|
HC REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,306.33 |
| Max. Negotiated Rate |
$29,741.77 |
| Rate for Payer: Aetna Commercial |
$26,767.59
|
| Rate for Payer: ASR ASR |
$28,849.52
|
| Rate for Payer: BCBS Trust/PPO |
$24,423.94
|
| Rate for Payer: BCN Commercial |
$24,423.94
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$27,957.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$28,849.52
|
| Rate for Payer: Healthscope Whirlpool |
$29,741.77
|
| Rate for Payer: Mclaren Commercial |
$26,767.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,172.76
|
|
|
HC REVAS MI/DES
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,700.12 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Trust/PPO |
$24,855.11
|
| Rate for Payer: BCN Commercial |
$24,855.11
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,839.27 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: Aetna Medicare |
$11,198.72
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Complete |
$12,106.73
|
| Rate for Payer: BCBS Trust/PPO |
$24,954.99
|
| Rate for Payer: BCN Commercial |
$24,954.99
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,213.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,799.08
|
| Rate for Payer: Priority Health Narrow Network |
$7,839.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,170.33 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: Aetna Medicare |
$11,198.72
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Complete |
$12,106.73
|
| Rate for Payer: BCBS Trust/PPO |
$24,954.99
|
| Rate for Payer: BCN Commercial |
$24,954.99
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,213.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,712.91
|
| Rate for Payer: Priority Health Narrow Network |
$6,170.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,700.12 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Trust/PPO |
$24,855.11
|
| Rate for Payer: BCN Commercial |
$24,855.11
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,258.54 |
| Max. Negotiated Rate |
$16,344.72 |
| Rate for Payer: Aetna Commercial |
$14,710.25
|
| Rate for Payer: ASR ASR |
$15,854.38
|
| Rate for Payer: BCBS Trust/PPO |
$13,422.28
|
| Rate for Payer: BCN Commercial |
$13,422.28
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Commercial |
$15,364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Healthscope Commercial |
$15,854.38
|
| Rate for Payer: Healthscope Whirlpool |
$16,344.72
|
| Rate for Payer: Mclaren Commercial |
$14,710.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Nomi Health Commercial |
$13,402.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,383.35
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,321.09 |
| Max. Negotiated Rate |
$16,344.72 |
| Rate for Payer: Aetna Commercial |
$14,710.25
|
| Rate for Payer: Aetna Medicare |
$6,350.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,937.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,937.60
|
| Rate for Payer: ASR ASR |
$15,854.38
|
| Rate for Payer: BCBS Complete |
$3,487.46
|
| Rate for Payer: BCBS MAPPO |
$6,350.08
|
| Rate for Payer: BCBS Trust/PPO |
$13,476.22
|
| Rate for Payer: BCN Commercial |
$13,476.22
|
| Rate for Payer: BCN Medicare Advantage |
$6,350.08
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Commercial |
$15,364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,350.08
|
| Rate for Payer: Healthscope Commercial |
$15,854.38
|
| Rate for Payer: Healthscope Whirlpool |
$16,344.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,350.08
|
| Rate for Payer: Mclaren Commercial |
$14,710.25
|
| Rate for Payer: Mclaren Medicaid |
$6,350.08
|
| Rate for Payer: Mclaren Medicare |
$6,350.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,667.58
|
| Rate for Payer: Meridian Medicaid |
$3,487.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,302.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,985.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Nomi Health Commercial |
$13,402.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: PACE Medicare |
$6,032.58
|
| Rate for Payer: PACE SWMI |
$6,350.08
|
| Rate for Payer: PHP Commercial |
$6,985.09
|
| Rate for Payer: PHP Medicaid |
$3,403.64
|
| Rate for Payer: PHP Medicare Advantage |
$6,350.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14,321.24
|
| Rate for Payer: Priority Health Medicare |
$6,350.08
|
| Rate for Payer: Priority Health Narrow Network |
$11,457.65
|
| Rate for Payer: Railroad Medicare Medicare |
$6,350.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,383.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,350.08
|
| Rate for Payer: UHC Exchange |
$9,842.62
|
| Rate for Payer: UHC Medicaid |
$3,321.09
|
| Rate for Payer: UHCCP DNSP |
$6,350.08
|
| Rate for Payer: UHCCP Medicaid |
$3,321.09
|
| Rate for Payer: VA VA |
$6,350.08
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,379.91 |
| Max. Negotiated Rate |
$3,173.22 |
| Rate for Payer: Aetna Commercial |
$2,855.90
|
| Rate for Payer: ASR ASR |
$3,078.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,605.85
|
| Rate for Payer: BCN Commercial |
$2,605.85
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Commercial |
$2,982.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Healthscope Commercial |
$3,078.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,173.22
|
| Rate for Payer: Mclaren Commercial |
$2,855.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Nomi Health Commercial |
$2,602.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,792.43
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,174.09 |
| Max. Negotiated Rate |
$3,173.22 |
| Rate for Payer: Aetna Commercial |
$2,855.90
|
| Rate for Payer: Aetna Medicare |
$1,174.09
|
| Rate for Payer: ASR ASR |
$3,078.02
|
| Rate for Payer: BCBS Complete |
$1,269.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,616.32
|
| Rate for Payer: BCN Commercial |
$2,616.32
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Commercial |
$2,982.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Healthscope Commercial |
$3,078.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,173.22
|
| Rate for Payer: Mclaren Commercial |
$2,855.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,538.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Nomi Health Commercial |
$2,602.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,780.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,224.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,792.43
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,935.33
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,951.50 |
| Max. Negotiated Rate |
$7,935.33 |
| Rate for Payer: Aetna Commercial |
$7,141.80
|
| Rate for Payer: ASR ASR |
