|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$36.08 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: ASR ASR |
$35.00
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$33.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$35.00
|
| Rate for Payer: Healthscope Whirlpool |
$36.08
|
| Rate for Payer: Mclaren Commercial |
$32.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.75
|
|
|
HC RENIN
|
Facility
|
IP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$42.34 |
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: ASR ASR |
$41.07
|
| Rate for Payer: BCBS Trust/PPO |
$34.77
|
| Rate for Payer: BCN Commercial |
$34.77
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Healthscope Whirlpool |
$42.34
|
| Rate for Payer: Mclaren Commercial |
$38.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.26
|
|
|
HC RENIN
|
Facility
|
OP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$125.89 |
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$41.07
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Healthscope Whirlpool |
$42.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$38.11
|
| Rate for Payer: Mclaren Medicaid |
$21.99
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$125.89
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$100.72
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.99
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicaid |
$11.50
|
| Rate for Payer: UHCCP DNSP |
$21.99
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.41
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Aetna Commercial |
$0.37
|
| Rate for Payer: Aetna Medicare |
$0.15
|
| Rate for Payer: ASR ASR |
$0.40
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: Cash Price |
$0.33
|
| Rate for Payer: Cofinity Commercial |
$0.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$0.40
|
| Rate for Payer: Healthscope Whirlpool |
$0.41
|
| Rate for Payer: Mclaren Commercial |
$0.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.35
|
| Rate for Payer: Nomi Health Commercial |
$0.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.36
|
| Rate for Payer: Priority Health Narrow Network |
$0.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.36
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.41
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Aetna Commercial |
$0.37
|
| Rate for Payer: ASR ASR |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: Cash Price |
$0.33
|
| Rate for Payer: Cofinity Commercial |
$0.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$0.40
|
| Rate for Payer: Healthscope Whirlpool |
$0.41
|
| Rate for Payer: Mclaren Commercial |
$0.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.35
|
| Rate for Payer: Nomi Health Commercial |
$0.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.36
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.14 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,329.61
|
| Rate for Payer: BCN Commercial |
$1,329.61
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$1,564.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,412.98
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,130.45
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,209.46 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.28
|
| Rate for Payer: BCN Commercial |
$1,324.28
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,564.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.62
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.14 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,329.61
|
| Rate for Payer: BCN Commercial |
$1,329.61
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$1,564.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$773.55
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$618.84
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,209.46 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.28
|
| Rate for Payer: BCN Commercial |
$1,324.28
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,564.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.62
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,695.85
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,271.89 |
| Max. Negotiated Rate |
$1,695.85 |
| Rate for Payer: Aetna Commercial |
$1,526.27
|
| Rate for Payer: ASR ASR |
$1,644.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.63
|
| Rate for Payer: BCN Commercial |
$1,392.63
|
| Rate for Payer: Cash Price |
$1,356.68
|
| Rate for Payer: Cofinity Commercial |
$1,594.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,356.68
|
| Rate for Payer: Healthscope Commercial |
$1,644.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,695.85
|
| Rate for Payer: Mclaren Commercial |
$1,526.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.47
|
| Rate for Payer: Nomi Health Commercial |
$1,390.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,271.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,492.35
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,695.85
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,695.85 |
| Rate for Payer: Aetna Commercial |
$1,526.27
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$1,644.97
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.23
|
| Rate for Payer: BCN Commercial |
$1,398.23
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$1,356.68
|
| Rate for Payer: Cash Price |
