|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$62.04 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$8.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.85
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Complete |
$4.89
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCBS Trust/PPO |
$28.96
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$28.30
|
| 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: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.68
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Mclaren Medicaid |
$4.65
|
| Rate for Payer: Mclaren Medicare |
$8.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: Meridian Medicaid |
$4.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Medicare |
$8.25
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PHP Commercial |
$9.55
|
| Rate for Payer: PHP Medicaid |
$4.65
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.04
|
| Rate for Payer: Priority Health Medicare |
$8.68
|
| Rate for Payer: Priority Health Narrow Network |
$49.63
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.68
|
| Rate for Payer: UHC Exchange |
$13.45
|
| Rate for Payer: UHC Medicare Advantage |
$8.68
|
| Rate for Payer: UHCCP DNSP |
$8.68
|
| Rate for Payer: UHCCP Medicaid |
$4.65
|
| Rate for Payer: VA VA |
$8.68
|
|
|
HC RENIN
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$114.19 |
| Rate for Payer: Aetna Commercial |
$37.36
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$40.26
|
| Rate for Payer: ASR Commercial |
$40.26
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$33.99
|
| Rate for Payer: BCN Commercial |
$32.18
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$39.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$41.51
|
| Rate for Payer: Healthscope Whirlpool |
$40.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$37.36
|
| Rate for Payer: Mclaren Medicaid |
$11.79
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.19
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$91.35
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.99
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicare Advantage |
$21.99
|
| Rate for Payer: UHCCP DNSP |
$21.99
|
| Rate for Payer: UHCCP Medicaid |
$11.79
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC RENIN
|
Facility
|
IP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$41.51 |
| Rate for Payer: Aetna Commercial |
$37.36
|
| Rate for Payer: ASR ASR |
$40.26
|
| Rate for Payer: ASR Commercial |
$40.26
|
| Rate for Payer: BCBS Trust/PPO |
$33.83
|
| Rate for Payer: BCN Commercial |
$32.18
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$39.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$41.51
|
| Rate for Payer: Healthscope Whirlpool |
$40.26
|
| Rate for Payer: Mclaren Commercial |
$37.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.53
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Aetna Commercial |
$0.36
|
| Rate for Payer: ASR ASR |
$0.39
|
| Rate for Payer: ASR Commercial |
$0.39
|
| Rate for Payer: BCBS Trust/PPO |
$0.33
|
| Rate for Payer: BCN Commercial |
$0.31
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Healthscope Commercial |
$0.40
|
| Rate for Payer: Healthscope Whirlpool |
$0.39
|
| Rate for Payer: Mclaren Commercial |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: Nomi Health Commercial |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.35
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Aetna Commercial |
$0.36
|
| Rate for Payer: Aetna Medicare |
$0.20
|
| Rate for Payer: ASR ASR |
$0.39
|
| Rate for Payer: ASR Commercial |
$0.39
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.33
|
| Rate for Payer: BCN Commercial |
$0.31
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Healthscope Commercial |
$0.40
|
| Rate for Payer: Healthscope Whirlpool |
$0.39
|
| Rate for Payer: Mclaren Commercial |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: Nomi Health Commercial |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.35
|
| Rate for Payer: Priority Health Narrow Network |
$0.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.35
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,027.65 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna Commercial |
$1,422.90
|
| Rate for Payer: ASR ASR |
$1,533.57
|
| Rate for Payer: ASR Commercial |
$1,533.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.36
|
| Rate for Payer: BCN Commercial |
$1,225.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,486.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Healthscope Commercial |
$1,581.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,533.57
|
| Rate for Payer: Mclaren Commercial |
$1,422.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,391.28
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.47 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna Commercial |
$1,422.90
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$1,533.57
|
| Rate for Payer: ASR Commercial |
$1,533.57
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.68
|
| Rate for Payer: BCN Commercial |
$1,225.75
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,486.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$1,581.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,533.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$1,422.90
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,385.27
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,108.28
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,391.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.47 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna Commercial |
$1,422.90
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$1,533.57
|
| Rate for Payer: ASR Commercial |
$1,533.57
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.68
|
| Rate for Payer: BCN Commercial |
$1,225.75
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,486.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$1,581.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,533.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$1,422.90
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.63
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$561.30
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,391.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,027.65 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna Commercial |
