|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.08 |
| Max. Negotiated Rate |
$78.59 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: ASR ASR |
$76.23
|
| Rate for Payer: ASR Commercial |
$76.23
|
| Rate for Payer: BCBS Trust/PPO |
$64.04
|
| Rate for Payer: BCN Commercial |
$60.93
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$73.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Healthscope Commercial |
$78.59
|
| Rate for Payer: Healthscope Whirlpool |
$76.23
|
| Rate for Payer: Mclaren Commercial |
$70.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.16
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$78.59 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: Aetna Medicare |
$23.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: ASR ASR |
$76.23
|
| Rate for Payer: ASR Commercial |
$76.23
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$64.36
|
| Rate for Payer: BCN Commercial |
$60.93
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$73.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$78.59
|
| Rate for Payer: Healthscope Whirlpool |
$76.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.88
|
| Rate for Payer: Mclaren Commercial |
$70.73
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$26.27
|
| Rate for Payer: PHP Medicaid |
$12.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.86
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health Narrow Network |
$55.09
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$37.01
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP DNSP |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: VA VA |
$23.88
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: BCBS Trust/PPO |
$84.52
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.43
|
| Rate for Payer: Priority Health Narrow Network |
$72.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Trust/PPO |
$84.11
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$2,572.19 |
| Rate for Payer: Aetna Commercial |
$2,314.97
|
| Rate for Payer: Aetna Medicare |
$517.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: ASR ASR |
$2,495.02
|
| Rate for Payer: ASR Commercial |
$2,495.02
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.37
|
| Rate for Payer: BCN Commercial |
$1,994.22
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,417.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,572.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,495.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$517.48
|
| Rate for Payer: Mclaren Commercial |
$2,314.97
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$569.23
|
| Rate for Payer: PHP Medicaid |
$277.37
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,253.75
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,803.11
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$802.09
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP DNSP |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,671.92 |
| Max. Negotiated Rate |
$2,572.19 |
| Rate for Payer: Aetna Commercial |
$2,314.97
|
| Rate for Payer: ASR ASR |
$2,495.02
|
| Rate for Payer: ASR Commercial |
$2,495.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.08
|
| Rate for Payer: BCN Commercial |
$1,994.22
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,417.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Healthscope Commercial |
$2,572.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,495.02
|
| Rate for Payer: Mclaren Commercial |
$2,314.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.53
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$3,560.39 |
| Rate for Payer: Aetna Commercial |
$3,204.35
|
| Rate for Payer: Aetna Medicare |
$992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: ASR ASR |
$3,453.58
|
| Rate for Payer: ASR Commercial |
$3,453.58
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,915.60
|
| Rate for Payer: BCN Commercial |
$2,760.37
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,346.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$3,560.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$992.24
|
| Rate for Payer: Mclaren Commercial |
$3,204.35
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$1,091.46
|
| Rate for Payer: PHP Medicaid |
$531.84
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,119.61
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,495.83
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,537.97
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP DNSP |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: VA VA |
$992.24
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,314.25 |
| Max. Negotiated Rate |
$3,560.39 |
| Rate for Payer: Aetna Commercial |
$3,204.35
|
| Rate for Payer: ASR ASR |
$3,453.58
|
| Rate for Payer: ASR Commercial |
$3,453.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,901.36
|
| Rate for Payer: BCN Commercial |
$2,760.37
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,346.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Healthscope Commercial |
$3,560.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.58
|
| Rate for Payer: Mclaren Commercial |
$3,204.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.14
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,558.54 |
| Max. Negotiated Rate |
$3,936.22 |
| Rate for Payer: Aetna Commercial |
$3,542.60
|
| Rate for Payer: ASR ASR |
$3,818.13
|
| Rate for Payer: ASR Commercial |
$3,818.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,207.63
|
| Rate for Payer: BCN Commercial |
$3,051.75
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,700.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Healthscope Commercial |
$3,936.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.13
|
| Rate for Payer: Mclaren Commercial |
