|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$148.34 |
| Max. Negotiated Rate |
$197.79 |
| Rate for Payer: Aetna Commercial |
$178.01
|
| Rate for Payer: ASR ASR |
$191.86
|
| Rate for Payer: BCBS Trust/PPO |
$162.43
|
| Rate for Payer: BCN Commercial |
$162.43
|
| 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: Healthscope Commercial |
$191.86
|
| Rate for Payer: Healthscope Whirlpool |
$197.79
|
| Rate for Payer: Mclaren Commercial |
$178.01
|
| 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: UHC All Payor (Choice/PPO) + Core |
$174.06
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$323.22
|
| 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 |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$296.10
|
| Rate for Payer: BCN Commercial |
$296.10
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Commercial |
$337.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$348.36
|
| Rate for Payer: Healthscope Whirlpool |
$359.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$323.22
|
| 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 |
$305.26
|
| Rate for Payer: Nomi Health Commercial |
$294.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| 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 |
$314.67
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$251.75
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.03
|
| 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 SPICA
|
Facility
|
IP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$269.35 |
| Max. Negotiated Rate |
$359.13 |
| Rate for Payer: Aetna Commercial |
$323.22
|
| Rate for Payer: ASR ASR |
$348.36
|
| Rate for Payer: BCBS Trust/PPO |
$294.92
|
| Rate for Payer: BCN Commercial |
$294.92
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Commercial |
$337.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Healthscope Commercial |
$348.36
|
| Rate for Payer: Healthscope Whirlpool |
$359.13
|
| Rate for Payer: Mclaren Commercial |
$323.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.26
|
| Rate for Payer: Nomi Health Commercial |
$294.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.03
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$217.62
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.22 |
| Max. Negotiated Rate |
$217.62 |
| Rate for Payer: Aetna Commercial |
$195.86
|
| Rate for Payer: ASR ASR |
$211.09
|
| Rate for Payer: BCBS Trust/PPO |
$178.71
|
| Rate for Payer: BCN Commercial |
$178.71
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$204.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Healthscope Commercial |
$211.09
|
| Rate for Payer: Healthscope Whirlpool |
$217.62
|
| Rate for Payer: Mclaren Commercial |
$195.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.51
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$217.62
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$217.62 |
| Rate for Payer: Aetna Commercial |
$195.86
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$211.09
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$179.43
|
| Rate for Payer: BCN Commercial |
$179.43
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$204.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$211.09
|
| Rate for Payer: Healthscope Whirlpool |
$217.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$195.86
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$145.69
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$145.69 |
| Rate for Payer: Aetna Commercial |
$131.12
|
| Rate for Payer: Aetna Commercial |
$196.69
|
| Rate for Payer: ASR ASR |
$141.32
|
| Rate for Payer: ASR ASR |
$211.98
|
| Rate for Payer: BCBS Trust/PPO |
$119.64
|
| Rate for Payer: BCBS Trust/PPO |
$179.47
|
| Rate for Payer: BCN Commercial |
$119.64
|
| Rate for Payer: BCN Commercial |
$179.47
|
| Rate for Payer: Cash Price |
$174.83
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$205.43
|
| Rate for Payer: Cofinity Commercial |
$136.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.83
|
| Rate for Payer: Healthscope Commercial |
$141.32
|
| Rate for Payer: Healthscope Commercial |
$211.98
|
| Rate for Payer: Healthscope Whirlpool |
$218.54
|
| Rate for Payer: Healthscope Whirlpool |
$145.69
|
| Rate for Payer: Mclaren Commercial |
$196.69
|
| Rate for Payer: Mclaren Commercial |
$131.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$179.20
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.21
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$145.69 |
| Rate for Payer: Aetna Commercial |
$131.12
|
| Rate for Payer: Aetna Commercial |
$196.69
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$141.32
|
| Rate for Payer: ASR ASR |
$211.98
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$180.19
|
| Rate for Payer: BCBS Trust/PPO |
$120.12
|
| Rate for Payer: BCN Commercial |
$180.19
|
| Rate for Payer: BCN Commercial |
$120.12
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$174.83
|
| Rate for Payer: Cash Price |
$174.83
|
| Rate for Payer: Cofinity Commercial |
$136.95
|
| Rate for Payer: Cofinity Commercial |
$205.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$141.32
|
| Rate for Payer: Healthscope Commercial |
$211.98
|
| Rate for Payer: Healthscope Whirlpool |
$145.69
|
| Rate for Payer: Healthscope Whirlpool |
$218.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$196.69
|
| Rate for Payer: Mclaren Commercial |
$131.12
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.76
|
| Rate for Payer: Nomi Health Commercial |
