|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$3,968.92
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,572.03
|
| 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 |
$3,849.85
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,272.37
|
| Rate for Payer: BCN Commercial |
$3,272.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,175.14
|
| Rate for Payer: Cash Price |
$3,175.14
|
| Rate for Payer: Cofinity Commercial |
$3,730.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,175.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,849.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,968.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,572.03
|
| 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 |
$3,373.58
|
| Rate for Payer: Nomi Health Commercial |
$3,254.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,976.69
|
| 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 |
$3,334.26
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,667.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,492.65
|
| 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
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$3,968.92
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,976.69 |
| Max. Negotiated Rate |
$3,968.92 |
| Rate for Payer: Aetna Commercial |
$3,572.03
|
| Rate for Payer: ASR ASR |
$3,849.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,259.28
|
| Rate for Payer: BCN Commercial |
$3,259.28
|
| Rate for Payer: Cash Price |
$3,175.14
|
| Rate for Payer: Cofinity Commercial |
$3,730.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,175.14
|
| Rate for Payer: Healthscope Commercial |
$3,849.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,968.92
|
| Rate for Payer: Mclaren Commercial |
$3,572.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,373.58
|
| Rate for Payer: Nomi Health Commercial |
$3,254.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,976.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,492.65
|
|
|
HC TRANS CATH REPAIR MITRAL VALVE ADDL
|
Facility
|
OP
|
$4,326.94
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
48100155
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,600.97 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Aetna Commercial |
$3,894.25
|
| Rate for Payer: Aetna Medicare |
$1,600.97
|
| Rate for Payer: ASR ASR |
$4,197.13
|
| Rate for Payer: BCBS Complete |
$1,730.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,567.56
|
| Rate for Payer: BCN Commercial |
$3,567.56
|
| Rate for Payer: Cash Price |
$3,461.55
|
| Rate for Payer: Cofinity Commercial |
$4,067.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,461.55
|
| Rate for Payer: Healthscope Commercial |
$4,197.13
|
| Rate for Payer: Healthscope Whirlpool |
$4,326.94
|
| Rate for Payer: Mclaren Commercial |
$3,894.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,461.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,677.90
|
| Rate for Payer: Nomi Health Commercial |
$3,548.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,245.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,791.26
|
| Rate for Payer: Priority Health Narrow Network |
$3,033.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,807.71
|
|
|
HC TRANS CATH REPAIR MITRAL VALVE ADDL
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
48100155
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,245.20 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Aetna Commercial |
$3,894.25
|
| Rate for Payer: ASR ASR |
$4,197.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,553.28
|
| Rate for Payer: BCN Commercial |
$3,553.28
|
| Rate for Payer: Cash Price |
$3,461.55
|
| Rate for Payer: Cofinity Commercial |
$4,067.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,461.55
|
| Rate for Payer: Healthscope Commercial |
$4,197.13
|
| Rate for Payer: Healthscope Whirlpool |
$4,326.94
|
| Rate for Payer: Mclaren Commercial |
$3,894.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,677.90
|
| Rate for Payer: Nomi Health Commercial |
$3,548.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,245.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,807.71
|
|
|
HC TRANS CATH REPAIR MITRAL VALVE INITIAL
|
Facility
|
IP
|
$18,306.49
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
48100154
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,729.87 |
| Max. Negotiated Rate |
$18,306.49 |
| Rate for Payer: Aetna Commercial |
$16,475.84
|
| Rate for Payer: ASR ASR |
$17,757.30
|
| Rate for Payer: BCBS Trust/PPO |
$15,033.29
|
| Rate for Payer: BCN Commercial |
$15,033.29
|
| Rate for Payer: Cash Price |
$14,645.19
|
| Rate for Payer: Cofinity Commercial |
$17,208.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,645.19
|
| Rate for Payer: Healthscope Commercial |
$17,757.30
|
| Rate for Payer: Healthscope Whirlpool |
$18,306.49
|
| Rate for Payer: Mclaren Commercial |
$16,475.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,560.52
|
