|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
IP
|
$186.64
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$121.32 |
| Max. Negotiated Rate |
$186.64 |
| Rate for Payer: Aetna Commercial |
$167.98
|
| Rate for Payer: ASR ASR |
$181.04
|
| Rate for Payer: ASR Commercial |
$181.04
|
| Rate for Payer: BCBS Trust/PPO |
$152.09
|
| Rate for Payer: BCN Commercial |
$144.70
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.31
|
| Rate for Payer: Healthscope Commercial |
$186.64
|
| Rate for Payer: Healthscope Whirlpool |
$181.04
|
| Rate for Payer: Mclaren Commercial |
$167.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.64
|
| Rate for Payer: Nomi Health Commercial |
$153.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.24
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
OP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$51.30 |
| Max. Negotiated Rate |
$128.24 |
| Rate for Payer: Aetna Commercial |
$115.42
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: ASR ASR |
$124.39
|
| Rate for Payer: ASR Commercial |
$124.39
|
| Rate for Payer: BCBS Complete |
$51.30
|
| Rate for Payer: BCBS Trust/PPO |
$105.02
|
| Rate for Payer: BCN Commercial |
$99.42
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$120.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$128.24
|
| Rate for Payer: Healthscope Whirlpool |
$124.39
|
| Rate for Payer: Mclaren Commercial |
$115.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: Nomi Health Commercial |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.36
|
| Rate for Payer: Priority Health Narrow Network |
$89.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.85
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
IP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$83.36 |
| Max. Negotiated Rate |
$128.24 |
| Rate for Payer: Aetna Commercial |
$115.42
|
| Rate for Payer: ASR ASR |
$124.39
|
| Rate for Payer: ASR Commercial |
$124.39
|
| Rate for Payer: BCBS Trust/PPO |
$104.50
|
| Rate for Payer: BCN Commercial |
$99.42
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$120.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$128.24
|
| Rate for Payer: Healthscope Whirlpool |
$124.39
|
| Rate for Payer: Mclaren Commercial |
$115.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: Nomi Health Commercial |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.85
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
IP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$133.52 |
| Max. Negotiated Rate |
$205.42 |
| Rate for Payer: Aetna Commercial |
$184.88
|
| Rate for Payer: ASR ASR |
$199.26
|
| Rate for Payer: ASR Commercial |
$199.26
|
| Rate for Payer: BCBS Trust/PPO |
$167.40
|
| Rate for Payer: BCN Commercial |
$159.26
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$193.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Healthscope Commercial |
$205.42
|
| Rate for Payer: Healthscope Whirlpool |
$199.26
|
| Rate for Payer: Mclaren Commercial |
$184.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: Nomi Health Commercial |
$168.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.77
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
OP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$236.51 |
| Rate for Payer: Aetna Commercial |
$184.88
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$199.26
|
| Rate for Payer: ASR Commercial |
$199.26
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$168.22
|
| Rate for Payer: BCN Commercial |
$159.26
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$193.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$205.42
|
| Rate for Payer: Healthscope Whirlpool |
$199.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$184.88
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: Nomi Health Commercial |
$168.44
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.99
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$144.00
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC PULSE OX SINGLE
|
Facility
|
OP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$34.57 |
| Max. Negotiated Rate |
$86.43 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Medicare |
$43.22
|
| Rate for Payer: ASR ASR |
$83.84
|
| Rate for Payer: ASR Commercial |
$83.84
|
| Rate for Payer: BCBS Complete |
$34.57
|
| Rate for Payer: BCBS Trust/PPO |
$70.78
|
| Rate for Payer: BCN Commercial |
$67.01
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$81.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$86.43
|
| Rate for Payer: Healthscope Whirlpool |
$83.84
|
| Rate for Payer: Mclaren Commercial |
$77.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.73
|
| Rate for Payer: Priority Health Narrow Network |
$60.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.06
|
|
|
HC PULSE OX SINGLE
|
Facility
|
IP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$56.18 |
| Max. Negotiated Rate |
$86.43 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: ASR ASR |
$83.84
|
| Rate for Payer: ASR Commercial |
$83.84
|
| Rate for Payer: BCBS Trust/PPO |
$70.43
|
| Rate for Payer: BCN Commercial |
$67.01
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$81.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$86.43
|
| Rate for Payer: Healthscope Whirlpool |
$83.84
|
| Rate for Payer: Mclaren Commercial |
$77.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.06
|
|
|
HC PULSERIDER
|
Facility
|
IP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,094.90 |
| Max. Negotiated Rate |
$17,069.07 |
| Rate for Payer: Aetna Commercial |
$15,362.16
|
| Rate for Payer: ASR ASR |
$16,557.00
|
| Rate for Payer: ASR Commercial |
$16,557.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,909.59
|
| Rate for Payer: BCN Commercial |
$13,233.65
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$16,044.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$17,069.07
|
| Rate for Payer: Healthscope Whirlpool |
$16,557.00
|
| Rate for Payer: Mclaren Commercial |
$15,362.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: Nomi Health Commercial |
$13,996.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,020.78
|