$179.20
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.37
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$217.62
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$217.62 |
| Rate for Payer: Aetna Commercial |
$195.86
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$211.09
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$179.43
|
| Rate for Payer: BCN Commercial |
$179.43
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$204.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$211.09
|
| Rate for Payer: Healthscope Whirlpool |
$217.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$195.86
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.68
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$152.55
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$217.62
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.22 |
| Max. Negotiated Rate |
$217.62 |
| Rate for Payer: Aetna Commercial |
$195.86
|
| Rate for Payer: ASR ASR |
$211.09
|
| Rate for Payer: BCBS Trust/PPO |
$178.71
|
| Rate for Payer: BCN Commercial |
$178.71
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$204.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Healthscope Commercial |
$211.09
|
| Rate for Payer: Healthscope Whirlpool |
$217.62
|
| Rate for Payer: Mclaren Commercial |
$195.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.51
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$145.69 |
| Rate for Payer: Aetna Commercial |
$131.12
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$141.32
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$120.12
|
| Rate for Payer: BCN Commercial |
$120.12
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$136.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$141.32
|
| Rate for Payer: Healthscope Whirlpool |
$145.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$131.12
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.65
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$102.13
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$145.69
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$145.69 |
| Rate for Payer: Aetna Commercial |
$131.12
|
| Rate for Payer: ASR ASR |
$141.32
|
| Rate for Payer: BCBS Trust/PPO |
$119.64
|
| Rate for Payer: BCN Commercial |
$119.64
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$136.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Healthscope Commercial |
$141.32
|
| Rate for Payer: Healthscope Whirlpool |
$145.69
|
| Rate for Payer: Mclaren Commercial |
$131.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.21
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$10,769.70
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,077.27 |
| Max. Negotiated Rate |
$10,769.70 |
| Rate for Payer: Aetna Commercial |
$9,692.73
|
| Rate for Payer: Aetna Commercial |
$6,461.82
|
| Rate for Payer: ASR ASR |
$10,446.61
|
| Rate for Payer: ASR ASR |
$6,964.41
|
| Rate for Payer: BCBS Trust/PPO |
$8,844.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,896.05
|
| Rate for Payer: BCN Commercial |
$8,844.08
|
| Rate for Payer: BCN Commercial |
$5,896.05
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$8,615.76
|
| Rate for Payer: Cofinity Commercial |
$6,749.01
|
| Rate for Payer: Cofinity Commercial |
$10,123.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,615.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Healthscope Commercial |
$10,446.61
|
| Rate for Payer: Healthscope Commercial |
$6,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$7,179.80
|
| Rate for Payer: Healthscope Whirlpool |
$10,769.70
|
| Rate for Payer: Mclaren Commercial |
$6,461.82
|
| Rate for Payer: Mclaren Commercial |
$9,692.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,154.25
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: Nomi Health Commercial |
$8,831.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,077.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,384.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,318.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,477.34
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$10,769.70
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$10,769.70 |
| Rate for Payer: Aetna Commercial |
$9,692.73
|
| Rate for Payer: Aetna Commercial |
$6,461.82
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$6,964.41
|
| Rate for Payer: ASR ASR |
$10,446.61
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,919.75
|
| Rate for Payer: BCBS Trust/PPO |
$8,879.62
|
| Rate for Payer: BCN Commercial |
$8,879.62
|
| Rate for Payer: BCN Commercial |
$5,919.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$8,615.76
|
| Rate for Payer: Cash Price |
$8,615.76
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$10,123.52
|
| Rate for Payer: Cofinity Commercial |
$6,749.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,615.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$10,446.61
|
| Rate for Payer: Healthscope Commercial |
$6,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$7,179.80
|
| Rate for Payer: Healthscope Whirlpool |
$10,769.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$6,461.82
|
| Rate for Payer: Mclaren Commercial |
$9,692.73
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,154.25
|
| Rate for Payer: Nomi Health Commercial |
$8,831.15
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,384.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,077.27
