|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
OP
|
$7,178.76
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,871.50 |
| Max. Negotiated Rate |
$7,178.76 |
| Rate for Payer: Aetna Commercial |
$6,460.88
|
| Rate for Payer: Aetna Medicare |
$3,589.38
|
| Rate for Payer: ASR ASR |
$6,963.40
|
| Rate for Payer: ASR Commercial |
$6,963.40
|
| Rate for Payer: BCBS Complete |
$2,871.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,878.69
|
| Rate for Payer: BCN Commercial |
$5,565.69
|
| Rate for Payer: Cash Price |
$5,743.01
|
| Rate for Payer: Cofinity Commercial |
$6,748.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.01
|
| Rate for Payer: Healthscope Commercial |
$7,178.76
|
| Rate for Payer: Healthscope Whirlpool |
$6,963.40
|
| Rate for Payer: Mclaren Commercial |
$6,460.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,101.95
|
| Rate for Payer: Nomi Health Commercial |
$5,886.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,290.03
|
| Rate for Payer: Priority Health Narrow Network |
$5,032.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,317.31
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
IP
|
$7,178.76
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,666.19 |
| Max. Negotiated Rate |
$7,178.76 |
| Rate for Payer: Aetna Commercial |
$6,460.88
|
| Rate for Payer: ASR ASR |
$6,963.40
|
| Rate for Payer: ASR Commercial |
$6,963.40
|
| Rate for Payer: BCBS Trust/PPO |
$5,849.97
|
| Rate for Payer: BCN Commercial |
$5,565.69
|
| Rate for Payer: Cash Price |
$5,743.01
|
| Rate for Payer: Cofinity Commercial |
$6,748.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.01
|
| Rate for Payer: Healthscope Commercial |
$7,178.76
|
| Rate for Payer: Healthscope Whirlpool |
$6,963.40
|
| Rate for Payer: Mclaren Commercial |
$6,460.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,101.95
|
| Rate for Payer: Nomi Health Commercial |
$5,886.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,317.31
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,164.72
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,265.89 |
| Max. Negotiated Rate |
$8,164.72 |
| Rate for Payer: Aetna Commercial |
$7,348.25
|
| Rate for Payer: Aetna Medicare |
$4,082.36
|
| Rate for Payer: ASR ASR |
$7,919.78
|
| Rate for Payer: ASR Commercial |
$7,919.78
|
| Rate for Payer: BCBS Complete |
$3,265.89
|
| Rate for Payer: BCBS Trust/PPO |
$6,686.09
|
| Rate for Payer: BCN Commercial |
$6,330.11
|
| Rate for Payer: Cash Price |
$6,531.78
|
| Rate for Payer: Cofinity Commercial |
$7,674.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,531.78
|
| Rate for Payer: Healthscope Commercial |
$8,164.72
|
| Rate for Payer: Healthscope Whirlpool |
$7,919.78
|
| Rate for Payer: Mclaren Commercial |
$7,348.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,940.01
|
| Rate for Payer: Nomi Health Commercial |
$6,695.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,307.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,153.93
|
| Rate for Payer: Priority Health Narrow Network |
$5,723.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,184.95
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,164.72
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,307.07 |
| Max. Negotiated Rate |
$8,164.72 |
| Rate for Payer: Aetna Commercial |
$7,348.25
|
| Rate for Payer: ASR ASR |
$7,919.78
|
| Rate for Payer: ASR Commercial |
$7,919.78
|
| Rate for Payer: BCBS Trust/PPO |
$6,653.43
|
| Rate for Payer: BCN Commercial |
$6,330.11
|
| Rate for Payer: Cash Price |
$6,531.78
|
| Rate for Payer: Cofinity Commercial |
$7,674.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,531.78
|
| Rate for Payer: Healthscope Commercial |
$8,164.72
|
| Rate for Payer: Healthscope Whirlpool |
$7,919.78
|
| Rate for Payer: Mclaren Commercial |
$7,348.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,940.01
|
| Rate for Payer: Nomi Health Commercial |
$6,695.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,307.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,184.95
|
|
|
HC STOOL CULTURE
|
Facility
|
OP
|
$39.95
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna Commercial |
$35.96
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$38.75
|
| Rate for Payer: ASR Commercial |
$38.75
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$32.72
|
| Rate for Payer: BCN Commercial |
$30.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$37.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$39.95
|
| Rate for Payer: Healthscope Whirlpool |
$38.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$5.06
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.64
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$23.71
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$5.06
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC STOOL CULTURE
|
Facility
|
IP
|
$39.95
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna Commercial |
$35.96
|
| Rate for Payer: ASR ASR |
$38.75
|
| Rate for Payer: ASR Commercial |
$38.75
|
| Rate for Payer: BCBS Trust/PPO |
$32.56
|
| Rate for Payer: BCN Commercial |
$30.97
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$37.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$39.95
|
| Rate for Payer: Healthscope Whirlpool |
$38.75
|
| Rate for Payer: Mclaren Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.16
|
|
|
HC STOOL CULTURE CMPT
|
Facility
|
IP
|
$39.95
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna Commercial |
$35.96
|
| Rate for Payer: ASR ASR |
$38.75
|
| Rate for Payer: ASR Commercial |
$38.75
|
| Rate for Payer: BCBS Trust/PPO |
$32.56
|
| Rate for Payer: BCN Commercial |
$30.97
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$37.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$39.95