$3,542.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,463.87
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$3,936.22 |
| Rate for Payer: Aetna Commercial |
$3,542.60
|
| Rate for Payer: Aetna Medicare |
$992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: ASR ASR |
$3,818.13
|
| Rate for Payer: ASR Commercial |
$3,818.13
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,223.37
|
| Rate for Payer: BCN Commercial |
$3,051.75
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,700.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$3,936.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$992.24
|
| Rate for Payer: Mclaren Commercial |
$3,542.60
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$1,091.46
|
| Rate for Payer: PHP Medicaid |
$531.84
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,448.92
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,759.29
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,463.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,537.97
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP DNSP |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: VA VA |
$992.24
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$293.95 |
| Max. Negotiated Rate |
$734.88 |
| Rate for Payer: Aetna Commercial |
$661.39
|
| Rate for Payer: Aetna Medicare |
$367.44
|
| Rate for Payer: ASR ASR |
$712.83
|
| Rate for Payer: ASR Commercial |
$712.83
|
| Rate for Payer: BCBS Complete |
$293.95
|
| Rate for Payer: BCBS Trust/PPO |
$601.79
|
| Rate for Payer: BCN Commercial |
$569.75
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$690.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$734.88
|
| Rate for Payer: Healthscope Whirlpool |
$712.83
|
| Rate for Payer: Mclaren Commercial |
$661.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.90
|
| Rate for Payer: Priority Health Narrow Network |
$515.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.69
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$477.67 |
| Max. Negotiated Rate |
$734.88 |
| Rate for Payer: Aetna Commercial |
$661.39
|
| Rate for Payer: ASR ASR |
$712.83
|
| Rate for Payer: ASR Commercial |
$712.83
|
| Rate for Payer: BCBS Trust/PPO |
$598.85
|
| Rate for Payer: BCN Commercial |
$569.75
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$690.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$734.88
|
| Rate for Payer: Healthscope Whirlpool |
$712.83
|
| Rate for Payer: Mclaren Commercial |
$661.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.69
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.38
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$1.52
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.70
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$1.45
|
| Rate for Payer: Mclaren Medicare |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$1.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$2.97
|
| Rate for Payer: PHP Medicaid |
$1.45
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$2.70
|
| Rate for Payer: UHCCP DNSP |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$1.45
|
| Rate for Payer: VA VA |
$2.70
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,986.82 |
| Max. Negotiated Rate |
$4,967.05 |
| Rate for Payer: Aetna Commercial |
$4,470.35
|
| Rate for Payer: Aetna Medicare |
$2,483.53
|
| Rate for Payer: ASR ASR |
$4,818.04
|
| Rate for Payer: ASR Commercial |
$4,818.04
|
| Rate for Payer: BCBS Complete |
$1,986.82
|
| Rate for Payer: BCBS Trust/PPO |
$4,067.52
|
| Rate for Payer: BCN Commercial |
$3,850.95
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,669.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,967.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,818.04
|
| Rate for Payer: Mclaren Commercial |
$4,470.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: Nomi Health Commercial |
$4,072.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,352.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,481.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,371.00
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,228.58 |
| Max. Negotiated Rate |
$4,967.05 |
| Rate for Payer: Aetna Commercial |
$4,470.35
|
| Rate for Payer: ASR ASR |
$4,818.04
|
| Rate for Payer: ASR Commercial |
$4,818.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,047.65
|
| Rate for Payer: BCN Commercial |
$3,850.95
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,669.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,967.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,818.04
|
| Rate for Payer: Mclaren Commercial |
$4,470.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: Nomi Health Commercial |
$4,072.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,371.00
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,735.09 |
| Max. Negotiated Rate |
$5,746.30 |
| Rate for Payer: Aetna Commercial |
$5,171.67
|
| Rate for Payer: ASR ASR |
$5,573.91
|
| Rate for Payer: ASR Commercial |
$5,573.91
|
| Rate for Payer: BCBS Trust/PPO |
$4,682.66
|
| Rate for Payer: BCN Commercial |
$4,455.11
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$5,401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Healthscope Commercial |
$5,746.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,573.91
|
| Rate for Payer: Mclaren Commercial |
$5,171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: Nomi Health Commercial |
$4,711.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,056.74
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,298.52 |
| Max. Negotiated Rate |
$5,746.30 |
| Rate for Payer: Aetna Commercial |
$5,171.67
|
| Rate for Payer: Aetna Medicare |
$2,873.15
|
| Rate for Payer: ASR ASR |
$5,573.91
|
| Rate for Payer: ASR Commercial |
$5,573.91
|
