|
HC REVAS DES/CABG ADD.
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,416.24 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Trust/PPO |
$15,566.14
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,640.76 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: Aetna Medicare |
$9,550.95
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS Trust/PPO |
$15,642.55
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,737.08
|
| Rate for Payer: Priority Health Narrow Network |
$13,390.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$29,158.60 |
| Rate for Payer: Aetna Commercial |
$26,242.74
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$28,283.84
|
| Rate for Payer: ASR Commercial |
$28,283.84
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$23,877.98
|
| Rate for Payer: BCN Commercial |
$22,606.66
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$27,409.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$29,158.60
|
| Rate for Payer: Healthscope Whirlpool |
$28,283.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$26,242.74
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,548.77
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$20,440.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,659.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,953.09 |
| Max. Negotiated Rate |
$29,158.60 |
| Rate for Payer: Aetna Commercial |
$26,242.74
|
| Rate for Payer: ASR ASR |
$28,283.84
|
| Rate for Payer: ASR Commercial |
$28,283.84
|
| Rate for Payer: BCBS Trust/PPO |
$23,761.34
|
| Rate for Payer: BCN Commercial |
$22,606.66
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$27,409.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$29,158.60
|
| Rate for Payer: Healthscope Whirlpool |
$28,283.84
|
| Rate for Payer: Mclaren Commercial |
$26,242.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,659.57
|
|
|
HC REVAS MI/DES
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Trust/PPO |
$24,180.81
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,869.34 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: Aetna Medicare |
$14,836.67
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS Trust/PPO |
$24,299.51
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,999.79
|
| Rate for Payer: Priority Health Narrow Network |
$20,801.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Trust/PPO |
$24,180.81
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,869.34 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: Aetna Medicare |
$14,836.67
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS Trust/PPO |
$24,299.51
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,999.79
|
| Rate for Payer: Priority Health Narrow Network |
$20,801.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,430.76 |
| Max. Negotiated Rate |
$16,024.24 |
| Rate for Payer: Aetna Commercial |
$14,421.82
|
| Rate for Payer: Aetna Medicare |
$6,400.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,000.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,000.84
|
| Rate for Payer: ASR ASR |
$15,543.51
|
| Rate for Payer: ASR Commercial |
$15,543.51
|
| Rate for Payer: BCBS Complete |
$3,602.30
|
| Rate for Payer: BCBS MAPPO |
$6,400.67
|
| Rate for Payer: BCBS Trust/PPO |
$13,122.25
|
| Rate for Payer: BCN Commercial |
$12,423.59
|
| Rate for Payer: BCN Medicare Advantage |
$6,400.67
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$15,062.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,400.67
|
| Rate for Payer: Healthscope Commercial |
$16,024.24
|
| Rate for Payer: Healthscope Whirlpool |
$15,543.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,400.67
|
| Rate for Payer: Mclaren Commercial |
$14,421.82
|
| Rate for Payer: Mclaren Medicaid |
$3,430.76
|
| Rate for Payer: Mclaren Medicare |
$6,400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,720.70
|
| Rate for Payer: Meridian Medicaid |
$3,602.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: Nomi Health Commercial |
$13,139.88
|
| Rate for Payer: PACE Medicare |
$6,080.64
|
| Rate for Payer: PACE SWMI |
$6,400.67
|
| Rate for Payer: PHP Commercial |
$7,040.74
|
| Rate for Payer: PHP Medicaid |
$3,430.76
|
| Rate for Payer: PHP Medicare Advantage |
$6,400.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,430.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,040.44
|
| Rate for Payer: Priority Health Medicare |
$6,400.67
|
| Rate for Payer: Priority Health Narrow Network |
$11,232.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6,400.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,101.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,400.67
|
| Rate for Payer: UHC Exchange |
$9,921.04
|
| Rate for Payer: UHC Medicare Advantage |
$6,400.67
|
| Rate for Payer: UHCCP DNSP |
$6,400.67
|
| Rate for Payer: UHCCP Medicaid |
$3,430.76
|
| Rate for Payer: VA VA |
$6,400.67
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,415.76 |
| Max. Negotiated Rate |
$16,024.24 |
| Rate for Payer: Aetna Commercial |
$14,421.82
|
| Rate for Payer: ASR ASR |
$15,543.51
|
| Rate for Payer: ASR Commercial |
$15,543.51
|
| Rate for Payer: BCBS Trust/PPO |
$13,058.15
|
| Rate for Payer: BCN Commercial |
