|
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
|
OP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,962.51
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$2,115.15
|
| Rate for Payer: ASR Commercial |
$2,115.15
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.67
|
| Rate for Payer: BCN Commercial |
$1,690.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| 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 |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,180.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,115.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,962.51
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| 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 |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| 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 |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,528.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,918.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
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 DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.60 |
| Max. Negotiated Rate |
$603.23 |
| Rate for Payer: Aetna Commercial |
$309.00
|
| Rate for Payer: Aetna Medicare |
$389.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: ASR ASR |
$333.03
|
| Rate for Payer: ASR Commercial |
$333.03
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCBS Trust/PPO |
$281.15
|
| Rate for Payer: BCN Commercial |
$266.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| 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 |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$343.33
|
| Rate for Payer: Healthscope Whirlpool |
$333.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.18
|
| Rate for Payer: Mclaren Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$281.53
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$428.10
|
| Rate for Payer: PHP Medicaid |
$208.60
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| 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 |
$389.18
|
| Rate for Payer: Priority Health Narrow Network |
$240.67
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$603.23
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP DNSP |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: VA VA |
$389.18
|
|
|
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 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 |
$208.60 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: Aetna Medicare |
$389.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: ASR Commercial |
$1,088.34
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCBS Trust/PPO |
$918.81
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| 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 |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.18
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$428.10
|
| Rate for Payer: PHP Medicaid |
$208.60
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.10
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health Narrow Network |
$786.52
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$603.23
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP DNSP |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: VA VA |
$389.18
|
|
|
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 FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: ASR Commercial |
$346.29
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$292.35
|
| Rate for Payer: BCN Commercial |
$276.78
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| 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 |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$357.00
|
| Rate for Payer: Healthscope Whirlpool |
$346.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.80
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$250.26
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| 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 |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
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 OF ANAL TAGS
|
Facility
|
OP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,433.59 |
| Max. Negotiated Rate |
$5,084.21 |
| Rate for Payer: Aetna Commercial |
$4,575.79
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$4,931.68
|
| Rate for Payer: ASR Commercial |
$4,931.68
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,163.46
|
| Rate for Payer: BCN Commercial |
$3,941.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| 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 |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$5,084.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,931.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$4,575.79
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| 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 |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,454.78
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$3,564.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,474.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
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 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
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,902.45 |
| Max. Negotiated Rate |
$5,501.48 |
| Rate for Payer: Aetna Commercial |
$2,755.83
|
| Rate for Payer: Aetna Medicare |
$3,549.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,436.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,436.68
|
| Rate for Payer: ASR ASR |
$2,970.17
|
| Rate for Payer: ASR Commercial |
$2,970.17
|
| Rate for Payer: BCBS Complete |
$1,997.57
|
| Rate for Payer: BCBS MAPPO |
$3,549.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.50
|
| Rate for Payer: BCN Commercial |
$2,373.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,549.34
|
| 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 |
$3,549.34
|
| Rate for Payer: Healthscope Commercial |
$3,062.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,970.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,549.34
|
| Rate for Payer: Mclaren Commercial |
$2,755.83
|
| Rate for Payer: Mclaren Medicaid |
$1,902.45
|
| Rate for Payer: Mclaren Medicare |
$3,549.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,726.81
|
| Rate for Payer: Meridian Medicaid |
$1,997.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,081.74
|
| 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 |
$3,371.87
|
| Rate for Payer: PACE SWMI |
$3,549.34
|
| Rate for Payer: PHP Commercial |
$3,904.27
|
| Rate for Payer: PHP Medicaid |
$1,902.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,549.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,902.45
|
| 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 |