$1,356.68
|
| Rate for Payer: Cofinity Commercial |
$1,594.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,356.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$1,644.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,695.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$1,526.27
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.47
|
| Rate for Payer: Nomi Health Commercial |
$1,390.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,271.89
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$773.55
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$618.84
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,492.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM
|
Facility
|
IP
|
$1,927.80
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
76100531
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,445.85 |
| Max. Negotiated Rate |
$1,927.80 |
| Rate for Payer: Aetna Commercial |
$1,735.02
|
| Rate for Payer: ASR ASR |
$1,869.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,583.11
|
| Rate for Payer: BCN Commercial |
$1,583.11
|
| Rate for Payer: Cash Price |
$1,542.24
|
| Rate for Payer: Cofinity Commercial |
$1,812.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,542.24
|
| Rate for Payer: Healthscope Commercial |
$1,869.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,927.80
|
| Rate for Payer: Mclaren Commercial |
$1,735.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,638.63
|
| Rate for Payer: Nomi Health Commercial |
$1,580.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,696.46
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM
|
Facility
|
OP
|
$1,927.80
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
76100531
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,927.80 |
| Rate for Payer: Aetna Commercial |
$1,735.02
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$1,869.97
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,589.47
|
| Rate for Payer: BCN Commercial |
$1,589.47
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$1,542.24
|
| Rate for Payer: Cash Price |
$1,542.24
|
| Rate for Payer: Cofinity Commercial |
$1,812.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,542.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$1,869.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,927.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$1,735.02
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,638.63
|
| Rate for Payer: Nomi Health Commercial |
$1,580.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.85
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$422.24
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,696.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5CM
|
Facility
|
OP
|
$1,603.27
|
|
|
Service Code
|
CPT 13121
|
| Hospital Charge Code |
76100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,603.27 |
| Rate for Payer: Aetna Commercial |
$1,442.94
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$1,555.17
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.90
|
| Rate for Payer: BCN Commercial |
$1,321.90
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$1,282.62
|
| Rate for Payer: Cash Price |
$1,282.62
|
| Rate for Payer: Cofinity Commercial |
$1,507.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,282.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$1,555.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,603.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$1,442.94
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,362.78
|
| Rate for Payer: Nomi Health Commercial |
$1,314.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,202.45
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$422.24
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,410.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5CM
|
Facility
|
IP
|
$1,603.27
|
|
|
Service Code
|
CPT 13121
|
| Hospital Charge Code |
76100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,202.45 |
| Max. Negotiated Rate |
$1,603.27 |
| Rate for Payer: Aetna Commercial |
$1,442.94
|
| Rate for Payer: ASR ASR |
$1,555.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.61
|
| Rate for Payer: BCN Commercial |
$1,316.61
|
| Rate for Payer: Cash Price |
$1,282.62
|
| Rate for Payer: Cofinity Commercial |
$1,507.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,282.62
|
| Rate for Payer: Healthscope Commercial |
$1,555.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,603.27
|
| Rate for Payer: Mclaren Commercial |
$1,442.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,362.78
|
| Rate for Payer: Nomi Health Commercial |
$1,314.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,202.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,410.88
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<
|
Facility
|
OP
|
$3,431.75
|
|
|
Service Code
|
CPT 13122
|
| Hospital Charge Code |
76100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.60 |
| Max. Negotiated Rate |
$3,431.75 |
| Rate for Payer: Aetna Commercial |
$3,088.57
|
| Rate for Payer: Aetna Medicare |
$1,269.75
|
| Rate for Payer: ASR ASR |
$3,328.80
|
| Rate for Payer: BCBS Complete |
$1,372.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,829.48
|
| Rate for Payer: BCN Commercial |
$2,829.48
|
| Rate for Payer: Cash Price |
$2,745.40
|
| Rate for Payer: Cash Price |
$2,745.40