|
|
HC PULSERIDER
|
Facility
|
OP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,827.63 |
| Max. Negotiated Rate |
$17,069.07 |
| Rate for Payer: Aetna Commercial |
$15,362.16
|
| Rate for Payer: Aetna Medicare |
$8,534.53
|
| Rate for Payer: ASR ASR |
$16,557.00
|
| Rate for Payer: ASR Commercial |
$16,557.00
|
| Rate for Payer: BCBS Complete |
$6,827.63
|
| Rate for Payer: BCBS Trust/PPO |
$13,977.86
|
| Rate for Payer: BCN Commercial |
$13,233.65
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$16,044.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$17,069.07
|
| Rate for Payer: Healthscope Whirlpool |
$16,557.00
|
| Rate for Payer: Mclaren Commercial |
$15,362.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: Nomi Health Commercial |
$13,996.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,955.92
|
| Rate for Payer: Priority Health Narrow Network |
$11,965.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,020.78
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
OP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.90 |
| Max. Negotiated Rate |
$457.25 |
| Rate for Payer: Aetna Commercial |
$411.52
|
| Rate for Payer: Aetna Medicare |
$228.62
|
| Rate for Payer: ASR ASR |
$443.53
|
| Rate for Payer: ASR Commercial |
$443.53
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS Trust/PPO |
$374.44
|
| Rate for Payer: BCN Commercial |
$354.51
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$429.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$457.25
|
| Rate for Payer: Healthscope Whirlpool |
$443.53
|
| Rate for Payer: Mclaren Commercial |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: Nomi Health Commercial |
$374.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.64
|
| Rate for Payer: Priority Health Narrow Network |
$320.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$402.38
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
IP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$297.21 |
| Max. Negotiated Rate |
$457.25 |
| Rate for Payer: Aetna Commercial |
$411.52
|
| Rate for Payer: ASR ASR |
$443.53
|
| Rate for Payer: ASR Commercial |
$443.53
|
| Rate for Payer: BCBS Trust/PPO |
$372.61
|
| Rate for Payer: BCN Commercial |
$354.51
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$429.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$457.25
|
| Rate for Payer: Healthscope Whirlpool |
$443.53
|
| Rate for Payer: Mclaren Commercial |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: Nomi Health Commercial |
$374.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$402.38
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.19
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Trust/PPO |
$68.08
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.19
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Complete |
$33.42
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.21
|
| Rate for Payer: Priority Health Narrow Network |
$58.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.43 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$287.21
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$309.55
|
| Rate for Payer: ASR Commercial |
$309.55
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$261.33
|
| Rate for Payer: BCN Commercial |
$247.41
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$299.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$319.12
|
| Rate for Payer: Healthscope Whirlpool |
$309.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$287.21
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: Nomi Health Commercial |
$261.68
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.61
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$223.70
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.43 |
| Max. Negotiated Rate |
$319.12 |
| Rate for Payer: Aetna Commercial |
$287.21
|
| Rate for Payer: ASR ASR |
$309.55
|
| Rate for Payer: ASR Commercial |
$309.55
|
| Rate for Payer: BCBS Trust/PPO |
$260.05
|
| Rate for Payer: BCN Commercial |
$247.41
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$299.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Healthscope Commercial |
$319.12
|
| Rate for Payer: Healthscope Whirlpool |
$309.55
|
| Rate for Payer: Mclaren Commercial |
$287.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: Nomi Health Commercial |
$261.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.83
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
OP
|
$951.99
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$856.79
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$923.43
|
| Rate for Payer: ASR Commercial |
$923.43
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$779.58
|
| Rate for Payer: BCN Commercial |
$738.08
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$951.99
|
| Rate for Payer: Healthscope Whirlpool |
$923.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$856.79
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.13
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$667.34
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
IP
|
$951.99
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.79 |
| Max. Negotiated Rate |
$951.99 |
| Rate for Payer: Aetna Commercial |
$856.79
|
| Rate for Payer: ASR ASR |
$923.43
|
| Rate for Payer: ASR Commercial |
$923.43
|
| Rate for Payer: BCBS Trust/PPO |
$775.78
|
| Rate for Payer: BCN Commercial |
$738.08
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Healthscope Commercial |
$951.99
|
| Rate for Payer: Healthscope Whirlpool |
$923.43
|
| Rate for Payer: Mclaren Commercial |
$856.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.75
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
IP
|
$275.29
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.94 |
| Max. Negotiated Rate |
$275.29 |
| Rate for Payer: Aetna Commercial |
$247.76
|
| Rate for Payer: ASR ASR |
$267.03
|
| Rate for Payer: ASR Commercial |
$267.03
|
| Rate for Payer: BCBS Trust/PPO |
$224.33
|
| Rate for Payer: BCN Commercial |
$213.43
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cofinity Commercial |
$258.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.23