$3,549.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,146.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,549.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,694.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,549.34
|
| Rate for Payer: UHC Exchange |
$5,501.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,549.34
|
| Rate for Payer: UHCCP DNSP |
$3,549.34
|
| Rate for Payer: UHCCP Medicaid |
$1,902.45
|
| Rate for Payer: VA VA |
$3,549.34
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,189.35 |
| Max. Negotiated Rate |
$3,368.23 |
| Rate for Payer: Aetna Commercial |
$3,031.41
|
| Rate for Payer: ASR ASR |
$3,267.18
|
| Rate for Payer: ASR Commercial |
$3,267.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,744.77
|
| Rate for Payer: BCN Commercial |
$2,611.39
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$3,166.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Healthscope Commercial |
$3,368.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,267.18
|
| Rate for Payer: Mclaren Commercial |
$3,031.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: Nomi Health Commercial |
$2,761.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,964.04
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,189.35 |
| Max. Negotiated Rate |
$12,510.67 |
| Rate for Payer: Aetna Commercial |
$3,031.41
|
| Rate for Payer: Aetna Medicare |
$8,071.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,089.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,089.25
|
| Rate for Payer: ASR ASR |
$3,267.18
|
| Rate for Payer: ASR Commercial |
$3,267.18
|
| Rate for Payer: BCBS Complete |
$4,542.58
|
| Rate for Payer: BCBS MAPPO |
$8,071.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.24
|
| Rate for Payer: BCN Commercial |
$2,611.39
|
| Rate for Payer: BCN Medicare Advantage |
$8,071.40
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$3,166.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,071.40
|
| Rate for Payer: Healthscope Commercial |
$3,368.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,267.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,071.40
|
| Rate for Payer: Mclaren Commercial |
$3,031.41
|
| Rate for Payer: Mclaren Medicaid |
$4,326.27
|
| Rate for Payer: Mclaren Medicare |
$8,071.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,474.97
|
| Rate for Payer: Meridian Medicaid |
$4,542.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,282.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: Nomi Health Commercial |
$2,761.95
|
| Rate for Payer: PACE Medicare |
$7,667.83
|
| Rate for Payer: PACE SWMI |
$8,071.40
|
| Rate for Payer: PHP Commercial |
$8,878.54
|
| Rate for Payer: PHP Medicaid |
$4,326.27
|
| Rate for Payer: PHP Medicare Advantage |
$8,071.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,326.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,951.24
|
| Rate for Payer: Priority Health Medicare |
$8,071.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,361.13
|
| Rate for Payer: Railroad Medicare Medicare |
$8,071.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,964.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,071.40
|
| Rate for Payer: UHC Exchange |
$12,510.67
|
| Rate for Payer: UHC Medicare Advantage |
$8,071.40
|
| Rate for Payer: UHCCP DNSP |
$8,071.40
|
| Rate for Payer: UHCCP Medicaid |
$4,326.27
|
| Rate for Payer: VA VA |
$8,071.40
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,566.46
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,598.70
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,060.42
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,648.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$2,443.55
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$2,633.61
|
| Rate for Payer: ASR Commercial |
$2,633.61
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.36
|
| Rate for Payer: BCN Commercial |
$2,104.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,552.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,715.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,633.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,443.55
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,378.94
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,903.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,389.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,764.79 |
| Max. Negotiated Rate |
$2,715.06 |
| Rate for Payer: Aetna Commercial |
$2,443.55
|
| Rate for Payer: ASR ASR |
$2,633.61
|
| Rate for Payer: ASR Commercial |
$2,633.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,212.50
|
| Rate for Payer: BCN Commercial |
$2,104.99
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,552.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Healthscope Commercial |
$2,715.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,633.61
|
| Rate for Payer: Mclaren Commercial |
$2,443.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,389.25
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,598.70
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,060.42
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,648.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,566.46
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,315.00 |
| Max. Negotiated Rate |
$5,100.00 |
| Rate for Payer: Aetna Commercial |
$4,590.00
|
| Rate for Payer: ASR ASR |
$4,947.00
|
| Rate for Payer: ASR Commercial |
$4,947.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,155.99
|
| Rate for Payer: BCN Commercial |
$3,954.03
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$4,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Healthscope Commercial |
$5,100.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,947.00
|
| Rate for Payer: Mclaren Commercial |
$4,590.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: Nomi Health Commercial |
$4,182.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,488.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$5,100.00 |
| Rate for Payer: Aetna Commercial |
$4,590.00
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$4,947.00
|
| Rate for Payer: ASR Commercial |
$4,947.00
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,176.39
|
| Rate for Payer: BCN Commercial |
$3,954.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$4,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$5,100.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,947.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$4,590.00
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: Nomi Health Commercial |
$4,182.00
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,468.62
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$3,575.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,488.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
