|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$112.96 |
| Max. Negotiated Rate |
$173.78 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: ASR ASR |
$168.57
|
| Rate for Payer: ASR Commercial |
$168.57
|
| Rate for Payer: BCBS Trust/PPO |
$141.61
|
| Rate for Payer: BCN Commercial |
$134.73
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$163.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Healthscope Commercial |
$173.78
|
| Rate for Payer: Healthscope Whirlpool |
$168.57
|
| Rate for Payer: Mclaren Commercial |
$156.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: Nomi Health Commercial |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.93
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$174.52
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$188.09
|
| Rate for Payer: ASR Commercial |
$188.09
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$158.79
|
| Rate for Payer: BCN Commercial |
$150.34
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$182.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$193.91
|
| Rate for Payer: Healthscope Whirlpool |
$188.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$174.52
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.90
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$135.93
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$193.91 |
| Rate for Payer: Aetna Commercial |
$174.52
|
| Rate for Payer: ASR ASR |
$188.09
|
| Rate for Payer: ASR Commercial |
$188.09
|
| Rate for Payer: BCBS Trust/PPO |
$158.02
|
| Rate for Payer: BCN Commercial |
$150.34
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$182.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Healthscope Commercial |
$193.91
|
| Rate for Payer: Healthscope Whirlpool |
$188.09
|
| Rate for Payer: Mclaren Commercial |
$174.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.64
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$228.86 |
| Max. Negotiated Rate |
$352.09 |
| Rate for Payer: Aetna Commercial |
$316.88
|
| Rate for Payer: ASR ASR |
$341.53
|
| Rate for Payer: ASR Commercial |
$341.53
|
| Rate for Payer: BCBS Trust/PPO |
$286.92
|
| Rate for Payer: BCN Commercial |
$272.98
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$330.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Healthscope Commercial |
$352.09
|
| Rate for Payer: Healthscope Whirlpool |
$341.53
|
| Rate for Payer: Mclaren Commercial |
$316.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: Nomi Health Commercial |
$288.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.84
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$316.88
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$341.53
|
| Rate for Payer: ASR Commercial |
$341.53
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$288.33
|
| Rate for Payer: BCN Commercial |
$272.98
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$330.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$352.09
|
| Rate for Payer: Healthscope Whirlpool |
$341.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$316.88
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: Nomi Health Commercial |
$288.71
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.50
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$246.82
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Aetna Commercial |
$192.02
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$206.95
|
| Rate for Payer: ASR Commercial |
$206.95
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$174.71
|
| Rate for Payer: BCN Commercial |
$165.41
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$200.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$213.35
|
| Rate for Payer: Healthscope Whirlpool |
$206.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$192.02
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.02
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$80.82
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.68 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Aetna Commercial |
$192.02
|
| Rate for Payer: ASR ASR |
$206.95
|
| Rate for Payer: ASR Commercial |
$206.95
|
| Rate for Payer: BCBS Trust/PPO |
$173.86
|
| Rate for Payer: BCN Commercial |
$165.41
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$200.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$213.35
|
| Rate for Payer: Healthscope Whirlpool |
$206.95
|
| Rate for Payer: Mclaren Commercial |
$192.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.75
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna Commercial |
$128.55
|
| Rate for Payer: ASR ASR |
$138.55
|
| Rate for Payer: ASR Commercial |
$138.55
|
| Rate for Payer: BCBS Trust/PPO |
$116.39
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$134.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Whirlpool |
$138.55
|
| Rate for Payer: Mclaren Commercial |
$128.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.69
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna Commercial |
$128.55
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$138.55
|
| Rate for Payer: ASR Commercial |
$138.55
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$116.96
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$134.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Whirlpool |
$138.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$128.55
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.02
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$80.82
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.68 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Aetna Commercial |
$192.02
|
| Rate for Payer: ASR ASR |
$206.95
|
| Rate for Payer: ASR Commercial |
$206.95
|
| Rate for Payer: BCBS Trust/PPO |
$173.86
|
| Rate for Payer: BCN Commercial |
$165.41
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$200.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$213.35
|
| Rate for Payer: Healthscope Whirlpool |
$206.95
|
| Rate for Payer: Mclaren Commercial |
