|
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 |
$850.89 |
| Max. Negotiated Rate |
$4,176.90 |
| Rate for Payer: Aetna Commercial |
$3,759.21
|
| 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 |
$4,051.59
|
| Rate for Payer: ASR Commercial |
$4,051.59
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,420.46
|
| Rate for Payer: BCN Commercial |
$3,238.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| 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 |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,176.90
|
| Rate for Payer: Healthscope Whirlpool |
$4,051.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,759.21
|
| 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 |
$3,550.36
|
| Rate for Payer: Nomi Health Commercial |
$3,425.06
|
| 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 |
$2,714.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,659.80
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,928.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,675.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC 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 |
$2,714.98 |
| 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 |
$2,714.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,675.67
|
|
|
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 |
$850.89 |
| Max. Negotiated Rate |
$2,734.04 |
| Rate for Payer: Aetna Commercial |
$1,927.66
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,077.59
|
| Rate for Payer: ASR Commercial |
$2,077.59
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.96
|
| Rate for Payer: BCN Commercial |
$1,660.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| 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 |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,141.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.66
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.57
|
| Rate for Payer: Nomi Health Commercial |
$1,756.32
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,734.04
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,884.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC 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 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 |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$102.46
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$110.42
|
| Rate for Payer: ASR Commercial |
$110.42
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$93.22
|
| Rate for Payer: BCN Commercial |
$88.26
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| 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 |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Healthscope Whirlpool |
$110.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$102.46
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.35
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.03
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$150.42
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,499.57
|
| 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 |
$2,693.98
|
| Rate for Payer: ASR Commercial |
$2,693.98
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,274.33
|
| Rate for Payer: BCN Commercial |
$2,153.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| 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 |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,777.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,693.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,499.57
|
| 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 |
$2,360.70
|
| Rate for Payer: Nomi Health Commercial |
$2,277.39
|
| 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 |
$1,805.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,433.47
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,444.02
|
| 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 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 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 |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$874.33
|
| 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 |
$942.34
|
| Rate for Payer: ASR Commercial |
$942.34
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$795.54
|
| Rate for Payer: BCN Commercial |
$753.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| 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 |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$971.48
|
| Rate for Payer: Healthscope Whirlpool |
$942.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$874.33
|
| 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 |
$825.76
|
| Rate for Payer: Nomi Health Commercial |
$796.61
|
| 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 |
$631.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.21
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$681.01
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.90
|
| 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 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 NEPHROSTOMY TUBE
|
Facility
|
IP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$601.03 |
| Max. Negotiated Rate |
$924.66 |
| Rate for Payer: Aetna Commercial |
$832.19
|
| Rate for Payer: ASR ASR |
$896.92
|
| Rate for Payer: ASR Commercial |
$896.92
|
| Rate for Payer: BCBS Trust/PPO |
$753.51
|
| Rate for Payer: BCN Commercial |
$716.89
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$869.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Healthscope Commercial |
$924.66
|
| Rate for Payer: Healthscope Whirlpool |
$896.92
|
| Rate for Payer: Mclaren Commercial |
$832.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: Nomi Health Commercial |
$758.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.70
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.53 |
| Max. Negotiated Rate |
$1,013.65 |
| Rate for Payer: Aetna Commercial |
$832.19
|
| Rate for Payer: Aetna Medicare |
$653.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.46
|
| Rate for Payer: ASR ASR |
$896.92
|
| Rate for Payer: ASR Commercial |
$896.92
|
| Rate for Payer: BCBS Complete |
$368.05
|
| Rate for Payer: BCBS MAPPO |
$653.97
|
| Rate for Payer: BCBS Trust/PPO |
$757.20
|
| Rate for Payer: BCN Commercial |
$716.89
|
| Rate for Payer: BCN Medicare Advantage |
$653.97
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$869.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.97
|
| Rate for Payer: Healthscope Commercial |
$924.66
|
| Rate for Payer: Healthscope Whirlpool |
$896.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$653.97
|
| Rate for Payer: Mclaren Commercial |
$832.19
|
| Rate for Payer: Mclaren Medicaid |
$350.53
|
| Rate for Payer: Mclaren Medicare |
$653.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.67
|
| Rate for Payer: Meridian Medicaid |
$368.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: Nomi Health Commercial |
$758.22
|
| Rate for Payer: PACE Medicare |
$621.27
|
| Rate for Payer: PACE SWMI |