$12,423.59
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$15,062.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Healthscope Commercial |
$16,024.24
|
| Rate for Payer: Healthscope Whirlpool |
$15,543.51
|
| Rate for Payer: Mclaren Commercial |
$14,421.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: Nomi Health Commercial |
$13,139.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,101.33
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,244.40 |
| Max. Negotiated Rate |
$3,111.00 |
| Rate for Payer: Aetna Commercial |
$2,799.90
|
| Rate for Payer: Aetna Medicare |
$1,555.50
|
| Rate for Payer: ASR ASR |
$3,017.67
|
| Rate for Payer: ASR Commercial |
$3,017.67
|
| Rate for Payer: BCBS Complete |
$1,244.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,547.60
|
| Rate for Payer: BCN Commercial |
$2,411.96
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,924.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Healthscope Commercial |
$3,111.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,017.67
|
| Rate for Payer: Mclaren Commercial |
$2,799.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: Nomi Health Commercial |
$2,551.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,725.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,180.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,737.68
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,022.15 |
| Max. Negotiated Rate |
$3,111.00 |
| Rate for Payer: Aetna Commercial |
$2,799.90
|
| Rate for Payer: ASR ASR |
$3,017.67
|
| Rate for Payer: ASR Commercial |
$3,017.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,535.15
|
| Rate for Payer: BCN Commercial |
$2,411.96
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,924.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Healthscope Commercial |
$3,111.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,017.67
|
| Rate for Payer: Mclaren Commercial |
$2,799.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: Nomi Health Commercial |
$2,551.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,737.68
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,912.35 |
| Max. Negotiated Rate |
$7,557.46 |
| Rate for Payer: Aetna Commercial |
$6,801.71
|
| Rate for Payer: ASR ASR |
$7,330.74
|
| Rate for Payer: ASR Commercial |
$7,330.74
|
| Rate for Payer: BCBS Trust/PPO |
$6,158.57
|
| Rate for Payer: BCN Commercial |
$5,859.30
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$7,104.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Healthscope Commercial |
$7,557.46
|
| Rate for Payer: Healthscope Whirlpool |
$7,330.74
|
| Rate for Payer: Mclaren Commercial |
$6,801.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: Nomi Health Commercial |
$6,197.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,650.56
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$6,801.71
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$7,330.74
|
| Rate for Payer: ASR Commercial |
$7,330.74
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$6,188.80
|
| Rate for Payer: BCN Commercial |
$5,859.30
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$7,104.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$7,557.46
|
| Rate for Payer: Healthscope Whirlpool |
$7,330.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$6,801.71
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: Nomi Health Commercial |
$6,197.12
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,621.85
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$5,297.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,650.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$5,297.28
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$5,709.29
|
| Rate for Payer: ASR Commercial |
$5,709.29
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,819.94
|
| Rate for Payer: BCN Commercial |
$4,563.32
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$5,532.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$5,885.87
|
| Rate for Payer: Healthscope Whirlpool |
$5,709.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$5,297.28
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: Nomi Health Commercial |
$4,826.41
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,157.20
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,125.99
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,179.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,825.82 |
| Max. Negotiated Rate |
$5,885.87 |
| Rate for Payer: Aetna Commercial |
$5,297.28
|
| Rate for Payer: ASR ASR |
$5,709.29
|
| Rate for Payer: ASR Commercial |
$5,709.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,796.40
|
| Rate for Payer: BCN Commercial |
$4,563.32
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$5,532.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Healthscope Commercial |
$5,885.87
|
| Rate for Payer: Healthscope Whirlpool |
$5,709.29
|
| Rate for Payer: Mclaren Commercial |
$5,297.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: Nomi Health Commercial |
$4,826.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,179.57
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$2,683.22 |
