|
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 |
$31.05 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: Aetna Commercial |
$192.01
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$206.95
|
| Rate for Payer: ASR Commercial |
$206.95
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$174.71
|
| Rate for Payer: BCN Commercial |
$165.41
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| 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 |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$213.35
|
| Rate for Payer: Healthscope Whirlpool |
$206.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$192.01
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| 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 |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$149.56
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
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 |
$31.05 |
| Max. Negotiated Rate |
$142.83 |
| Rate for Payer: Aetna Commercial |
$128.55
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$138.55
|
| Rate for Payer: ASR Commercial |
$138.55
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$116.96
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| 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 |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Whirlpool |
$138.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$128.55
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| 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 |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$100.12
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
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
|
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 EAR CANAL LESION(S)
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,039.02 |
| Rate for Payer: Aetna Commercial |
$6,335.12
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$6,827.85
|
| Rate for Payer: ASR Commercial |
$6,827.85
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,764.25
|
| Rate for Payer: BCN Commercial |
$5,457.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| 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 |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,039.02
|
| Rate for Payer: Healthscope Whirlpool |
$6,827.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$6,335.12
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| 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 |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| 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 |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$4,934.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,194.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
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 |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$2,296.30
|
| 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 |
$2,474.91
|
| Rate for Payer: ASR Commercial |
$2,474.91
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,089.38
|
| Rate for Payer: BCN Commercial |
$1,978.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| 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 |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,551.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,474.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,296.30
|
| 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 |
$2,168.73
|
| Rate for Payer: Nomi Health Commercial |
$2,092.19
|
| 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 |
$1,658.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,235.58
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,788.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,245.28
|
| 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 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 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 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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$856.79
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$923.43
|
| Rate for Payer: ASR Commercial |
$923.43
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$779.58
|
| Rate for Payer: BCN Commercial |
$738.08
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$951.99
|
| Rate for Payer: Healthscope Whirlpool |
$923.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$856.79
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.13
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$667.34
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC 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 |
$222.71
|
| 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 |
$222.71
|
| 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 |
$222.71
|
| 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 |
$222.71
|
| 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
|
OP
|
$1,716.66
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,544.99
|
| 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 |
$1,665.16
|
| Rate for Payer: ASR Commercial |
$1,665.16
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.77
|
| Rate for Payer: BCN Commercial |
$1,330.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,716.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,665.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,544.99
|
| 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 |
$1,459.16
|
| Rate for Payer: Nomi Health Commercial |
$1,407.66
|
| 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 |
$1,115.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,504.14
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,203.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,510.66
|
| 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 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 XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,176.90
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,176.90 |
| Rate for Payer: Aetna Commercial |
$3,759.21
|
| 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 |
$4,051.59
|
| Rate for Payer: ASR Commercial |
$4,051.59
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,420.46
|
| Rate for Payer: BCN Commercial |
$3,238.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cofinity Commercial |
$3,926.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,176.90
|
| Rate for Payer: Healthscope Whirlpool |
$4,051.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$3,759.21
|
| 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 |
$3,550.36
|
| Rate for Payer: Nomi Health Commercial |
$3,425.06
|
| 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 |
$2,714.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,659.80
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,928.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,675.67
|
| 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 REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,176.90
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,714.99 |
| Max. Negotiated Rate |
$4,176.90 |
| Rate for Payer: Aetna Commercial |
$3,759.21
|
| Rate for Payer: ASR ASR |
$4,051.59
|
| Rate for Payer: ASR Commercial |
$4,051.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,403.76
|
| Rate for Payer: BCN Commercial |
$3,238.35