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Healthscope Whirlpool |
$267.03
|
| Rate for Payer: Mclaren Commercial |
$247.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.00
|
| Rate for Payer: Nomi Health Commercial |
$225.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.26
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
OP
|
$275.29
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.94 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$247.76
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$267.03
|
| Rate for Payer: ASR Commercial |
$267.03
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$225.43
|
| Rate for Payer: BCN Commercial |
$213.43
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cofinity Commercial |
$258.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Healthscope Whirlpool |
$267.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$247.76
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.00
|
| Rate for Payer: Nomi Health Commercial |
$225.74
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.21
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$192.98
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
OP
|
$777.71
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$777.71 |
| Rate for Payer: Aetna Commercial |
$699.94
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$754.38
|
| Rate for Payer: ASR Commercial |
$754.38
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$636.87
|
| Rate for Payer: BCN Commercial |
$602.96
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$731.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$777.71
|
| Rate for Payer: Healthscope Whirlpool |
$754.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$699.94
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$681.43
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$545.17
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
IP
|
$777.71
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$505.51 |
| Max. Negotiated Rate |
$777.71 |
| Rate for Payer: Aetna Commercial |
$699.94
|
| Rate for Payer: ASR ASR |
$754.38
|
| Rate for Payer: ASR Commercial |
$754.38
|
| Rate for Payer: BCBS Trust/PPO |
$633.76
|
| Rate for Payer: BCN Commercial |
$602.96
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$731.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$777.71
|
| Rate for Payer: Healthscope Whirlpool |
$754.38
|
| Rate for Payer: Mclaren Commercial |
$699.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.38
|
|
|
HC PUNCTURE WITH INJECTION CERVICAL
|
Facility
|
IP
|
$777.71
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
36100269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$505.51 |
| Max. Negotiated Rate |
$777.71 |
| Rate for Payer: Aetna Commercial |
$699.94
|
| Rate for Payer: ASR ASR |
$754.38
|
| Rate for Payer: ASR Commercial |
$754.38
|
| Rate for Payer: BCBS Trust/PPO |
$633.76
|
| Rate for Payer: BCN Commercial |
$602.96
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$731.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$777.71
|
| Rate for Payer: Healthscope Whirlpool |
$754.38
|
| Rate for Payer: Mclaren Commercial |
$699.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.38
|
|
|
HC PUNCTURE WITH INJECTION CERVICAL
|
Facility
|
OP
|
$777.71
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
36100269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$777.71 |
| Rate for Payer: Aetna Commercial |
$699.94
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$754.38
|
| Rate for Payer: ASR Commercial |
$754.38
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$636.87
|
| Rate for Payer: BCN Commercial |
$602.96
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$731.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$777.71
|
| Rate for Payer: Healthscope Whirlpool |
$754.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$699.94
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$681.43
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$545.17
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC PURAPLY AM (1.6 SQ CM DISC) PER SQ CM
|
Facility
|
OP
|
$737.39
|
|
|
Service Code
|
HCPCS Q4196
|
| Hospital Charge Code |
63600128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$294.96 |
| Max. Negotiated Rate |
$737.39 |
| Rate for Payer: Aetna Commercial |
$663.65
|
| Rate for Payer: Aetna Medicare |
$368.69
|
| Rate for Payer: ASR ASR |
$715.27
|
| Rate for Payer: ASR Commercial |
$715.27
|
| Rate for Payer: BCBS Complete |
$294.96
|
| Rate for Payer: BCBS Trust/PPO |
$603.85
|
| Rate for Payer: BCN Commercial |
$571.70
|
| Rate for Payer: Cash Price |
$589.91
|
| Rate for Payer: Cofinity Commercial |
$693.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.91
|
| Rate for Payer: Healthscope Commercial |
$737.39
|
| Rate for Payer: Healthscope Whirlpool |
$715.27
|
| Rate for Payer: Mclaren Commercial |
$663.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.78
|
| Rate for Payer: Nomi Health Commercial |
$604.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.10
|
| Rate for Payer: Priority Health Narrow Network |
$516.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.90
|
|
|
HC PURAPLY AM (1.6 SQ CM DISC) PER SQ CM
|
Facility
|
IP
|
$737.39
|
|
|
Service Code
|
HCPCS Q4196
|
| Hospital Charge Code |
63600128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$479.30 |
| Max. Negotiated Rate |
$737.39 |
| Rate for Payer: Aetna Commercial |
$663.65
|
| Rate for Payer: ASR ASR |
$715.27
|
| Rate for Payer: ASR Commercial |
$715.27
|
| Rate for Payer: BCBS Trust/PPO |
$600.90
|
| Rate for Payer: BCN Commercial |
$571.70
|
| Rate for Payer: Cash Price |
$589.91
|
| Rate for Payer: Cofinity Commercial |
$693.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.91
|
| Rate for Payer: Healthscope Commercial |
$737.39
|
| Rate for Payer: Healthscope Whirlpool |
$715.27
|
| Rate for Payer: Mclaren Commercial |
$663.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.78
|
| Rate for Payer: Nomi Health Commercial |
$604.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.90
|
|
