|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$162.90
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$122.17 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna Commercial |
$146.61
|
| Rate for Payer: ASR ASR |
$158.01
|
| Rate for Payer: BCBS Trust/PPO |
$133.77
|
| Rate for Payer: BCN Commercial |
$133.77
|
| Rate for Payer: Cash Price |
$130.32
|
| Rate for Payer: Cofinity Commercial |
$153.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.32
|
| Rate for Payer: Healthscope Commercial |
$158.01
|
| Rate for Payer: Healthscope Whirlpool |
$162.90
|
| Rate for Payer: Mclaren Commercial |
$146.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.47
|
| Rate for Payer: Nomi Health Commercial |
$133.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.35
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$162.90
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$60.27 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna Commercial |
$146.61
|
| Rate for Payer: Aetna Medicare |
$60.27
|
| Rate for Payer: ASR ASR |
$158.01
|
| Rate for Payer: BCBS Complete |
$65.16
|
| Rate for Payer: BCBS Trust/PPO |
$134.31
|
| Rate for Payer: BCN Commercial |
$134.31
|
| Rate for Payer: Cash Price |
$130.32
|
| Rate for Payer: Cofinity Commercial |
$153.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.32
|
| Rate for Payer: Healthscope Commercial |
$158.01
|
| Rate for Payer: Healthscope Whirlpool |
$162.90
|
| Rate for Payer: Mclaren Commercial |
$146.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.47
|
| Rate for Payer: Nomi Health Commercial |
$133.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$142.73
|
| Rate for Payer: Priority Health Narrow Network |
$114.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.35
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$445.46
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$334.10 |
| Max. Negotiated Rate |
$445.46 |
| Rate for Payer: Aetna Commercial |
$400.91
|
| Rate for Payer: ASR ASR |
$432.10
|
| Rate for Payer: BCBS Trust/PPO |
$365.81
|
| Rate for Payer: BCN Commercial |
$365.81
|
| Rate for Payer: Cash Price |
$356.37
|
| Rate for Payer: Cofinity Commercial |
$418.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.37
|
| Rate for Payer: Healthscope Commercial |
$432.10
|
| Rate for Payer: Healthscope Whirlpool |
$445.46
|
| Rate for Payer: Mclaren Commercial |
$400.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.64
|
| Rate for Payer: Nomi Health Commercial |
$365.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.00
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$445.46
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$164.82 |
| Max. Negotiated Rate |
$445.46 |
| Rate for Payer: Aetna Commercial |
$400.91
|
| Rate for Payer: Aetna Medicare |
$164.82
|
| Rate for Payer: ASR ASR |
$432.10
|
| Rate for Payer: BCBS Complete |
$178.18
|
| Rate for Payer: BCBS Trust/PPO |
$367.28
|
| Rate for Payer: BCN Commercial |
$367.28
|
| Rate for Payer: Cash Price |
$356.37
|
| Rate for Payer: Cofinity Commercial |
$418.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.37
|
| Rate for Payer: Healthscope Commercial |
$432.10
|
| Rate for Payer: Healthscope Whirlpool |
$445.46
|
| Rate for Payer: Mclaren Commercial |
$400.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.64
|
| Rate for Payer: Nomi Health Commercial |
$365.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$390.31
|
| Rate for Payer: Priority Health Narrow Network |
$312.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.00
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,401.38
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,328.51 |
| Max. Negotiated Rate |
$14,401.38 |
| Rate for Payer: Aetna Commercial |
$12,961.24
|
| Rate for Payer: Aetna Medicare |
$5,328.51
|
| Rate for Payer: ASR ASR |
$13,969.34
|
| Rate for Payer: BCBS Complete |
$5,760.55
|
| Rate for Payer: BCBS Trust/PPO |
$11,873.94
|
| Rate for Payer: BCN Commercial |
$11,873.94
|
| Rate for Payer: Cash Price |
$11,521.10
|
| Rate for Payer: Cofinity Commercial |
$13,537.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,521.10
|
| Rate for Payer: Healthscope Commercial |
$13,969.34
|
| Rate for Payer: Healthscope Whirlpool |
$14,401.38
|
| Rate for Payer: Mclaren Commercial |
$12,961.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,521.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,241.17
|
| Rate for Payer: Nomi Health Commercial |
$11,809.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,801.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,618.49
|
| Rate for Payer: Priority Health Narrow Network |
$10,095.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,673.21
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,401.38
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,801.03 |
| Max. Negotiated Rate |
$14,401.38 |
| Rate for Payer: Aetna Commercial |
$12,961.24
|
| Rate for Payer: ASR ASR |
$13,969.34
|
| Rate for Payer: BCBS Trust/PPO |
$11,826.41
|
| Rate for Payer: BCN Commercial |
$11,826.41
|
| Rate for Payer: Cash Price |
$11,521.10
|
| Rate for Payer: Cofinity Commercial |
$13,537.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,521.10
|
| Rate for Payer: Healthscope Commercial |