|
| Rate for Payer: Cofinity Commercial |
$3,225.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,745.40
|
| Rate for Payer: Healthscope Commercial |
$3,328.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,431.75
|
| Rate for Payer: Mclaren Commercial |
$3,088.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,745.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,916.99
|
| Rate for Payer: Nomi Health Commercial |
$2,814.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,573.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,019.94
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<
|
Facility
|
IP
|
$3,431.75
|
|
|
Service Code
|
CPT 13122
|
| Hospital Charge Code |
76100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,573.81 |
| Max. Negotiated Rate |
$3,431.75 |
| Rate for Payer: Aetna Commercial |
$3,088.57
|
| Rate for Payer: ASR ASR |
$3,328.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,818.15
|
| Rate for Payer: BCN Commercial |
$2,818.15
|
| Rate for Payer: Cash Price |
$2,745.40
|
| Rate for Payer: Cofinity Commercial |
$3,225.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,745.40
|
| Rate for Payer: Healthscope Commercial |
$3,328.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,431.75
|
| Rate for Payer: Mclaren Commercial |
$3,088.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,916.99
|
| Rate for Payer: Nomi Health Commercial |
$2,814.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,573.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,019.94
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,090.74
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,090.74 |
| Rate for Payer: Aetna Commercial |
$981.67
|
| 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 |
$1,058.02
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$899.32
|
| Rate for Payer: BCN Commercial |
$899.32
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$872.59
|
| Rate for Payer: Cash Price |
$872.59
|
| Rate for Payer: Cofinity Commercial |
$1,025.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,058.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,090.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$981.67
|
| 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 |
$927.13
|
| Rate for Payer: Nomi Health Commercial |
$894.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.05
|
| 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 |
$955.71
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$764.61
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$959.85
|
| 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 REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,090.74
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$818.05 |
| Max. Negotiated Rate |
$1,090.74 |
| Rate for Payer: Aetna Commercial |
$981.67
|
| Rate for Payer: ASR ASR |
$1,058.02
|
| Rate for Payer: BCBS Trust/PPO |
$895.72
|
| Rate for Payer: BCN Commercial |
$895.72
|
| Rate for Payer: Cash Price |
$872.59
|
| Rate for Payer: Cofinity Commercial |
$1,025.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.59
|
| Rate for Payer: Healthscope Commercial |
$1,058.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,090.74
|
| Rate for Payer: Mclaren Commercial |
$981.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$927.13
|
| Rate for Payer: Nomi Health Commercial |
$894.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$959.85
|
|
|
HC REPAIR ECTROPION EXTENSIVE
|
Facility
|
IP
|
$4,403.39
|
|
|
Service Code
|
CPT 67917
|
| Hospital Charge Code |
76100568
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,302.54 |
| Max. Negotiated Rate |
$4,403.39 |
| Rate for Payer: Aetna Commercial |
$3,963.05
|
| Rate for Payer: ASR ASR |
$4,271.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,616.06
|
| Rate for Payer: BCN Commercial |
$3,616.06
|
| Rate for Payer: Cash Price |
$3,522.71
|
| Rate for Payer: Cofinity Commercial |
$4,139.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,522.71
|
| Rate for Payer: Healthscope Commercial |
$4,271.29
|
| Rate for Payer: Healthscope Whirlpool |
$4,403.39
|
| Rate for Payer: Mclaren Commercial |
$3,963.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,742.88
|
| Rate for Payer: Nomi Health Commercial |
$3,610.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,302.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,874.98
|
|
|
HC REPAIR ECTROPION EXTENSIVE
|
Facility
|
OP
|
$4,403.39
|
|
|
Service Code
|
CPT 67917
|
| Hospital Charge Code |
76100568
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,238.96 |
| Max. Negotiated Rate |
$4,403.39 |
| Rate for Payer: Aetna Commercial |
$3,963.05
|
| Rate for Payer: Aetna Medicare |
$2,368.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,961.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,961.18
|
| Rate for Payer: ASR ASR |
$4,271.29
|
| Rate for Payer: BCBS Complete |
$1,301.02
|
| Rate for Payer: BCBS MAPPO |
$2,368.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,630.60
|
| Rate for Payer: BCN Commercial |
$3,630.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,368.94
|
| Rate for Payer: Cash Price |
$3,522.71
|
| Rate for Payer: Cash Price |
$3,522.71
|
| Rate for Payer: Cofinity Commercial |
$4,139.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,522.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,368.94