$7,697.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,516.49
|
| Rate for Payer: BCN Commercial |
$6,516.49
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cofinity Commercial |
$7,459.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,348.26
|
| Rate for Payer: Healthscope Commercial |
$7,697.27
|
| Rate for Payer: Healthscope Whirlpool |
$7,935.33
|
| Rate for Payer: Mclaren Commercial |
$7,141.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,745.03
|
| Rate for Payer: Nomi Health Commercial |
$6,506.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,951.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,983.09
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,935.33
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,150.44 |
| Max. Negotiated Rate |
$9,336.87 |
| Rate for Payer: Aetna Commercial |
$7,141.80
|
| Rate for Payer: Aetna Medicare |
$6,023.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: ASR ASR |
$7,697.27
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,542.68
|
| Rate for Payer: BCN Commercial |
$6,542.68
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cofinity Commercial |
$7,459.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,348.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$7,697.27
|
| Rate for Payer: Healthscope Whirlpool |
$7,935.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$7,141.80
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$3,308.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,745.03
|
| Rate for Payer: Nomi Health Commercial |
$6,506.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,951.50
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$6,626.17
|
| Rate for Payer: PHP Medicaid |
$3,228.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,952.94
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$5,562.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,983.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Exchange |
$9,336.87
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP DNSP |
$6,023.79
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$6,003.59
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,502.69 |
| Max. Negotiated Rate |
$6,003.59 |
| Rate for Payer: Aetna Commercial |
$5,403.23
|
| Rate for Payer: ASR ASR |
$5,823.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,930.15
|
| Rate for Payer: BCN Commercial |
$4,930.15
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cofinity Commercial |
$5,643.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,802.87
|
| Rate for Payer: Healthscope Commercial |
$5,823.48
|
| Rate for Payer: Healthscope Whirlpool |
$6,003.59
|
| Rate for Payer: Mclaren Commercial |
$5,403.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,103.05
|
| Rate for Payer: Nomi Health Commercial |
$4,922.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,502.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,283.16
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$6,003.59
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,150.44 |
| Max. Negotiated Rate |
$9,336.87 |
| Rate for Payer: Aetna Commercial |
$5,403.23
|
| Rate for Payer: Aetna Medicare |
$6,023.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: ASR ASR |
$5,823.48
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,949.96
|
| Rate for Payer: BCN Commercial |
$4,949.96
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cofinity Commercial |
$5,643.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,802.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$5,823.48
|
| Rate for Payer: Healthscope Whirlpool |
$6,003.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$5,403.23
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$3,308.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,103.05
|
| Rate for Payer: Nomi Health Commercial |
$4,922.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,502.69
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$6,626.17
|
| Rate for Payer: PHP Medicaid |
$3,228.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,260.35
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$4,208.52
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,283.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Exchange |
$9,336.87
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP DNSP |
$6,023.79
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,052.66 |
| Max. Negotiated Rate |
$2,736.88 |
| Rate for Payer: Aetna Commercial |
$2,463.19
|
| Rate for Payer: ASR ASR |
$2,654.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,247.53
|
| Rate for Payer: BCN Commercial |
$2,247.53
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,572.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,654.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,736.88
|
| Rate for Payer: Mclaren Commercial |
$2,463.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,408.45
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$3,015.84 |
| Rate for Payer: Aetna Commercial |
$2,463.19
|
| Rate for Payer: Aetna Medicare |
$1,945.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: ASR ASR |
$2,654.77
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,256.56
|
| Rate for Payer: BCN Commercial |
$2,256.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,572.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,654.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,736.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,945.70
|
| Rate for Payer: Mclaren Commercial |
$2,463.19
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$1,068.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,140.27
|
| Rate for Payer: PHP Medicaid |
$1,042.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,170.01
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,736.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,408.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Exchange |
$3,015.84
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP DNSP |
$1,945.70
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,824.29
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,368.22 |
| Max. Negotiated Rate |
$1,824.29 |
| Rate for Payer: Aetna Commercial |
$1,641.86
|
| Rate for Payer: ASR ASR |
$1,769.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,498.11
|
| Rate for Payer: BCN Commercial |
$1,498.11
|
| Rate for Payer: Cash Price |
$1,459.43
|
| Rate for Payer: Cofinity Commercial |
$1,714.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,459.43
|
| Rate for Payer: Healthscope Commercial |
$1,769.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,824.29
|
| Rate for Payer: Mclaren Commercial |
$1,641.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,550.65
|
