|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
IP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$387.26 |
| Max. Negotiated Rate |
$595.78 |
| Rate for Payer: Aetna Commercial |
$536.20
|
| Rate for Payer: ASR ASR |
$577.91
|
| Rate for Payer: ASR Commercial |
$577.91
|
| Rate for Payer: BCBS Trust/PPO |
$485.50
|
| Rate for Payer: BCN Commercial |
$461.91
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$560.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$595.78
|
| Rate for Payer: Healthscope Whirlpool |
$577.91
|
| Rate for Payer: Mclaren Commercial |
$536.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: Nomi Health Commercial |
$488.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.29
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.62 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.28
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$36.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.54
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$40.19
|
| Rate for Payer: PHP Medicaid |
$19.59
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$34.03
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$56.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP DNSP |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: VA VA |
$36.54
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.68 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Aetna Commercial |
$312.12
|
| Rate for Payer: Aetna Medicare |
$126.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: ASR ASR |
$336.40
|
| Rate for Payer: ASR Commercial |
$336.40
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$283.99
|
| Rate for Payer: BCN Commercial |
$268.87
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$325.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$346.80
|
| Rate for Payer: Healthscope Whirlpool |
$336.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.26
|
| Rate for Payer: Mclaren Commercial |
$312.12
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: Nomi Health Commercial |
$284.38
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$138.89
|
| Rate for Payer: PHP Medicaid |
$67.68
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.64
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$106.11
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$195.70
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP DNSP |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: VA VA |
$126.26
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$225.42 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Aetna Commercial |
$312.12
|
| Rate for Payer: ASR ASR |
$336.40
|
| Rate for Payer: ASR Commercial |
$336.40
|
| Rate for Payer: BCBS Trust/PPO |
$282.61
|
| Rate for Payer: BCN Commercial |
$268.87
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$325.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Healthscope Commercial |
$346.80
|
| Rate for Payer: Healthscope Whirlpool |
$336.40
|
| Rate for Payer: Mclaren Commercial |
$312.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: Nomi Health Commercial |
$284.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.18
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
OP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$103.28
|
| Rate for Payer: Aetna Medicare |
$36.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: ASR ASR |
$111.31
|
| Rate for Payer: ASR Commercial |
$111.31
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$93.97
|
| Rate for Payer: BCN Commercial |
$88.97
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Healthscope Whirlpool |
$111.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.54
|
| Rate for Payer: Mclaren Commercial |
$103.28
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$94.10
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$40.19
|
| Rate for Payer: PHP Medicaid |
$19.59
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.54
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$80.44
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$56.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP DNSP |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: VA VA |
$36.54
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.59 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$103.28
|
| Rate for Payer: ASR ASR |
$111.31
|
| Rate for Payer: ASR Commercial |
$111.31
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$88.97
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Healthscope Whirlpool |
$111.31
|
| Rate for Payer: Mclaren Commercial |
$103.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$94.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.98
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$237.99 |
| Max. Negotiated Rate |
$366.14 |
| Rate for Payer: Aetna Commercial |
$329.53
|
| Rate for Payer: ASR ASR |
$355.16
|
| Rate for Payer: ASR Commercial |
$355.16
|
| Rate for Payer: BCBS Trust/PPO |
$298.37
|
| Rate for Payer: BCN Commercial |
$283.87
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Healthscope Commercial |
$366.14
|
| Rate for Payer: Healthscope Whirlpool |
$355.16
|
| Rate for Payer: Mclaren Commercial |
$329.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.20
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.68 |
| Max. Negotiated Rate |
$366.14 |
| Rate for Payer: Aetna Commercial |
$329.53
|
| Rate for Payer: Aetna Medicare |
$126.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: ASR ASR |
$355.16
|
| Rate for Payer: ASR Commercial |
$355.16
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$299.83
|
| Rate for Payer: BCN Commercial |
$283.87
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$366.14
|
| Rate for Payer: Healthscope Whirlpool |
$355.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.26
|
| Rate for Payer: Mclaren Commercial |
$329.53
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$138.89
|
| Rate for Payer: PHP Medicaid |
$67.68
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.81
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$256.66
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$195.70
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP DNSP |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: VA VA |
$126.26
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.96 |
| Max. Negotiated Rate |
$662.41 |
| Rate for Payer: Aetna Commercial |
$596.17
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: ASR ASR |
$642.54
|
| Rate for Payer: ASR Commercial |
$642.54
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: BCBS Trust/PPO |
$542.45
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$662.41
|
| Rate for Payer: Healthscope Whirlpool |
$642.54
|
| Rate for Payer: Mclaren Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.40
|
| Rate for Payer: Priority Health Narrow Network |
$464.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.92
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$430.57 |
| Max. Negotiated Rate |
$662.41 |
| Rate for Payer: Aetna Commercial |
$596.17
|
| Rate for Payer: ASR ASR |
$642.54
|
| Rate for Payer: ASR Commercial |
$642.54
|
| Rate for Payer: BCBS Trust/PPO |
$539.80
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$662.41
|
| Rate for Payer: Healthscope Whirlpool |
$642.54
|
| Rate for Payer: Mclaren Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.92
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,417.37 |
| Max. Negotiated Rate |
$2,180.57 |
| Rate for Payer: Aetna Commercial |
$1,962.51
|
| Rate for Payer: ASR ASR |
$2,115.15
|
| Rate for Payer: ASR Commercial |
$2,115.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.95
|
| Rate for Payer: BCN Commercial |
$1,690.60
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$2,049.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Healthscope Commercial |