| Rate for Payer: Nomi Health Commercial |
$15,011.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,729.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,109.71
|
|
|
HC TRANS CATH REPAIR MITRAL VALVE INITIAL
|
Facility
|
OP
|
$18,306.49
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
48100154
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,773.40 |
| Max. Negotiated Rate |
$18,306.49 |
| Rate for Payer: Aetna Commercial |
$16,475.84
|
| Rate for Payer: Aetna Medicare |
$6,773.40
|
| Rate for Payer: ASR ASR |
$17,757.30
|
| Rate for Payer: BCBS Complete |
$7,322.60
|
| Rate for Payer: BCBS Trust/PPO |
$15,093.70
|
| Rate for Payer: BCN Commercial |
$15,093.70
|
| Rate for Payer: Cash Price |
$14,645.19
|
| Rate for Payer: Cofinity Commercial |
$17,208.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,645.19
|
| Rate for Payer: Healthscope Commercial |
$17,757.30
|
| Rate for Payer: Healthscope Whirlpool |
$18,306.49
|
| Rate for Payer: Mclaren Commercial |
$16,475.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,645.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,560.52
|
| Rate for Payer: Nomi Health Commercial |
$15,011.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,729.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16,040.15
|
| Rate for Payer: Priority Health Narrow Network |
$12,832.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,109.71
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
IP
|
$16,324.08
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,243.06 |
| Max. Negotiated Rate |
$16,324.08 |
| Rate for Payer: Aetna Commercial |
$14,691.67
|
| Rate for Payer: ASR ASR |
$15,834.36
|
| Rate for Payer: BCBS Trust/PPO |
$13,405.33
|
| Rate for Payer: BCN Commercial |
$13,405.33
|
| Rate for Payer: Cash Price |
$13,059.26
|
| Rate for Payer: Cofinity Commercial |
$15,344.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,059.26
|
| Rate for Payer: Healthscope Commercial |
$15,834.36
|
| Rate for Payer: Healthscope Whirlpool |
$16,324.08
|
| Rate for Payer: Mclaren Commercial |
$14,691.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,875.47
|
| Rate for Payer: Nomi Health Commercial |
$13,385.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,243.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,365.19
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
OP
|
$16,324.08
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$16,324.08 |
| Rate for Payer: Aetna Commercial |
$14,691.67
|
| Rate for Payer: Aetna Medicare |
$5,671.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: ASR ASR |
$15,834.36
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$13,459.20
|
| Rate for Payer: BCN Commercial |
$13,459.20
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$13,059.26
|
| Rate for Payer: Cash Price |
$13,059.26
|
| Rate for Payer: Cofinity Commercial |
$15,344.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,059.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$15,834.36
|
| Rate for Payer: Healthscope Whirlpool |
$16,324.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,671.10
|
| Rate for Payer: Mclaren Commercial |
$14,691.67
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$3,114.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,875.47
|
| Rate for Payer: Nomi Health Commercial |
$13,385.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,243.06
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$6,238.21
|
| Rate for Payer: PHP Medicaid |
$3,039.71
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14,303.16
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health Narrow Network |
$11,443.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,365.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Exchange |
$8,790.20
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP DNSP |
$5,671.10
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
IP
|
$574.63
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$430.97 |
| Max. Negotiated Rate |
$574.63 |
| Rate for Payer: Aetna Commercial |
$517.17
|
| Rate for Payer: ASR ASR |
$557.39
|
| Rate for Payer: BCBS Trust/PPO |
$471.89
|
| Rate for Payer: BCN Commercial |
$471.89
|
| Rate for Payer: Cash Price |
$459.70
|
| Rate for Payer: Cofinity Commercial |
$540.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.70
|
| Rate for Payer: Healthscope Commercial |
$557.39
|
| Rate for Payer: Healthscope Whirlpool |
$574.63
|
| Rate for Payer: Mclaren Commercial |
$517.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.44
|
| Rate for Payer: Nomi Health Commercial |
$471.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$505.67
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
OP
|
$574.63
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$212.61 |
| Max. Negotiated Rate |
$574.63 |
| Rate for Payer: Aetna Commercial |
$517.17
|
| Rate for Payer: Aetna Medicare |
$212.61
|
| Rate for Payer: ASR ASR |
$557.39
|
| Rate for Payer: BCBS Complete |
$229.85
|