$653.97
|
| Rate for Payer: PHP Commercial |
$719.37
|
| Rate for Payer: PHP Medicaid |
$350.53
|
| Rate for Payer: PHP Medicare Advantage |
$653.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$810.19
|
| Rate for Payer: Priority Health Medicare |
$653.97
|
| Rate for Payer: Priority Health Narrow Network |
$648.19
|
| Rate for Payer: Railroad Medicare Medicare |
$653.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.97
|
| Rate for Payer: UHC Exchange |
$1,013.65
|
| Rate for Payer: UHC Medicare Advantage |
$653.97
|
| Rate for Payer: UHCCP DNSP |
$653.97
|
| Rate for Payer: UHCCP Medicaid |
$350.53
|
| Rate for Payer: VA VA |
$653.97
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,618.37
|
| 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 |
$2,822.02
|
| Rate for Payer: ASR Commercial |
$2,822.02
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,382.43
|
| Rate for Payer: BCN Commercial |
$2,255.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,734.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,909.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,822.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,618.37
|
| 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 |
$2,472.90
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| 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 |
$1,891.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,549.13
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,039.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,560.18
|
| 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 REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,891.04 |
| Max. Negotiated Rate |
$2,909.30 |
| Rate for Payer: Aetna Commercial |
$2,618.37
|
| Rate for Payer: ASR ASR |
$2,822.02
|
| Rate for Payer: ASR Commercial |
$2,822.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,370.79
|
| Rate for Payer: BCN Commercial |
$2,255.58
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,734.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Healthscope Commercial |
$2,909.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,822.02
|
| Rate for Payer: Mclaren Commercial |
$2,618.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.90
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,560.18
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Trust/PPO |
$6,815.82
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,703.94 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,849.28
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,328.54
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$5,863.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,966.07 |
| Max. Negotiated Rate |
$4,563.19 |
| Rate for Payer: Aetna Commercial |
$4,106.87
|
| Rate for Payer: ASR ASR |
$4,426.29
|
| Rate for Payer: ASR Commercial |
$4,426.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,718.54
|
| Rate for Payer: BCN Commercial |
$3,537.84
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$4,289.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Healthscope Commercial |
$4,563.19
|
| Rate for Payer: Healthscope Whirlpool |
$4,426.29
|
| Rate for Payer: Mclaren Commercial |
$4,106.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: Nomi Health Commercial |
$3,741.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,015.61
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$4,563.19 |
| Rate for Payer: Aetna Commercial |
$4,106.87
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$4,426.29
|
| Rate for Payer: ASR Commercial |
$4,426.29
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,736.80
|
| Rate for Payer: BCN Commercial |
$3,537.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$4,289.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$4,563.19
|
| Rate for Payer: Healthscope Whirlpool |
$4,426.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$4,106.87
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: Nomi Health Commercial |
$3,741.82
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,998.27
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$3,198.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,015.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$36.57
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$22.44
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Complete |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$36.75
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.32
|
| Rate for Payer: Priority Health Narrow Network |
$31.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$25.77
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$15.81
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.71
|
| Rate for Payer: Priority Health Narrow Network |
$22.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$960.64 |
| Max. Negotiated Rate |
$5,105.09 |
| Rate for Payer: Aetna Commercial |
$4,594.58
|
| Rate for Payer: Aetna Medicare |
$1,792.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: ASR ASR |
$4,951.94
|
| Rate for Payer: ASR Commercial |
$4,951.94
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,180.56
|
| Rate for Payer: BCN Commercial |
$3,957.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$4,798.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$5,105.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,951.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,792.24
|
| Rate for Payer: Mclaren Commercial |
$4,594.58
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: Nomi Health Commercial |
$4,186.17
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$1,971.46
|
| Rate for Payer: PHP Medicaid |
$960.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,473.08
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$3,578.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,492.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$2,777.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP DNSP |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: VA VA |
$1,792.24
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,318.31 |
| Max. Negotiated Rate |
$5,105.09 |
| Rate for Payer: Aetna Commercial |
$4,594.58
|
| Rate for Payer: ASR ASR |
$4,951.94
|
| Rate for Payer: ASR Commercial |
$4,951.94
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.14
|
| Rate for Payer: BCN Commercial |
$3,957.98
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$4,798.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Healthscope Commercial |
$5,105.09
|
| Rate for Payer: Healthscope Whirlpool |
$4,951.94
|
| Rate for Payer: Mclaren Commercial |
$4,594.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: Nomi Health Commercial |
$4,186.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,492.48
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$35.37 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Trust/PPO |
$28.82
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
|