$192.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.75
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$213.35
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Aetna Commercial |
$192.02
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$206.95
|
| Rate for Payer: ASR Commercial |
$206.95
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$174.71
|
| Rate for Payer: BCN Commercial |
$165.41
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$200.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$213.35
|
| Rate for Payer: Healthscope Whirlpool |
$206.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$192.02
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.94
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$149.56
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$142.83
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna Commercial |
$128.55
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$138.55
|
| Rate for Payer: ASR Commercial |
$138.55
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$116.96
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$134.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Whirlpool |
$138.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$128.55
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.15
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$100.12
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$142.83
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna Commercial |
$128.55
|
| Rate for Payer: ASR ASR |
$138.55
|
| Rate for Payer: ASR Commercial |
$138.55
|
| Rate for Payer: BCBS Trust/PPO |
$116.39
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$134.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Whirlpool |
$138.55
|
| Rate for Payer: Mclaren Commercial |
$128.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.69
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$7,039.02 |
| Rate for Payer: Aetna Commercial |
$6,335.12
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$6,827.85
|
| Rate for Payer: ASR Commercial |
$6,827.85
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,764.25
|
| Rate for Payer: BCN Commercial |
$5,457.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,616.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$7,039.02
|
| Rate for Payer: Healthscope Whirlpool |
$6,827.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$6,335.12
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,983.17
|
| Rate for Payer: Nomi Health Commercial |
$5,772.00
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,575.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,167.59
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$4,934.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,194.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$7,039.02
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,575.36 |
| Max. Negotiated Rate |
$7,039.02 |
| Rate for Payer: Aetna Commercial |
$6,335.12
|
| Rate for Payer: ASR ASR |
$6,827.85
|
| Rate for Payer: ASR Commercial |
$6,827.85
|
| Rate for Payer: BCBS Trust/PPO |
$5,736.10
|
| Rate for Payer: BCN Commercial |
$5,457.35
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,616.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Healthscope Commercial |
$7,039.02
|
| Rate for Payer: Healthscope Whirlpool |
$6,827.85
|
| Rate for Payer: Mclaren Commercial |
$6,335.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,983.17
|
| Rate for Payer: Nomi Health Commercial |
$5,772.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,575.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,194.34
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,551.45
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,658.44 |
| Max. Negotiated Rate |
$2,551.45 |
| Rate for Payer: Aetna Commercial |
$2,296.30
|
| Rate for Payer: ASR ASR |
$2,474.91
|
| Rate for Payer: ASR Commercial |
$2,474.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,079.18
|
| Rate for Payer: BCN Commercial |
$1,978.14
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cofinity Commercial |
$2,398.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.16
|
| Rate for Payer: Healthscope Commercial |
$2,551.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,474.91
|
| Rate for Payer: Mclaren Commercial |
$2,296.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.73
|
| Rate for Payer: Nomi Health Commercial |
$2,092.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,245.28
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,551.45
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,296.30
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$2,474.91
|
| Rate for Payer: ASR Commercial |
$2,474.91
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,089.38
|
| Rate for Payer: BCN Commercial |
$1,978.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cofinity Commercial |
$2,398.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,551.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,474.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,296.30
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.73
|
| Rate for Payer: Nomi Health Commercial |
$2,092.19
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,235.58
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,788.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,245.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$377.89
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$377.89 |
| Rate for Payer: Aetna Commercial |
$340.10
|
| Rate for Payer: ASR ASR |
$366.55
|
| Rate for Payer: ASR Commercial |
$366.55
|
| Rate for Payer: BCBS Trust/PPO |
$307.94
|
| Rate for Payer: BCN Commercial |
$292.98
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$355.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$377.89
|
| Rate for Payer: Healthscope Whirlpool |
$366.55
|
| Rate for Payer: Mclaren Commercial |
