
|
| Rate for Payer: Healthscope Whirlpool |
$878.37
|
| Rate for Payer: Mclaren Commercial |
$790.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Nomi Health Commercial |
$720.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.97
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$790.53
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$852.02
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$724.22
|
| Rate for Payer: BCN Commercial |
$724.22
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Commercial |
$825.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$852.02
|
| Rate for Payer: Healthscope Whirlpool |
$878.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$790.53
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Nomi Health Commercial |
$720.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$769.63
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$615.74
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Exchange |
$1,400.77
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$132.94 |
| Max. Negotiated Rate |
$177.26 |
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: ASR ASR |
$171.94
|
| Rate for Payer: BCBS Trust/PPO |
$145.57
|
| Rate for Payer: BCN Commercial |
$145.57
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Healthscope Commercial |
$171.94
|
| Rate for Payer: Healthscope Whirlpool |
$177.26
|
| Rate for Payer: Mclaren Commercial |
$159.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Nomi Health Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.99
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$124.26 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: Aetna Medicare |
$278.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: ASR ASR |
$171.94
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$146.15
|
| Rate for Payer: BCN Commercial |
$146.15
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$171.94
|
| Rate for Payer: Healthscope Whirlpool |
$177.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$159.53
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$153.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Nomi Health Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$306.56
|
| Rate for Payer: PHP Medicaid |
$149.38
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$155.32
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$124.26
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$431.97
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP DNSP |
$278.69
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.65 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$178.01
|
| Rate for Payer: Aetna Medicare |
$278.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: ASR ASR |
$191.86
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$163.08
|
| Rate for Payer: BCN Commercial |
$163.08
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$185.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$191.86
|
| Rate for Payer: Healthscope Whirlpool |
$197.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$178.01
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$153.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$306.56
|
| Rate for Payer: PHP Medicaid |
$149.38
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$173.30
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$138.65
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$431.97
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP DNSP |
$278.69
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