$13,969.34
|
| Rate for Payer: Healthscope Whirlpool |
$14,401.38
|
| Rate for Payer: Mclaren Commercial |
$12,961.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,241.17
|
| Rate for Payer: Nomi Health Commercial |
$11,809.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,801.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,673.21
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$153.55
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$115.16 |
| Max. Negotiated Rate |
$153.55 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: ASR ASR |
$148.94
|
| Rate for Payer: BCBS Trust/PPO |
$126.10
|
| Rate for Payer: BCN Commercial |
$126.10
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$144.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Healthscope Commercial |
$148.94
|
| Rate for Payer: Healthscope Whirlpool |
$153.55
|
| Rate for Payer: Mclaren Commercial |
$138.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.12
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$153.55
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$153.55 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$148.94
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$126.60
|
| Rate for Payer: BCN Commercial |
$126.60
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$144.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$148.94
|
| Rate for Payer: Healthscope Whirlpool |
$153.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$138.19
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$134.54
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$107.64
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$368.55
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$276.41 |
| Max. Negotiated Rate |
$368.55 |
| Rate for Payer: Aetna Commercial |
$331.69
|
| Rate for Payer: ASR ASR |
$357.49
|
| Rate for Payer: BCBS Trust/PPO |
$302.65
|
| Rate for Payer: BCN Commercial |
$302.65
|
| Rate for Payer: Cash Price |
$294.84
|
| Rate for Payer: Cofinity Commercial |
$346.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.84
|
| Rate for Payer: Healthscope Commercial |
$357.49
|
| Rate for Payer: Healthscope Whirlpool |
$368.55
|
| Rate for Payer: Mclaren Commercial |
$331.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.27
|
| Rate for Payer: Nomi Health Commercial |
$302.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.32
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$368.55
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$368.55 |
| Rate for Payer: Aetna Commercial |
$331.69
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$357.49
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$303.87
|
| Rate for Payer: BCN Commercial |
$303.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$294.84
|
| Rate for Payer: Cash Price |
$294.84
|
| Rate for Payer: Cofinity Commercial |
$346.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$357.49
|
| Rate for Payer: Healthscope Whirlpool |
$368.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$331.69
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.27
|
| Rate for Payer: Nomi Health Commercial |
$302.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.41
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$322.92
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$258.35
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$491.40
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$368.55 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$442.26
|
| Rate for Payer: ASR ASR |
$476.66
|
| Rate for Payer: BCBS Trust/PPO |
$403.54
|
| Rate for Payer: BCN Commercial |
$403.54
|
| Rate for Payer: Cash Price |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.12
|
| Rate for Payer: Healthscope Commercial |
$476.66
|
| Rate for Payer: Healthscope Whirlpool |
$491.40
|
| Rate for Payer: Mclaren Commercial |
$442.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.69
|
| Rate for Payer: Nomi Health Commercial |
$402.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$432.43
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$491.40
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$442.26
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$476.66
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$405.16
|
| Rate for Payer: BCN Commercial |
$405.16
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$393.12
|
| Rate for Payer: Cash Price |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$476.66
|
| Rate for Payer: Healthscope Whirlpool |
$491.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$442.26
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.69
|
| Rate for Payer: Nomi Health Commercial |
$402.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.55
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$430.56
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$344.47
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$432.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
IP
|
$614.24
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$460.68 |
| Max. Negotiated Rate |
$614.24 |
| Rate for Payer: Aetna Commercial |
$552.82
|
| Rate for Payer: ASR ASR |
$595.81
|
| Rate for Payer: BCBS Trust/PPO |
$504.41
|
| Rate for Payer: BCN Commercial |