$340.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.54
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$377.89
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.16 |
| Max. Negotiated Rate |
$377.89 |
| Rate for Payer: Aetna Commercial |
$340.10
|
| Rate for Payer: Aetna Medicare |
$188.94
|
| Rate for Payer: ASR ASR |
$366.55
|
| Rate for Payer: ASR Commercial |
$366.55
|
| Rate for Payer: BCBS Complete |
$151.16
|
| Rate for Payer: BCBS Trust/PPO |
$309.45
|
| Rate for Payer: BCN Commercial |
$292.98
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$355.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$377.89
|
| Rate for Payer: Healthscope Whirlpool |
$366.55
|
| Rate for Payer: Mclaren Commercial |
$340.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.11
|
| Rate for Payer: Priority Health Narrow Network |
$264.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.54
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$951.99
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.79 |
| Max. Negotiated Rate |
$951.99 |
| Rate for Payer: Aetna Commercial |
$856.79
|
| Rate for Payer: ASR ASR |
$923.43
|
| Rate for Payer: ASR Commercial |
$923.43
|
| Rate for Payer: BCBS Trust/PPO |
$775.78
|
| Rate for Payer: BCN Commercial |
$738.08
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Healthscope Commercial |
$951.99
|
| Rate for Payer: Healthscope Whirlpool |
$923.43
|
| Rate for Payer: Mclaren Commercial |
$856.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.75
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$951.99
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,284.67 |
| Rate for Payer: Aetna Commercial |
$856.79
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$923.43
|
| Rate for Payer: ASR Commercial |
$923.43
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$779.58
|
| Rate for Payer: BCN Commercial |
$738.08
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$951.99
|
| Rate for Payer: Healthscope Whirlpool |
$923.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$856.79
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.67
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.74
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$247.45
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.84 |
| Max. Negotiated Rate |
$247.45 |
| Rate for Payer: Aetna Commercial |
$222.70
|
| Rate for Payer: ASR ASR |
$240.03
|
| Rate for Payer: ASR Commercial |
$240.03
|
| Rate for Payer: BCBS Trust/PPO |
$201.65
|
| Rate for Payer: BCN Commercial |
$191.85
|
| Rate for Payer: Cash Price |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$232.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.96
|
| Rate for Payer: Healthscope Commercial |
$247.45
|
| Rate for Payer: Healthscope Whirlpool |
$240.03
|
| Rate for Payer: Mclaren Commercial |
$222.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.33
|
| Rate for Payer: Nomi Health Commercial |
$202.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.76
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$247.45
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$98.98 |
| Max. Negotiated Rate |
$247.45 |
| Rate for Payer: Aetna Commercial |
$222.70
|
| Rate for Payer: Aetna Medicare |
$123.72
|
| Rate for Payer: ASR ASR |
$240.03
|
| Rate for Payer: ASR Commercial |
$240.03
|
| Rate for Payer: BCBS Complete |
$98.98
|
| Rate for Payer: BCBS Trust/PPO |
$202.64
|
| Rate for Payer: BCN Commercial |
$191.85
|
| Rate for Payer: Cash Price |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$232.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.96
|
| Rate for Payer: Healthscope Commercial |
$247.45
|
| Rate for Payer: Healthscope Whirlpool |
$240.03
|
| Rate for Payer: Mclaren Commercial |
$222.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.33
|
| Rate for Payer: Nomi Health Commercial |
$202.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.82
|
| Rate for Payer: Priority Health Narrow Network |
$173.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.76
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,716.66
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,115.83 |
| Max. Negotiated Rate |
$1,716.66 |
| Rate for Payer: Aetna Commercial |
$1,544.99
|
| Rate for Payer: ASR ASR |
$1,665.16
|
| Rate for Payer: ASR Commercial |
$1,665.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.91
|
| Rate for Payer: BCN Commercial |
$1,330.93
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cofinity Commercial |
$1,613.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.33
|
| Rate for Payer: Healthscope Commercial |
$1,716.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,665.16
|
| Rate for Payer: Mclaren Commercial |
$1,544.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.16
|
| Rate for Payer: Nomi Health Commercial |
$1,407.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,510.66
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,716.66
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$615.76 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,544.99
|
| 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 |
$1,665.16
|
| Rate for Payer: ASR Commercial |
$1,665.16
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.77
|
| Rate for Payer: BCN Commercial |
$1,330.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cofinity Commercial |
$1,613.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,716.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,665.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,544.99
|
| 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 |
$1,459.16
|
| Rate for Payer: Nomi Health Commercial |
$1,407.66
|
| 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 |
$1,115.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.70
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$615.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,510.66
|
| 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
|
|