| Rate for Payer: BCBS Complete |
$2,298.52
|
| Rate for Payer: BCBS Trust/PPO |
$4,705.65
|
| Rate for Payer: BCN Commercial |
$4,455.11
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$5,401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Healthscope Commercial |
$5,746.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,573.91
|
| Rate for Payer: Mclaren Commercial |
$5,171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: Nomi Health Commercial |
$4,711.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,034.91
|
| Rate for Payer: Priority Health Narrow Network |
$4,028.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,056.74
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,205.60 |
| Max. Negotiated Rate |
$9,547.08 |
| Rate for Payer: Aetna Commercial |
$8,592.37
|
| Rate for Payer: ASR ASR |
$9,260.67
|
| Rate for Payer: ASR Commercial |
$9,260.67
|
| Rate for Payer: BCBS Trust/PPO |
$7,779.92
|
| Rate for Payer: BCN Commercial |
$7,401.85
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,974.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Healthscope Commercial |
$9,547.08
|
| Rate for Payer: Healthscope Whirlpool |
$9,260.67
|
| Rate for Payer: Mclaren Commercial |
$8,592.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$7,828.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,401.43
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$9,547.08 |
| Rate for Payer: Aetna Commercial |
$8,592.37
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$9,260.67
|
| Rate for Payer: ASR Commercial |
$9,260.67
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$7,818.10
|
| Rate for Payer: BCN Commercial |
$7,401.85
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,974.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$9,547.08
|
| Rate for Payer: Healthscope Whirlpool |
$9,260.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$8,592.37
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$7,828.61
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,365.15
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$6,692.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,401.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$10,966.23 |
| Rate for Payer: Aetna Commercial |
$9,869.61
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$10,637.24
|
| Rate for Payer: ASR Commercial |
$10,637.24
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$8,980.25
|
| Rate for Payer: BCN Commercial |
$8,502.12
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$10,308.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$10,966.23
|
| Rate for Payer: Healthscope Whirlpool |
$10,637.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$9,869.61
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: Nomi Health Commercial |
$8,992.31
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,608.61
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$7,687.33
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,650.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,128.05 |
| Max. Negotiated Rate |
$10,966.23 |
| Rate for Payer: Aetna Commercial |
$9,869.61
|
| Rate for Payer: ASR ASR |
$10,637.24
|
| Rate for Payer: ASR Commercial |
$10,637.24
|
| Rate for Payer: BCBS Trust/PPO |
$8,936.38
|
| Rate for Payer: BCN Commercial |
$8,502.12
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$10,308.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Healthscope Commercial |
$10,966.23
|
| Rate for Payer: Healthscope Whirlpool |
$10,637.24
|
| Rate for Payer: Mclaren Commercial |
$9,869.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: Nomi Health Commercial |
$8,992.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,650.28
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$12,901.46 |
| Rate for Payer: Aetna Commercial |
$11,611.31
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$12,514.42
|
| Rate for Payer: ASR Commercial |
$12,514.42
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$10,565.01
|
| Rate for Payer: BCN Commercial |
$10,002.50
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$12,127.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$12,901.46
|
| Rate for Payer: Healthscope Whirlpool |
$12,514.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$11,611.31
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,304.26
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$9,043.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,353.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,385.95 |
| Max. Negotiated Rate |
$12,901.46 |
| Rate for Payer: Aetna Commercial |
$11,611.31
|
| Rate for Payer: ASR ASR |
$12,514.42
|
| Rate for Payer: ASR Commercial |
$12,514.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,513.40
|
| Rate for Payer: BCN Commercial |
$10,002.50
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$12,127.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Healthscope Commercial |
$12,901.46
|
| Rate for Payer: Healthscope Whirlpool |
$12,514.42
|
| Rate for Payer: Mclaren Commercial |
$11,611.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,353.28
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,385.95 |
| Max. Negotiated Rate |
$12,901.46 |
| Rate for Payer: Aetna Commercial |
$11,611.31
|
| Rate for Payer: ASR ASR |
$12,514.42
|
| Rate for Payer: ASR Commercial |
$12,514.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,513.40
|
| Rate for Payer: BCN Commercial |
$10,002.50
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$12,127.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Healthscope Commercial |
$12,901.46
|
| Rate for Payer: Healthscope Whirlpool |
$12,514.42
|
| Rate for Payer: Mclaren Commercial |
$11,611.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,353.28
|
|