| Rate for Payer: Nomi Health Commercial |
$1,495.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,605.38
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,824.29
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$674.99 |
| Max. Negotiated Rate |
$1,824.29 |
| Rate for Payer: Aetna Commercial |
$1,641.86
|
| Rate for Payer: Aetna Medicare |
$674.99
|
| Rate for Payer: ASR ASR |
$1,769.56
|
| Rate for Payer: BCBS Complete |
$729.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,504.13
|
| Rate for Payer: BCN Commercial |
$1,504.13
|
| Rate for Payer: Cash Price |
$1,459.43
|
| Rate for Payer: Cofinity Commercial |
$1,714.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,459.43
|
| Rate for Payer: Healthscope Commercial |
$1,769.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,824.29
|
| Rate for Payer: Mclaren Commercial |
$1,641.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,459.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,550.65
|
| Rate for Payer: Nomi Health Commercial |
$1,495.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,598.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,278.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,605.38
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$82.33 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$5.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$3.11
|
| Rate for Payer: BCBS MAPPO |
$5.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.67
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.67
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$5.67
|
| Rate for Payer: Mclaren Medicare |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Medicaid |
$3.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$5.39
|
| Rate for Payer: PACE SWMI |
$5.67
|
| Rate for Payer: PHP Commercial |
$6.24
|
| Rate for Payer: PHP Medicaid |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.33
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health Narrow Network |
$65.86
|
| Rate for Payer: Railroad Medicare Medicare |
$5.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.67
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicaid |
$2.97
|
| Rate for Payer: UHCCP DNSP |
$5.67
|
| Rate for Payer: UHCCP Medicaid |
$2.97
|
| Rate for Payer: VA VA |
$5.67
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$289.66
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$217.25 |
| Max. Negotiated Rate |
$289.66 |
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: ASR ASR |
$280.97
|
| Rate for Payer: BCBS Trust/PPO |
$237.87
|
| Rate for Payer: BCN Commercial |
$237.87
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cofinity Commercial |
$272.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.73
|
| Rate for Payer: Healthscope Commercial |
$280.97
|
| Rate for Payer: Healthscope Whirlpool |
$289.66
|
| Rate for Payer: Mclaren Commercial |
$260.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.21
|
| Rate for Payer: Nomi Health Commercial |
$237.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.90
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$289.66
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$289.66 |
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: Aetna Medicare |
$107.17
|
| Rate for Payer: ASR ASR |
$280.97
|
| Rate for Payer: BCBS Complete |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$238.82
|
| Rate for Payer: BCN Commercial |
$238.82
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cofinity Commercial |
$272.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.73
|
| Rate for Payer: Healthscope Commercial |
$280.97
|
| Rate for Payer: Healthscope Whirlpool |
$289.66
|
| Rate for Payer: Mclaren Commercial |
$260.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.21
|
| Rate for Payer: Nomi Health Commercial |
$237.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.57
|
| Rate for Payer: Priority Health Narrow Network |
$66.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.90
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
IP
|
$3,842.58
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,881.93 |
| Max. Negotiated Rate |
$3,842.58 |
| Rate for Payer: Aetna Commercial |
$3,458.32
|
| Rate for Payer: ASR ASR |
$3,727.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,155.53
|
| Rate for Payer: BCN Commercial |
$3,155.53
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,612.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Healthscope Commercial |
$3,727.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,842.58
|
| Rate for Payer: Mclaren Commercial |
$3,458.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,381.47
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
OP
|
$3,842.58
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.48 |
| Max. Negotiated Rate |
$3,842.58 |
| Rate for Payer: Aetna Commercial |
$3,458.32
|
| Rate for Payer: Aetna Medicare |
$1,213.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,516.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,516.45
|
| Rate for Payer: ASR ASR |
$3,727.30
|
| Rate for Payer: BCBS Complete |
$666.27
|
| Rate for Payer: BCBS MAPPO |
$1,213.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,168.21
|
| Rate for Payer: BCN Commercial |
$3,168.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.16
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,612.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.16
|
| Rate for Payer: Healthscope Commercial |
$3,727.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,842.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,213.16
|
| Rate for Payer: Mclaren Commercial |
$3,458.32
|
| Rate for Payer: Mclaren Medicaid |
$1,213.16
|
| Rate for Payer: Mclaren Medicare |
$1,213.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.82
|
| Rate for Payer: Meridian Medicaid |
$666.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,395.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,334.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PACE Medicare |
$1,152.50
|
| Rate for Payer: PACE SWMI |
$1,213.16
|
| Rate for Payer: PHP Commercial |
$1,334.48
|
| Rate for Payer: PHP Medicaid |
$650.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,366.87
|
| Rate for Payer: Priority Health Medicare |
$1,213.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,693.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,213.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,381.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,213.16
|
| Rate for Payer: UHC Exchange |
$1,880.40
|
| Rate for Payer: UHC Medicaid |
$634.48
|
| Rate for Payer: UHCCP DNSP |
$1,213.16
|
| Rate for Payer: UHCCP Medicaid |
$634.48
|
| Rate for Payer: VA VA |
$1,213.16
|
|