$1,422.90
|
| Rate for Payer: ASR ASR |
$1,533.57
|
| Rate for Payer: ASR Commercial |
$1,533.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.36
|
| Rate for Payer: BCN Commercial |
$1,225.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,486.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Healthscope Commercial |
$1,581.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,533.57
|
| Rate for Payer: Mclaren Commercial |
$1,422.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,391.28
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,080.69 |
| Max. Negotiated Rate |
$1,662.60 |
| Rate for Payer: Aetna Commercial |
$1,496.34
|
| Rate for Payer: ASR ASR |
$1,612.72
|
| Rate for Payer: ASR Commercial |
$1,612.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,354.85
|
| Rate for Payer: BCN Commercial |
$1,289.01
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,562.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| Rate for Payer: Healthscope Commercial |
$1,662.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.72
|
| Rate for Payer: Mclaren Commercial |
$1,496.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: Nomi Health Commercial |
$1,363.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,463.09
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.47 |
| Max. Negotiated Rate |
$1,662.60 |
| Rate for Payer: Aetna Commercial |
$1,496.34
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$1,612.72
|
| Rate for Payer: ASR Commercial |
$1,612.72
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,361.50
|
| Rate for Payer: BCN Commercial |
$1,289.01
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,562.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$1,662.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,612.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$1,496.34
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: Nomi Health Commercial |
$1,363.33
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.63
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$561.30
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,463.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.69 |
| Max. Negotiated Rate |
$1,069.35 |
| Rate for Payer: Aetna Commercial |
$962.42
|
| Rate for Payer: Aetna Medicare |
$605.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: ASR ASR |
$1,037.27
|
| Rate for Payer: ASR Commercial |
$1,037.27
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$875.69
|
| Rate for Payer: BCN Commercial |
$829.07
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$1,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$1,069.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$605.76
|
| Rate for Payer: Mclaren Commercial |
$962.42
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$666.34
|
| Rate for Payer: PHP Medicaid |
$324.69
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.96
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$749.61
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$941.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$938.93
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP DNSP |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: VA VA |
$605.76
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$695.08 |
| Max. Negotiated Rate |
$1,069.35 |
| Rate for Payer: Aetna Commercial |
$962.42
|
| Rate for Payer: ASR ASR |
$1,037.27
|
| Rate for Payer: ASR Commercial |
$1,037.27
|
| Rate for Payer: BCBS Trust/PPO |
$871.41
|
| Rate for Payer: BCN Commercial |
$829.07
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$1,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$1,069.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.27
|
| Rate for Payer: Mclaren Commercial |
$962.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$941.03
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,014.17 |
| Max. Negotiated Rate |
$4,637.18 |
| Rate for Payer: Aetna Commercial |
$4,173.46
|
| Rate for Payer: ASR ASR |
$4,498.06
|
| Rate for Payer: ASR Commercial |
$4,498.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,778.84
|
| Rate for Payer: BCN Commercial |
$3,595.21
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$4,358.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Healthscope Commercial |
$4,637.18
|
| Rate for Payer: Healthscope Whirlpool |
$4,498.06
|
| Rate for Payer: Mclaren Commercial |
$4,173.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: Nomi Health Commercial |
$3,802.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,080.72
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$840.47 |
| Max. Negotiated Rate |
$4,637.18 |
| Rate for Payer: Aetna Commercial |
$4,173.46
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$4,498.06
|
| Rate for Payer: ASR Commercial |
$4,498.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,797.39
|
| Rate for Payer: BCN Commercial |
$3,595.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$4,358.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$4,637.18
|
| Rate for Payer: Healthscope Whirlpool |
$4,498.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$4,173.46
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: Nomi Health Commercial |
$3,802.49
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,737.20
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,189.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,080.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,789.77 |
| Max. Negotiated Rate |
$4,291.95 |
| Rate for Payer: Aetna Commercial |
$3,862.76
|
| Rate for Payer: ASR ASR |
$4,163.19
|
| Rate for Payer: ASR Commercial |
$4,163.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,497.51
|
| Rate for Payer: BCN Commercial |
$3,327.55
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$4,034.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Healthscope Commercial |
$4,291.95
|
| Rate for Payer: Healthscope Whirlpool |
$4,163.19
|
| Rate for Payer: Mclaren Commercial |
$3,862.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,776.92
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.47 |
| Max. Negotiated Rate |
$4,291.95 |
| Rate for Payer: Aetna Commercial |
$3,862.76
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$4,163.19
|