|
| Rate for Payer: Healthscope Commercial |
$4,271.29
|
| Rate for Payer: Healthscope Whirlpool |
$4,403.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,368.94
|
| Rate for Payer: Mclaren Commercial |
$3,963.05
|
| Rate for Payer: Mclaren Medicaid |
$2,368.94
|
| Rate for Payer: Mclaren Medicare |
$2,368.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,487.39
|
| Rate for Payer: Meridian Medicaid |
$1,301.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,724.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,605.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,742.88
|
| Rate for Payer: Nomi Health Commercial |
$3,610.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,302.54
|
| Rate for Payer: PACE Medicare |
$2,250.49
|
| Rate for Payer: PACE SWMI |
$2,368.94
|
| Rate for Payer: PHP Commercial |
$2,605.83
|
| Rate for Payer: PHP Medicaid |
$1,269.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,368.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,238.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,858.25
|
| Rate for Payer: Priority Health Medicare |
$2,368.94
|
| Rate for Payer: Priority Health Narrow Network |
$3,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$2,368.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,874.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,368.94
|
| Rate for Payer: UHC Exchange |
$3,671.86
|
| Rate for Payer: UHC Medicaid |
$1,238.96
|
| Rate for Payer: UHCCP DNSP |
$2,368.94
|
| Rate for Payer: UHCCP Medicaid |
$1,238.96
|
| Rate for Payer: VA VA |
$2,368.94
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,729.92
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,547.44 |
| Max. Negotiated Rate |
$4,729.92 |
| Rate for Payer: Aetna Commercial |
$4,256.93
|
| Rate for Payer: ASR ASR |
$4,588.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,884.21
|
| Rate for Payer: BCN Commercial |
$3,884.21
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cofinity Commercial |
$4,446.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,783.94
|
| Rate for Payer: Healthscope Commercial |
$4,588.02
|
| Rate for Payer: Healthscope Whirlpool |
$4,729.92
|
| Rate for Payer: Mclaren Commercial |
$4,256.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,020.43
|
| Rate for Payer: Nomi Health Commercial |
$3,878.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,162.33
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,729.92
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$4,729.92 |
| Rate for Payer: Aetna Commercial |
$4,256.93
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$4,588.02
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.82
|
| Rate for Payer: BCN Commercial |
$3,899.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cofinity Commercial |
$4,446.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,783.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,588.02
|
| Rate for Payer: Healthscope Whirlpool |
$4,729.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$4,256.93
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,020.43
|
| Rate for Payer: Nomi Health Commercial |
$3,878.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.44
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,017.76
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,414.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,162.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,377.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$4,377.79 |
| Rate for Payer: Aetna Commercial |
$3,940.01
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$4,246.46
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,609.49
|
| Rate for Payer: BCN Commercial |
$3,609.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,502.23
|
| Rate for Payer: Cash Price |
$3,502.23
|
| Rate for Payer: Cofinity Commercial |
$4,115.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,502.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,246.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,377.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$3,940.01
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,721.12
|
| Rate for Payer: Nomi Health Commercial |
$3,589.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,283.34
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,835.82
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$3,068.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,852.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,377.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,283.34 |
| Max. Negotiated Rate |
$4,377.79 |
| Rate for Payer: Aetna Commercial |
$3,940.01
|
| Rate for Payer: ASR ASR |
$4,246.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,595.04
|
| Rate for Payer: BCN Commercial |
$3,595.04
|
| Rate for Payer: Cash Price |
$3,502.23
|
| Rate for Payer: Cofinity Commercial |
$4,115.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,502.23
|
| Rate for Payer: Healthscope Commercial |
$4,246.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,377.79
|
| Rate for Payer: Mclaren Commercial |
$3,940.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,721.12
|
| Rate for Payer: Nomi Health Commercial |
$3,589.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,283.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,852.46
|
|