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,436.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,290.94
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$7,549.56
|
| Rate for Payer: Priority Health Narrow Network |
$5,033.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,477.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,318.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,602.48
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,951.86 |
| Max. Negotiated Rate |
$2,602.48 |
| Rate for Payer: Aetna Commercial |
$2,342.23
|
| Rate for Payer: ASR ASR |
$2,524.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,137.16
|
| Rate for Payer: BCN Commercial |
$2,137.16
|
| Rate for Payer: Cash Price |
$2,081.98
|
| Rate for Payer: Cofinity Commercial |
$2,446.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.98
|
| Rate for Payer: Healthscope Commercial |
$2,524.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.48
|
| Rate for Payer: Mclaren Commercial |
$2,342.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,212.11
|
| Rate for Payer: Nomi Health Commercial |
$2,134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,951.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,290.18
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,602.48
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Aetna Commercial |
$2,342.23
|
| 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 |
$2,524.41
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.74
|
| Rate for Payer: BCN Commercial |
$2,145.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,081.98
|
| Rate for Payer: Cash Price |
$2,081.98
|
| Rate for Payer: Cofinity Commercial |
$2,446.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,524.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$2,342.23
|
| 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 |
$2,212.11
|
| Rate for Payer: Nomi Health Commercial |
$2,134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,951.86
|
| 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 |
$2,280.29
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,824.34
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,290.18
|
| 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 FB EYE
|
Facility
|
IP
|
$385.45
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.09 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$346.90
|
| Rate for Payer: ASR ASR |
$373.89
|
| Rate for Payer: BCBS Trust/PPO |
$316.53
|
| Rate for Payer: BCN Commercial |
$316.53
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$362.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$373.89
|
| Rate for Payer: Healthscope Whirlpool |
$385.45
|
| Rate for Payer: Mclaren Commercial |
$346.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.20
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$385.45
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.62 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$346.90
|
| Rate for Payer: Aetna Medicare |
$142.62
|
| Rate for Payer: ASR ASR |
$373.89
|
| Rate for Payer: BCBS Complete |
$154.18
|
| Rate for Payer: BCBS Trust/PPO |
$317.80
|
| Rate for Payer: BCN Commercial |
$317.80
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$362.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$373.89
|
| Rate for Payer: Healthscope Whirlpool |
$385.45
|
| Rate for Payer: Mclaren Commercial |
$346.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$337.73
|
| Rate for Payer: Priority Health Narrow Network |
$270.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.20
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$971.03
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$728.27 |
| Max. Negotiated Rate |
$971.03 |
| Rate for Payer: Aetna Commercial |
$873.93
|
| Rate for Payer: ASR ASR |
$941.90
|
| Rate for Payer: BCBS Trust/PPO |
$797.41
|
| Rate for Payer: BCN Commercial |
$797.41
|
| Rate for Payer: Cash Price |
$776.82
|
| Rate for Payer: Cofinity Commercial |
$912.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.82
|
| Rate for Payer: Healthscope Commercial |
$941.90
|
| Rate for Payer: Healthscope Whirlpool |
$971.03
|
| Rate for Payer: Mclaren Commercial |
$873.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.38
|
| Rate for Payer: Nomi Health Commercial |
$796.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.51
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$971.03
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,416.35 |
| Rate for Payer: Aetna Commercial |
$873.93
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$941.90
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$800.61
|
| Rate for Payer: BCN Commercial |
$800.61
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$776.82
|
| Rate for Payer: Cash Price |
$776.82
|
| Rate for Payer: Cofinity Commercial |
$912.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$941.90
|
| Rate for Payer: Healthscope Whirlpool |
$971.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$873.93
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.38
|
| Rate for Payer: Nomi Health Commercial |
$796.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.27
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,416.35
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,133.08
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$252.40
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$189.30 |
| Max. Negotiated Rate |
$252.40 |
| Rate for Payer: Aetna Commercial |
$227.16
|