| Rate for Payer: ASR Commercial |
$4,163.19
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,514.68
|
| Rate for Payer: BCN Commercial |
$3,327.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$4,034.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$4,291.95
|
| Rate for Payer: Healthscope Whirlpool |
$4,163.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$3,862.76
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,760.61
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,008.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,776.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$5,814.00 |
| Rate for Payer: Aetna Commercial |
$5,232.60
|
| 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 |
$5,639.58
|
| Rate for Payer: ASR Commercial |
$5,639.58
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,761.08
|
| Rate for Payer: BCN Commercial |
$4,507.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,465.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$5,814.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,639.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$5,232.60
|
| 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 |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| 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 |
$3,779.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,094.23
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$4,075.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,116.32
|
| 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 REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,779.10 |
| Max. Negotiated Rate |
$5,814.00 |
| Rate for Payer: Aetna Commercial |
$5,232.60
|
| Rate for Payer: ASR ASR |
$5,639.58
|
| Rate for Payer: ASR Commercial |
$5,639.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,737.83
|
| Rate for Payer: BCN Commercial |
$4,507.59
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,465.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Healthscope Commercial |
$5,814.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,639.58
|
| Rate for Payer: Mclaren Commercial |
$5,232.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,116.32
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,911.22 |
| Max. Negotiated Rate |
$5,526.85 |
| Rate for Payer: Aetna Commercial |
$4,396.96
|
| Rate for Payer: Aetna Medicare |
$3,565.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: ASR ASR |
$4,738.94
|
| Rate for Payer: ASR Commercial |
$4,738.94
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,000.74
|
| Rate for Payer: BCN Commercial |
$3,787.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,592.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$4,885.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,738.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,565.71
|
| Rate for Payer: Mclaren Commercial |
$4,396.96
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$3,922.28
|
| Rate for Payer: PHP Medicaid |
$1,911.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,280.68
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$3,424.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,299.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$5,526.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP DNSP |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: VA VA |
$3,565.71
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,175.58 |
| Max. Negotiated Rate |
$4,885.51 |
| Rate for Payer: Aetna Commercial |
$4,396.96
|
| Rate for Payer: ASR ASR |
$4,738.94
|
| Rate for Payer: ASR Commercial |
$4,738.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,981.20
|
| Rate for Payer: BCN Commercial |
$3,787.74
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,592.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Healthscope Commercial |
$4,885.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,738.94
|
| Rate for Payer: Mclaren Commercial |
$4,396.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,299.25
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$174.52
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$188.09
|
| Rate for Payer: ASR Commercial |
$188.09
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$158.79
|
| Rate for Payer: BCN Commercial |
$150.34
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| 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 |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$193.91
|
| Rate for Payer: Healthscope Whirlpool |
$188.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$174.52
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| 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 |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$135.93
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
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 REPAIR TENDON HAND/FINGER
|
Facility
|
IP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,739.72 |
| Max. Negotiated Rate |
$4,214.96 |
| Rate for Payer: Aetna Commercial |
$3,793.46
|
| Rate for Payer: ASR ASR |
$4,088.51
|
| Rate for Payer: ASR Commercial |
$4,088.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,434.77
|
| Rate for Payer: BCN Commercial |
$3,267.86
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,962.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$4,214.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,088.51
|
| Rate for Payer: Mclaren Commercial |
$3,793.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,709.16
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,685.98 |
| Max. Negotiated Rate |
$4,214.96 |
| Rate for Payer: Aetna Commercial |
$3,793.46
|
| Rate for Payer: Aetna Medicare |
$2,107.48
|
| Rate for Payer: ASR ASR |
$4,088.51
|
| Rate for Payer: ASR Commercial |
$4,088.51
|
| Rate for Payer: BCBS Complete |
$1,685.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,451.63
|
| Rate for Payer: BCN Commercial |
$3,267.86
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,962.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$4,214.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,088.51
|
| Rate for Payer: Mclaren Commercial |
$3,793.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,693.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,954.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,709.16
|
|