| Rate for Payer: BCBS Trust/PPO |
$473.78
|
| Rate for Payer: BCN Commercial |
$473.78
|
| Rate for Payer: Cash Price |
$459.70
|
| Rate for Payer: Cofinity Commercial |
$540.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.70
|
| Rate for Payer: Healthscope Commercial |
$557.39
|
| Rate for Payer: Healthscope Whirlpool |
$574.63
|
| Rate for Payer: Mclaren Commercial |
$517.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$459.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.44
|
| Rate for Payer: Nomi Health Commercial |
$471.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$503.49
|
| Rate for Payer: Priority Health Narrow Network |
$402.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$505.67
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,650.64
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,650.64 |
| Rate for Payer: Aetna Commercial |
$1,485.58
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,601.12
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.95
|
| Rate for Payer: BCN Commercial |
$1,360.95
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,320.51
|
| Rate for Payer: Cash Price |
$1,320.51
|
| Rate for Payer: Cofinity Commercial |
$1,551.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,601.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,650.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,485.58
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.04
|
| Rate for Payer: Nomi Health Commercial |
$1,353.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.98
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,446.29
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.10
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
IP
|
$1,650.64
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,237.98 |
| Max. Negotiated Rate |
$1,650.64 |
| Rate for Payer: Aetna Commercial |
$1,485.58
|
| Rate for Payer: ASR ASR |
$1,601.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,355.51
|
| Rate for Payer: BCN Commercial |
$1,355.51
|
| Rate for Payer: Cash Price |
$1,320.51
|
| Rate for Payer: Cofinity Commercial |
$1,551.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.51
|
| Rate for Payer: Healthscope Commercial |
$1,601.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,650.64
|
| Rate for Payer: Mclaren Commercial |
$1,485.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.04
|
| Rate for Payer: Nomi Health Commercial |
$1,353.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.56
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
OP
|
$733.73
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$733.73 |
| Rate for Payer: Aetna Commercial |
$660.36
|
| 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 |
$711.72
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$604.96
|
| Rate for Payer: BCN Commercial |
$604.96
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$586.98
|
| Rate for Payer: Cash Price |
$586.98
|
| Rate for Payer: Cofinity Commercial |
$689.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$711.72
|
| Rate for Payer: Healthscope Whirlpool |
$733.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$660.36
|
| 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 |
$623.67
|
| Rate for Payer: Nomi Health Commercial |
$601.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.30
|
| 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 |
$642.89
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$514.34
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.68
|
| 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 TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
IP
|
$733.73
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$550.30 |
| Max. Negotiated Rate |
$733.73 |
| Rate for Payer: Aetna Commercial |
$660.36
|
| Rate for Payer: ASR ASR |
$711.72
|
| Rate for Payer: BCBS Trust/PPO |
$602.54
|
| Rate for Payer: BCN Commercial |
$602.54
|
| Rate for Payer: Cash Price |
$586.98
|
| Rate for Payer: Cofinity Commercial |
$689.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.98
|
| Rate for Payer: Healthscope Commercial |
$711.72
|
| Rate for Payer: Healthscope Whirlpool |
$733.73
|
| Rate for Payer: Mclaren Commercial |
$660.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.67
|
| Rate for Payer: Nomi Health Commercial |
$601.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.68
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$334.79 |
| Max. Negotiated Rate |
$446.38 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| Rate for Payer: ASR ASR |
$432.99
|
| Rate for Payer: BCBS Trust/PPO |
$366.57
|
| Rate for Payer: BCN Commercial |
$366.57
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$576.32 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| 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 |
$432.99
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$368.04
|
| Rate for Payer: BCN Commercial |
$368.04