| Rate for Payer: ASR ASR |
$244.83
|
| Rate for Payer: BCBS Trust/PPO |
$207.27
|
| Rate for Payer: BCN Commercial |
$207.27
|
| Rate for Payer: Cash Price |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$237.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.92
|
| Rate for Payer: Healthscope Commercial |
$244.83
|
| Rate for Payer: Healthscope Whirlpool |
$252.40
|
| Rate for Payer: Mclaren Commercial |
$227.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.54
|
| Rate for Payer: Nomi Health Commercial |
$206.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.11
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$252.40
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.39 |
| Max. Negotiated Rate |
$252.40 |
| Rate for Payer: Aetna Commercial |
$227.16
|
| Rate for Payer: Aetna Medicare |
$93.39
|
| Rate for Payer: ASR ASR |
$244.83
|
| Rate for Payer: BCBS Complete |
$100.96
|
| Rate for Payer: BCBS Trust/PPO |
$208.10
|
| Rate for Payer: BCN Commercial |
$208.10
|
| Rate for Payer: Cash Price |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$237.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.92
|
| Rate for Payer: Healthscope Commercial |
$244.83
|
| Rate for Payer: Healthscope Whirlpool |
$252.40
|
| Rate for Payer: Mclaren Commercial |
$227.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.54
|
| Rate for Payer: Nomi Health Commercial |
$206.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$221.15
|
| Rate for Payer: Priority Health Narrow Network |
$176.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.11
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,750.99
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,313.24 |
| Max. Negotiated Rate |
$1,750.99 |
| Rate for Payer: Aetna Commercial |
$1,575.89
|
| Rate for Payer: ASR ASR |
$1,698.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,437.91
|
| Rate for Payer: BCN Commercial |
$1,437.91
|
| Rate for Payer: Cash Price |
$1,400.79
|
| Rate for Payer: Cofinity Commercial |
$1,645.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.79
|
| Rate for Payer: Healthscope Commercial |
$1,698.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,750.99
|
| Rate for Payer: Mclaren Commercial |
$1,575.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.34
|
| Rate for Payer: Nomi Health Commercial |
$1,435.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,540.87
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,750.99
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$678.88 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,575.89
|
| 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 |
$1,698.46
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.69
|
| Rate for Payer: BCN Commercial |
$1,443.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,400.79
|
| Rate for Payer: Cash Price |
$1,400.79
|
| Rate for Payer: Cofinity Commercial |
$1,645.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,698.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,750.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,575.89
|
| 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 |
$1,488.34
|
| Rate for Payer: Nomi Health Commercial |
$1,435.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.24
|
| 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 |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,540.87
|
| 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 REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,260.44
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$4,260.44 |
| Rate for Payer: Aetna Commercial |
$3,834.40
|
| 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 |
$4,132.63
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,512.73
|
| Rate for Payer: BCN Commercial |
$3,512.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,408.35
|
| Rate for Payer: Cash Price |
$3,408.35
|
| Rate for Payer: Cofinity Commercial |
$4,004.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,408.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,132.63
|
| Rate for Payer: Healthscope Whirlpool |
$4,260.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$3,834.40
|
| 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 |
$3,621.37
|
| Rate for Payer: Nomi Health Commercial |
$3,493.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,195.33
|
| 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 |
$3,733.00
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,986.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,749.19
|
| 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 REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,260.44
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,195.33 |
| Max. Negotiated Rate |
$4,260.44 |
| Rate for Payer: Aetna Commercial |
$3,834.40
|
| Rate for Payer: ASR ASR |
$4,132.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,498.67
|
| Rate for Payer: BCN Commercial |
$3,498.67
|
| Rate for Payer: Cash Price |
$3,408.35
|
| Rate for Payer: Cofinity Commercial |
$4,004.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,408.35
|
| Rate for Payer: Healthscope Commercial |
$4,132.63
|
| Rate for Payer: Healthscope Whirlpool |
$4,260.44
|
| Rate for Payer: Mclaren Commercial |
$3,834.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,621.37
|
| Rate for Payer: Nomi Health Commercial |
$3,493.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,195.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,749.19
|
|