$2,180.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,115.15
|
| Rate for Payer: Mclaren Commercial |
$1,962.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: Nomi Health Commercial |
$1,788.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,918.90
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,962.51
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$2,115.15
|
| Rate for Payer: ASR Commercial |
$2,115.15
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.67
|
| Rate for Payer: BCN Commercial |
$1,690.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$2,049.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$2,180.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,115.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,962.51
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: Nomi Health Commercial |
$1,788.07
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,910.62
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,528.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,918.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.16 |
| Max. Negotiated Rate |
$343.33 |
| Rate for Payer: Aetna Commercial |
$309.00
|
| Rate for Payer: ASR ASR |
$333.03
|
| Rate for Payer: ASR Commercial |
$333.03
|
| Rate for Payer: BCBS Trust/PPO |
$279.78
|
| Rate for Payer: BCN Commercial |
$266.18
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Healthscope Commercial |
$343.33
|
| Rate for Payer: Healthscope Whirlpool |
$333.03
|
| Rate for Payer: Mclaren Commercial |
$309.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$281.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.13
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.56 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$309.00
|
| Rate for Payer: Aetna Medicare |
$390.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: ASR ASR |
$333.03
|
| Rate for Payer: ASR Commercial |
$333.03
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$281.15
|
| Rate for Payer: BCN Commercial |
$266.18
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$343.33
|
| Rate for Payer: Healthscope Whirlpool |
$333.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$390.97
|
| Rate for Payer: Mclaren Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$281.53
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$430.07
|
| Rate for Payer: PHP Medicaid |
$209.56
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.83
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$240.67
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$606.00
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP DNSP |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: VA VA |
$390.97
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: ASR Commercial |
$1,088.34
|
| Rate for Payer: BCBS Trust/PPO |
$914.32
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.42 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: Aetna Medicare |
$390.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: ASR Commercial |
$1,088.34
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$918.81
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$390.97
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$430.07
|
| Rate for Payer: PHP Medicaid |
$209.56
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.03
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$150.42
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$606.00
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP DNSP |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: VA VA |
$390.97
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: ASR Commercial |
$346.29
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$292.35
|
| Rate for Payer: BCN Commercial |
$276.78
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$357.00
|
| Rate for Payer: Healthscope Whirlpool |
$346.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.02
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$80.82
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.05 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: ASR Commercial |
$346.29
|
| Rate for Payer: BCBS Trust/PPO |
$290.92
|
| Rate for Payer: BCN Commercial |
$276.78
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$357.00
|
| Rate for Payer: Healthscope Whirlpool |
$346.29
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,734.04 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,734.04
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,304.74 |
| Max. Negotiated Rate |
$5,084.21 |
| Rate for Payer: Aetna Commercial |
$4,575.79
|
| Rate for Payer: ASR ASR |
$4,931.68
|
| Rate for Payer: ASR Commercial |
$4,931.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,143.12
|
| Rate for Payer: BCN Commercial |
$3,941.79
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,779.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Healthscope Commercial |
$5,084.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,931.68
|
| Rate for Payer: Mclaren Commercial |
$4,575.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: Nomi Health Commercial |
$4,169.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,474.10
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,440.20 |
| Max. Negotiated Rate |
$5,084.21 |
| Rate for Payer: Aetna Commercial |
$4,575.79
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$4,931.68
|
| Rate for Payer: ASR Commercial |
$4,931.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$4,163.46
|
| Rate for Payer: BCN Commercial |
$3,941.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,779.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$5,084.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,931.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$4,575.79
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: Nomi Health Commercial |
$4,169.05
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,682.73
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,946.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,474.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,911.22 |
| Max. Negotiated Rate |
$5,526.85 |
| Rate for Payer: Aetna Commercial |
$2,755.83
|
| Rate for Payer: Aetna Medicare |
$3,565.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: ASR ASR |
$2,970.17
|
| Rate for Payer: ASR Commercial |
$2,970.17
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.50
|
| Rate for Payer: BCN Commercial |
$2,373.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,878.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$3,062.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,970.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,565.71
|
| Rate for Payer: Mclaren Commercial |
$2,755.83
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$3,922.28
|
| Rate for Payer: PHP Medicaid |
$1,911.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,682.95
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,146.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,694.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$5,526.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP DNSP |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: VA VA |
$3,565.71
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,990.32 |
| Max. Negotiated Rate |
$3,062.03 |
| Rate for Payer: Aetna Commercial |
$2,755.83
|
| Rate for Payer: ASR ASR |
$2,970.17
|
| Rate for Payer: ASR Commercial |
$2,970.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,495.25
|
| Rate for Payer: BCN Commercial |
$2,373.99
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,878.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Healthscope Commercial |
$3,062.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,970.17
|
| Rate for Payer: Mclaren Commercial |
$2,755.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,694.59
|
|