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| 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 |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| 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 |
$391.12
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$312.91
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
| 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 TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$638.76
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$479.07 |
| Max. Negotiated Rate |
$638.76 |
| Rate for Payer: Aetna Commercial |
$574.88
|
| Rate for Payer: ASR ASR |
$619.60
|
| Rate for Payer: BCBS Trust/PPO |
$524.55
|
| Rate for Payer: BCN Commercial |
$524.55
|
| Rate for Payer: Cash Price |
$511.01
|
| Rate for Payer: Cofinity Commercial |
$600.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.01
|
| Rate for Payer: Healthscope Commercial |
$619.60
|
| Rate for Payer: Healthscope Whirlpool |
$638.76
|
| Rate for Payer: Mclaren Commercial |
$574.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.95
|
| Rate for Payer: Nomi Health Commercial |
$523.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.11
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$638.76
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$1,326.26 |
| Rate for Payer: Aetna Commercial |
$574.88
|
| Rate for Payer: Aetna Medicare |
$855.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: ASR ASR |
$619.60
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$526.66
|
| Rate for Payer: BCN Commercial |
$526.66
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$511.01
|
| Rate for Payer: Cash Price |
$511.01
|
| Rate for Payer: Cofinity Commercial |
$600.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$619.60
|
| Rate for Payer: Healthscope Whirlpool |
$638.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$855.65
|
| Rate for Payer: Mclaren Commercial |
$574.88
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$469.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.95
|
| Rate for Payer: Nomi Health Commercial |
$523.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.07
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$941.22
|
| Rate for Payer: PHP Medicaid |
$458.63
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$559.68
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health Narrow Network |
$447.77
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,326.26
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP DNSP |
$855.65
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: VA VA |
$855.65
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$12.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.95
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.76
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.76
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$12.76
|
| Rate for Payer: Mclaren Medicare |
$12.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: Meridian Medicaid |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$12.12
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$14.04
|
| Rate for Payer: PHP Medicaid |
$6.84
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$76.27
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow Network |
$61.02
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.76
|
| Rate for Payer: UHC Exchange |
$19.78
|
| Rate for Payer: UHC Medicaid |
$6.67
|
| Rate for Payer: UHCCP DNSP |
$12.76
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: VA VA |
$12.76
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,220.39
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$915.29 |
| Max. Negotiated Rate |
$1,220.39 |
| Rate for Payer: Aetna Commercial |
$1,098.35
|
| Rate for Payer: ASR ASR |
$1,183.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.18
|
| Rate for Payer: BCN Commercial |
$1,002.18
|
| Rate for Payer: Cash Price |
$976.31
|
| Rate for Payer: Cofinity Commercial |
$1,147.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.31
|
| Rate for Payer: Healthscope Commercial |
$1,183.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,220.39
|
| Rate for Payer: Mclaren Commercial |
$1,098.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.33
|
| Rate for Payer: Nomi Health Commercial |
$1,000.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.94
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,220.39
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$229.91 |
| Max. Negotiated Rate |
$1,220.39 |
| Rate for Payer: Aetna Commercial |
$1,098.35
|
| Rate for Payer: Aetna Medicare |
$439.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.49
|
| Rate for Payer: ASR ASR |
$1,183.78
|
| Rate for Payer: BCBS Complete |
$241.42
|
| Rate for Payer: BCBS MAPPO |
$439.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.21
|
| Rate for Payer: BCN Commercial |
$1,006.21
|
| Rate for Payer: BCN Medicare Advantage |
$439.59
|
| Rate for Payer: Cash Price |
$976.31
|
| Rate for Payer: Cash Price |
$976.31
|