$504.41
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Healthscope Commercial |
$595.81
|
| Rate for Payer: Healthscope Whirlpool |
$614.24
|
| Rate for Payer: Mclaren Commercial |
$552.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.53
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$614.24
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$614.24 |
| Rate for Payer: Aetna Commercial |
$552.82
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$595.81
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$506.44
|
| Rate for Payer: BCN Commercial |
$506.44
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$595.81
|
| Rate for Payer: Healthscope Whirlpool |
$614.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$552.82
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$538.20
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$430.58
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,288.04 |
| Rate for Payer: Aetna Commercial |
$2,059.24
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$2,219.40
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,886.49
|
| Rate for Payer: BCN Commercial |
$1,886.49
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$2,150.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,219.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,288.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,059.24
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,004.08
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.27
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,013.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,716.03 |
| Max. Negotiated Rate |
$2,288.04 |
| Rate for Payer: Aetna Commercial |
$2,059.24
|
| Rate for Payer: ASR ASR |
$2,219.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,878.94
|
| Rate for Payer: BCN Commercial |
$1,878.94
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$2,150.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,219.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,288.04
|
| Rate for Payer: Mclaren Commercial |
$2,059.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,013.48
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
OP
|
$326.75
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$294.07
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$316.95
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$269.41
|
| Rate for Payer: BCN Commercial |
$269.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$261.40
|
| Rate for Payer: Cash Price |
$261.40
|
| Rate for Payer: Cofinity Commercial |
$307.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$316.95
|
| Rate for Payer: Healthscope Whirlpool |
$326.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$294.07
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.74
|
| Rate for Payer: Nomi Health Commercial |
$267.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.06
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
IP
|
$326.75
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$245.06 |
| Max. Negotiated Rate |
$326.75 |
| Rate for Payer: Aetna Commercial |
$294.07
|
| Rate for Payer: ASR ASR |
$316.95
|
| Rate for Payer: BCBS Trust/PPO |
$268.33
|
| Rate for Payer: BCN Commercial |
$268.33
|
| Rate for Payer: Cash Price |
$261.40
|
| Rate for Payer: Cofinity Commercial |
$307.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.40
|
| Rate for Payer: Healthscope Commercial |
$316.95
|
| Rate for Payer: Healthscope Whirlpool |
$326.75
|
| Rate for Payer: Mclaren Commercial |
$294.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.74
|
| Rate for Payer: Nomi Health Commercial |
$267.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.54
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
OP
|
$7,435.90
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$6,692.31
|
| Rate for Payer: Aetna Medicare |
$5,544.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: ASR ASR |
$7,212.82
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$6,130.90
|
| Rate for Payer: BCN Commercial |
$6,130.90
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$5,948.72
|
| Rate for Payer: Cash Price |
$5,948.72
|
| Rate for Payer: Cofinity Commercial |
$6,989.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$7,212.82
|
| Rate for Payer: Healthscope Whirlpool |
$7,435.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$6,692.31
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$3,045.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.52
|
| Rate for Payer: Nomi Health Commercial |
$6,097.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,576.93
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$6,098.93
|
| Rate for Payer: PHP Medicaid |
$2,971.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,515.34
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$5,212.57
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,543.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$8,593.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP DNSP |
$5,544.48
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
IP
|
$7,435.90
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,576.93 |
| Max. Negotiated Rate |
$7,435.90 |
| Rate for Payer: Aetna Commercial |
$6,692.31
|