|
| Rate for Payer: Healthscope Whirlpool |
$38.75
|
| Rate for Payer: Mclaren Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.16
|
|
|
HC STOOL CULTURE CMPT
|
Facility
|
OP
|
$39.95
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna Commercial |
$35.96
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$38.75
|
| Rate for Payer: ASR Commercial |
$38.75
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$32.72
|
| Rate for Payer: BCN Commercial |
$30.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$37.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$39.95
|
| Rate for Payer: Healthscope Whirlpool |
$38.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$5.06
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.64
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$23.71
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$5.06
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC STOOL CULTURE CMPT2
|
Facility
|
OP
|
$13.32
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600069
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$20.87 |
| Rate for Payer: Aetna Commercial |
$11.99
|
| Rate for Payer: Aetna Medicare |
$6.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: ASR ASR |
$12.92
|
| Rate for Payer: ASR Commercial |
$12.92
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCN Commercial |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$13.32
|
| Rate for Payer: Healthscope Whirlpool |
$12.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$11.99
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.32
|
| Rate for Payer: Nomi Health Commercial |
$10.92
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$7.35
|
| Rate for Payer: PHP Medicaid |
$3.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.87
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$16.70
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Exchange |
$10.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.68
|
| Rate for Payer: UHCCP DNSP |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC STOOL CULTURE CMPT2
|
Facility
|
IP
|
$13.32
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600069
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$13.32 |
| Rate for Payer: Aetna Commercial |
$11.99
|
| Rate for Payer: ASR ASR |
$12.92
|
| Rate for Payer: ASR Commercial |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$10.85
|
| Rate for Payer: BCN Commercial |
$10.33
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$13.32
|
| Rate for Payer: Healthscope Whirlpool |
$12.92
|
| Rate for Payer: Mclaren Commercial |
$11.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.32
|
| Rate for Payer: Nomi Health Commercial |
$10.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.72
|
|
|
HC STOOL CULTURE CMPT 3
|
Facility
|
OP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$34.84
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC STOOL CULTURE CMPT 3
|
Facility
|
IP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$34.67
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
OP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$121.07
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$130.48
|
| Rate for Payer: ASR Commercial |
$130.48
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.16
|
| Rate for Payer: BCN Commercial |
$104.29
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$126.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$134.52
|
| Rate for Payer: Healthscope Whirlpool |
$130.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$121.07
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.09
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$135.27
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
IP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$134.52 |
| Rate for Payer: Aetna Commercial |
$121.07
|
| Rate for Payer: ASR ASR |
$130.48
|
| Rate for Payer: ASR Commercial |
$130.48
|
| Rate for Payer: BCBS Trust/PPO |
$109.62
|
| Rate for Payer: BCN Commercial |
$104.29
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$126.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Healthscope Commercial |
$134.52
|
| Rate for Payer: Healthscope Whirlpool |
$130.48
|
| Rate for Payer: Mclaren Commercial |
$121.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.38
|
|
|
HC STRAPPING CASTING UNLISTED
|
Facility
|
OP
|
$232.22
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
42000053
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$225.25
|
| Rate for Payer: ASR Commercial |
$225.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$190.16
|
| Rate for Payer: BCN Commercial |
$180.04
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cofinity Commercial |
$218.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Healthscope Whirlpool |
$225.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$209.00
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$190.42
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.47
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$162.79
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC STRAPPING CASTING UNLISTED
|
Facility
|
IP
|
$232.22
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
42000053
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$150.94 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: ASR ASR |
$225.25
|
| Rate for Payer: ASR Commercial |
$225.25
|
| Rate for Payer: BCBS Trust/PPO |
$189.24
|
| Rate for Payer: BCN Commercial |
$180.04
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cofinity Commercial |
$218.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.78
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Healthscope Whirlpool |
$225.25