| Rate for Payer: Cofinity Commercial |
$1,147.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.59
|
| Rate for Payer: Healthscope Commercial |
$1,183.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,220.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$439.59
|
| Rate for Payer: Mclaren Commercial |
$1,098.35
|
| Rate for Payer: Mclaren Medicaid |
$439.59
|
| Rate for Payer: Mclaren Medicare |
$439.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$241.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.33
|
| Rate for Payer: Nomi Health Commercial |
$1,000.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.29
|
| Rate for Payer: PACE Medicare |
$417.61
|
| Rate for Payer: PACE SWMI |
$439.59
|
| Rate for Payer: PHP Commercial |
$483.55
|
| Rate for Payer: PHP Medicaid |
$235.62
|
| Rate for Payer: PHP Medicare Advantage |
$439.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$766.29
|
| Rate for Payer: Priority Health Medicare |
$439.59
|
| Rate for Payer: Priority Health Narrow Network |
$613.03
|
| Rate for Payer: Railroad Medicare Medicare |
$439.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.59
|
| Rate for Payer: UHC Exchange |
$681.36
|
| Rate for Payer: UHC Medicaid |
$229.91
|
| Rate for Payer: UHCCP DNSP |
$439.59
|
| Rate for Payer: UHCCP Medicaid |
$229.91
|
| Rate for Payer: VA VA |
$439.59
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$644.68
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$644.68 |
| Rate for Payer: Aetna Commercial |
$580.21
|
| Rate for Payer: ASR ASR |
$625.34
|
| Rate for Payer: BCBS Trust/PPO |
$529.41
|
| Rate for Payer: BCN Commercial |
$529.41
|
| Rate for Payer: Cash Price |
$515.74
|
| Rate for Payer: Cofinity Commercial |
$606.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.74
|
| Rate for Payer: Healthscope Commercial |
$625.34
|
| Rate for Payer: Healthscope Whirlpool |
$644.68
|
| Rate for Payer: Mclaren Commercial |
$580.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.98
|
| Rate for Payer: Nomi Health Commercial |
$528.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.32
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$644.68
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.91 |
| Max. Negotiated Rate |
$681.36 |
| Rate for Payer: Aetna Commercial |
$580.21
|
| Rate for Payer: Aetna Medicare |
$439.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.49
|
| Rate for Payer: ASR ASR |
$625.34
|
| Rate for Payer: BCBS Complete |
$241.42
|
| Rate for Payer: BCBS MAPPO |
$439.59
|
| Rate for Payer: BCBS Trust/PPO |
$531.54
|
| Rate for Payer: BCN Commercial |
$531.54
|
| Rate for Payer: BCN Medicare Advantage |
$439.59
|
| Rate for Payer: Cash Price |
$515.74
|
| Rate for Payer: Cash Price |
$515.74
|
| Rate for Payer: Cofinity Commercial |
$606.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.59
|
| Rate for Payer: Healthscope Commercial |
$625.34
|
| Rate for Payer: Healthscope Whirlpool |
$644.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$439.59
|
| Rate for Payer: Mclaren Commercial |
$580.21
|
| Rate for Payer: Mclaren Medicaid |
$439.59
|
| Rate for Payer: Mclaren Medicare |
$439.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$241.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.98
|
| Rate for Payer: Nomi Health Commercial |
$528.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.51
|
| Rate for Payer: PACE Medicare |
$417.61
|
| Rate for Payer: PACE SWMI |
$439.59
|
| Rate for Payer: PHP Commercial |
$483.55
|
| Rate for Payer: PHP Medicaid |
$235.62
|
| Rate for Payer: PHP Medicare Advantage |
$439.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$564.87
|
| Rate for Payer: Priority Health Medicare |
$439.59
|
| Rate for Payer: Priority Health Narrow Network |
$451.92
|
| Rate for Payer: Railroad Medicare Medicare |
$439.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.59
|
| Rate for Payer: UHC Exchange |
$681.36
|
| Rate for Payer: UHC Medicaid |
$229.91
|
| Rate for Payer: UHCCP DNSP |
$439.59
|
| Rate for Payer: UHCCP Medicaid |
$229.91
|
| Rate for Payer: VA VA |
$439.59
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
IP
|
$3,231.49
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,423.62 |
| Max. Negotiated Rate |
$3,231.49 |
| Rate for Payer: Aetna Commercial |
$2,908.34
|
| Rate for Payer: ASR ASR |
$3,134.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,653.70
|
| Rate for Payer: BCN Commercial |
$2,653.70
|
| Rate for Payer: Cash Price |
$2,585.19
|
| Rate for Payer: Cofinity Commercial |
$3,037.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,585.19
|
| Rate for Payer: Healthscope Commercial |
$3,134.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,231.49
|
| Rate for Payer: Mclaren Commercial |
$2,908.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,746.77
|
| Rate for Payer: Nomi Health Commercial |
$2,649.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,423.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,843.71
|
|