| Rate for Payer: Aetna Commercial |
$2,414.90
|
| Rate for Payer: ASR ASR |
$2,602.72
|
| Rate for Payer: ASR Commercial |
$2,602.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.56
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,683.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.72
|
| Rate for Payer: Mclaren Commercial |
$2,414.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.23
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$2,951.97 |
| Rate for Payer: Aetna Commercial |
$2,414.90
|
| Rate for Payer: Aetna Medicare |
$1,904.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: ASR ASR |
$2,602.72
|
| Rate for Payer: ASR Commercial |
$2,602.72
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.29
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,683.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,904.50
|
| Rate for Payer: Mclaren Commercial |
$2,414.90
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,094.95
|
| Rate for Payer: PHP Medicaid |
$1,020.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.04
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$2,951.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP DNSP |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,162.54 |
| Max. Negotiated Rate |
$1,788.52 |
| Rate for Payer: Aetna Commercial |
$1,609.67
|
| Rate for Payer: ASR ASR |
$1,734.86
|
| Rate for Payer: ASR Commercial |
$1,734.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.46
|
| Rate for Payer: BCN Commercial |
$1,386.64
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,681.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Healthscope Commercial |
$1,788.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,734.86
|
| Rate for Payer: Mclaren Commercial |
$1,609.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,573.90
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$715.41 |
| Max. Negotiated Rate |
$1,788.52 |
| Rate for Payer: Aetna Commercial |
$1,609.67
|
| Rate for Payer: Aetna Medicare |
$894.26
|
| Rate for Payer: ASR ASR |
$1,734.86
|
| Rate for Payer: ASR Commercial |
$1,734.86
|
| Rate for Payer: BCBS Complete |
$715.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.62
|
| Rate for Payer: BCN Commercial |
$1,386.64
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,681.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Healthscope Commercial |
$1,788.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,734.86
|
| Rate for Payer: Mclaren Commercial |
$1,609.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,567.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,253.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,573.90
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$5.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$3.19
|
| Rate for Payer: BCBS MAPPO |
$5.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.67
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.67
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.04
|
| Rate for Payer: Mclaren Medicare |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Medicaid |
$3.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$5.39
|
| Rate for Payer: PACE SWMI |
$5.67
|
| Rate for Payer: PHP Commercial |
$6.24
|
| Rate for Payer: PHP Medicaid |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.67
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.67
|
| Rate for Payer: UHCCP DNSP |
$5.67
|
| Rate for Payer: UHCCP Medicaid |
$3.04
|
| Rate for Payer: VA VA |
$5.67
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$184.59 |
| Max. Negotiated Rate |
$283.98 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: ASR ASR |
$275.46
|
| Rate for Payer: ASR Commercial |
$275.46
|
| Rate for Payer: BCBS Trust/PPO |
$231.42
|
| Rate for Payer: BCN Commercial |
$220.17
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$266.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$283.98
|
| Rate for Payer: Healthscope Whirlpool |
$275.46
|
| Rate for Payer: Mclaren Commercial |
$255.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: Nomi Health Commercial |
$232.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.90
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$113.59 |
| Max. Negotiated Rate |
$283.98 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna Medicare |
$141.99
|
| Rate for Payer: ASR ASR |
$275.46
|
| Rate for Payer: ASR Commercial |
$275.46
|
| Rate for Payer: BCBS Complete |
$113.59
|
| Rate for Payer: BCBS Trust/PPO |
$232.55
|
| Rate for Payer: BCN Commercial |
$220.17
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$266.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$283.98
|
| Rate for Payer: Healthscope Whirlpool |
$275.46
|
| Rate for Payer: Mclaren Commercial |
$255.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: Nomi Health Commercial |
$232.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.82
|
| Rate for Payer: Priority Health Narrow Network |
$199.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.90
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.82
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$24.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