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cofinity Commercial |
$3,926.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Healthscope Commercial |
$4,176.90
|
| Rate for Payer: Healthscope Whirlpool |
$4,051.59
|
| Rate for Payer: Mclaren Commercial |
$3,759.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,550.36
|
| Rate for Payer: Nomi Health Commercial |
$3,425.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,675.67
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,141.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.20 |
| Max. Negotiated Rate |
$2,141.85 |
| Rate for Payer: Aetna Commercial |
$1,927.66
|
| Rate for Payer: ASR ASR |
$2,077.59
|
| Rate for Payer: ASR Commercial |
$2,077.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.39
|
| Rate for Payer: BCN Commercial |
$1,660.58
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cofinity Commercial |
$2,013.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.48
|
| Rate for Payer: Healthscope Commercial |
$2,141.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.59
|
| Rate for Payer: Mclaren Commercial |
$1,927.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.57
|
| Rate for Payer: Nomi Health Commercial |
$1,756.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,884.83
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,141.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,927.66
|
| 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 |
$2,077.59
|
| Rate for Payer: ASR Commercial |
$2,077.59
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.96
|
| Rate for Payer: BCN Commercial |
$1,660.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cofinity Commercial |
$2,013.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,141.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,927.66
|
| 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 |
$1,820.57
|
| Rate for Payer: Nomi Health Commercial |
$1,756.32
|
| 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 |
$1,392.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.69
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,884.83
|
| 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 REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
IP
|
$113.84
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna Commercial |
$102.46
|
| Rate for Payer: ASR ASR |
$110.42
|
| Rate for Payer: ASR Commercial |
$110.42
|
| Rate for Payer: BCBS Trust/PPO |
$92.77
|
| Rate for Payer: BCN Commercial |
$88.26
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cofinity Commercial |
$107.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.07
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Healthscope Whirlpool |
$110.42
|
| Rate for Payer: Mclaren Commercial |
$102.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.18
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$113.84
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$102.46
|
| 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 |
$110.42
|
| Rate for Payer: ASR Commercial |
$110.42
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$93.22
|
| Rate for Payer: BCN Commercial |
$88.26
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cofinity Commercial |
$107.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Healthscope Whirlpool |
$110.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$102.46
|
| 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 |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.35
|
| 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 |
$74.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.75
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$79.80
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.18
|
| 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 REMOVE INT URETERAL STENT
|
Facility
|
IP
|
$2,777.30
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,805.24 |
| Max. Negotiated Rate |
$2,777.30 |
| Rate for Payer: Aetna Commercial |
$2,499.57
|
| Rate for Payer: ASR ASR |
$2,693.98
|
| Rate for Payer: ASR Commercial |
$2,693.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,263.22
|
| Rate for Payer: BCN Commercial |
$2,153.24
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,610.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Healthscope Commercial |
$2,777.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,693.98
|
| Rate for Payer: Mclaren Commercial |
$2,499.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: Nomi Health Commercial |
$2,277.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,444.02
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$2,499.57
|
| 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 |
$2,693.98
|
| Rate for Payer: ASR Commercial |
$2,693.98
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,274.33
|
| Rate for Payer: BCN Commercial |
$2,153.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,610.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,777.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,693.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,499.57
|
| 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 |
$2,360.70
|
| Rate for Payer: Nomi Health Commercial |
$2,277.39
|
| 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 |
$1,805.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,433.47
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,444.02
|
| 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 REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$971.48
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.46 |
| Max. Negotiated Rate |
$971.48 |
| Rate for Payer: Aetna Commercial |
$874.33
|
| Rate for Payer: ASR ASR |
$942.34
|
| Rate for Payer: ASR Commercial |
$942.34
|
| Rate for Payer: BCBS Trust/PPO |
$791.66
|
| Rate for Payer: BCN Commercial |
$753.19
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cofinity Commercial |
$913.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.18
|
| Rate for Payer: Healthscope Commercial |
$971.48
|
| Rate for Payer: Healthscope Whirlpool |
$942.34
|
| Rate for Payer: Mclaren Commercial |
$874.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.76
|
| Rate for Payer: Nomi Health Commercial |
$796.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.90
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$971.48
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.46 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$874.33
|
| 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 |
$942.34
|
| Rate for Payer: ASR Commercial |
$942.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$795.54
|
| Rate for Payer: BCN Commercial |
$753.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cofinity Commercial |
$913.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$971.48
|
| Rate for Payer: Healthscope Whirlpool |
$942.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$874.33
|
| 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 |
$825.76
|
| Rate for Payer: Nomi Health Commercial |
$796.61
|
| 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 |
$631.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.21
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$681.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.90
|
| 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
|
|