|
| Rate for Payer: Mclaren Commercial |
$209.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.35
|
|
|
HC STRAPPING CHEST KINESIOTAPING
|
Facility
|
IP
|
$121.67
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
42000052
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.09 |
| Max. Negotiated Rate |
$121.67 |
| Rate for Payer: Aetna Commercial |
$109.50
|
| Rate for Payer: ASR ASR |
$118.02
|
| Rate for Payer: ASR Commercial |
$118.02
|
| Rate for Payer: BCBS Trust/PPO |
$99.15
|
| Rate for Payer: BCN Commercial |
$94.33
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cofinity Commercial |
$114.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.34
|
| Rate for Payer: Healthscope Commercial |
$121.67
|
| Rate for Payer: Healthscope Whirlpool |
$118.02
|
| Rate for Payer: Mclaren Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.42
|
| Rate for Payer: Nomi Health Commercial |
$99.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.07
|
|
|
HC STRAPPING CHEST KINESIOTAPING
|
Facility
|
OP
|
$121.67
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
42000052
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.64 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$109.50
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$118.02
|
| Rate for Payer: ASR Commercial |
$118.02
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$99.64
|
| Rate for Payer: BCN Commercial |
$94.33
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cofinity Commercial |
$114.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$121.67
|
| Rate for Payer: Healthscope Whirlpool |
$118.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.42
|
| Rate for Payer: Nomi Health Commercial |
$99.77
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.55
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$67.64
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
42000002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
42000002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$169.09 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.09
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$135.27
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$111.05
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
43000006
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$171.81 |
| Rate for Payer: Aetna Commercial |
$99.94
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$107.72
|
| Rate for Payer: ASR Commercial |
$107.72
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$90.94
|
| Rate for Payer: BCN Commercial |
$86.10
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$111.05
|
| Rate for Payer: Healthscope Whirlpool |
$107.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$99.94
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.39
|
| Rate for Payer: Nomi Health Commercial |
$91.06
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.81
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$137.45
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$111.05
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
43000006
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$72.18 |
| Max. Negotiated Rate |
$111.05 |
| Rate for Payer: Aetna Commercial |
$99.94
|
| Rate for Payer: ASR ASR |
$107.72
|
| Rate for Payer: ASR Commercial |
$107.72
|
| Rate for Payer: BCBS Trust/PPO |
$90.49
|
| Rate for Payer: BCN Commercial |
$86.10
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.84
|
| Rate for Payer: Healthscope Commercial |
$111.05
|
| Rate for Payer: Healthscope Whirlpool |
$107.72
|
| Rate for Payer: Mclaren Commercial |
$99.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.39
|
| Rate for Payer: Nomi Health Commercial |
$91.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.72
|
|
|
HC STRAPPING HIP
|
Facility
|
IP
|
$123.37
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
42000003
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$80.19 |
| Max. Negotiated Rate |
$123.37 |
| Rate for Payer: Aetna Commercial |
$111.03
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: ASR Commercial |
$119.67
|
| Rate for Payer: BCBS Trust/PPO |
$100.53
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$123.37
|
| Rate for Payer: Healthscope Whirlpool |
$119.67
|
| Rate for Payer: Mclaren Commercial |
$111.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.86
|
| Rate for Payer: Nomi Health Commercial |
$101.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
|
|
HC STRAPPING HIP
|
Facility
|
OP
|
$123.37
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
42000003
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.49 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$111.03
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: ASR Commercial |
$119.67
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$101.03
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$123.37
|
| Rate for Payer: Healthscope Whirlpool |
$119.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$111.03
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.86
|
| Rate for Payer: Nomi Health Commercial |
$101.16
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.86
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$61.49
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
42000004
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: ASR Commercial |
$151.38
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$127.80
|
| Rate for Payer: BCN Commercial |
$120.99
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Healthscope Whirlpool |
$151.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.09
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$135.27
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