| Rate for Payer: ASR ASR |
$7,212.82
|
| Rate for Payer: BCBS Trust/PPO |
$6,106.36
|
| Rate for Payer: BCN Commercial |
$6,106.36
|
| Rate for Payer: Cash Price |
$5,948.72
|
| Rate for Payer: Cofinity Commercial |
$6,989.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.72
|
| Rate for Payer: Healthscope Commercial |
$7,212.82
|
| Rate for Payer: Healthscope Whirlpool |
$7,435.90
|
| Rate for Payer: Mclaren Commercial |
$6,692.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.52
|
| Rate for Payer: Nomi Health Commercial |
$6,097.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,576.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,543.59
|
|
|
HC SPIROMETRY
|
Facility
|
OP
|
$327.51
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$294.76
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$317.68
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$270.03
|
| Rate for Payer: BCN Commercial |
$270.03
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$262.01
|
| Rate for Payer: Cash Price |
$262.01
|
| Rate for Payer: Cofinity Commercial |
$307.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$317.68
|
| Rate for Payer: Healthscope Whirlpool |
$327.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$294.76
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.38
|
| Rate for Payer: Nomi Health Commercial |
$268.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.63
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$167.06
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$133.64
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC SPIROMETRY
|
Facility
|
IP
|
$327.51
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$327.51 |
| Rate for Payer: Aetna Commercial |
$294.76
|
| Rate for Payer: ASR ASR |
$317.68
|
| Rate for Payer: BCBS Trust/PPO |
$268.95
|
| Rate for Payer: BCN Commercial |
$268.95
|
| Rate for Payer: Cash Price |
$262.01
|
| Rate for Payer: Cofinity Commercial |
$307.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.01
|
| Rate for Payer: Healthscope Commercial |
$317.68
|
| Rate for Payer: Healthscope Whirlpool |
$327.51
|
| Rate for Payer: Mclaren Commercial |
$294.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.38
|
| Rate for Payer: Nomi Health Commercial |
$268.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.21
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
IP
|
$577.64
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$433.23 |
| Max. Negotiated Rate |
$577.64 |
| Rate for Payer: Aetna Commercial |
$519.88
|
| Rate for Payer: ASR ASR |
$560.31
|
| Rate for Payer: BCBS Trust/PPO |
$474.36
|
| Rate for Payer: BCN Commercial |
$474.36
|
| Rate for Payer: Cash Price |
$462.11
|
| Rate for Payer: Cofinity Commercial |
$542.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$462.11
|
| Rate for Payer: Healthscope Commercial |
$560.31
|
| Rate for Payer: Healthscope Whirlpool |
$577.64
|
| Rate for Payer: Mclaren Commercial |
$519.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.99
|
| Rate for Payer: Nomi Health Commercial |
$473.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$508.32
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
OP
|
$577.64
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$577.64 |
| Rate for Payer: Aetna Commercial |
$519.88
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$560.31
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$476.26
|
| Rate for Payer: BCN Commercial |
$476.26
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$462.11
|
| Rate for Payer: Cash Price |
$462.11
|
| Rate for Payer: Cofinity Commercial |
$542.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$462.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$560.31
|
| Rate for Payer: Healthscope Whirlpool |
$577.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$519.88
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.99
|
| Rate for Payer: Nomi Health Commercial |
$473.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.23
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$452.75
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$362.20
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$508.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
OP
|
$4,284.95
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,856.45
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,156.40
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,532.94
|
| Rate for Payer: BCN Commercial |
$3,532.94
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,427.96
|
| Rate for Payer: Cash Price |
$3,427.96
|
| Rate for Payer: Cofinity Commercial |
$4,027.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,427.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,156.40
|
| Rate for Payer: Healthscope Whirlpool |
$4,284.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,856.45
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,642.21
|
| Rate for Payer: Nomi Health Commercial |
$3,513.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,213.71
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,754.47
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,003.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,770.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
