|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$169.47 |
| Max. Negotiated Rate |
$225.96 |
| Rate for Payer: Aetna Commercial |
$203.36
|
| Rate for Payer: ASR ASR |
$219.18
|
| Rate for Payer: BCBS Trust/PPO |
$185.56
|
| Rate for Payer: BCN Commercial |
$185.56
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Commercial |
$212.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Healthscope Commercial |
$219.18
|
| Rate for Payer: Healthscope Whirlpool |
$225.96
|
| Rate for Payer: Mclaren Commercial |
$203.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Nomi Health Commercial |
$185.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.84
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$88.78 |
| Max. Negotiated Rate |
$263.13 |
| Rate for Payer: Aetna Commercial |
$203.36
|
| Rate for Payer: Aetna Medicare |
$169.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: ASR ASR |
$219.18
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$186.30
|
| Rate for Payer: BCCCP Commercial |
$110.97
|
| Rate for Payer: BCN Commercial |
$186.30
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Commercial |
$212.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$219.18
|
| Rate for Payer: Healthscope Whirlpool |
$225.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.76
|
| Rate for Payer: Mclaren Commercial |
$203.36
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$93.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Nomi Health Commercial |
$185.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$186.74
|
| Rate for Payer: PHP Medicaid |
$90.99
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health Narrow Network |
$158.40
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$263.13
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP DNSP |
$169.76
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: VA VA |
$169.76
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,251.56
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,188.67 |
| Max. Negotiated Rate |
$4,251.56 |
| Rate for Payer: Aetna Commercial |
$3,826.40
|
| Rate for Payer: ASR ASR |
$4,124.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,491.38
|
| Rate for Payer: BCN Commercial |
$3,491.38
|
| Rate for Payer: Cash Price |
$3,401.25
|
| Rate for Payer: Cofinity Commercial |
$3,996.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.25
|
| Rate for Payer: Healthscope Commercial |
$4,124.01
|
| Rate for Payer: Healthscope Whirlpool |
$4,251.56
|
| Rate for Payer: Mclaren Commercial |
$3,826.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,613.83
|
| Rate for Payer: Nomi Health Commercial |
$3,486.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,188.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,741.37
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,251.56
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,573.08 |
| Max. Negotiated Rate |
$4,251.56 |
| Rate for Payer: Aetna Commercial |
$3,826.40
|
| Rate for Payer: Aetna Medicare |
$1,573.08
|
| Rate for Payer: ASR ASR |
$4,124.01
|
| Rate for Payer: BCBS Complete |
$1,700.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,505.41
|
| Rate for Payer: BCN Commercial |
$3,505.41
|
| Rate for Payer: Cash Price |
$3,401.25
|
| Rate for Payer: Cofinity Commercial |
$3,996.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.25
|
| Rate for Payer: Healthscope Commercial |
$4,124.01
|
| Rate for Payer: Healthscope Whirlpool |
$4,251.56
|
| Rate for Payer: Mclaren Commercial |
$3,826.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,401.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,613.83
|
| Rate for Payer: Nomi Health Commercial |
$3,486.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,188.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,725.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,980.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,741.37
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,745.44
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,809.08 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,370.90
|
| Rate for Payer: ASR ASR |
$3,633.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,075.76
|
| Rate for Payer: BCN Commercial |
$3,075.76
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,520.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,633.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,745.44
|
| Rate for Payer: Mclaren Commercial |
$3,370.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,809.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,295.99
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,745.44
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,385.81 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,370.90
|
| Rate for Payer: Aetna Medicare |
$1,385.81
|
| Rate for Payer: ASR ASR |
$3,633.08
|
| Rate for Payer: BCBS Complete |
$1,498.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,088.12
|
| Rate for Payer: BCN Commercial |
$3,088.12
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,520.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,633.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,745.44
|
| Rate for Payer: Mclaren Commercial |
$3,370.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,996.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,809.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,281.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,625.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,295.99
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,101.11
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,681.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,101.11
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,681.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$791.16
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.14 |
| Max. Negotiated Rate |
$1,141.44 |
| Rate for Payer: Aetna Commercial |
$712.04
|
| Rate for Payer: Aetna Medicare |
$736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: ASR ASR |
$767.43
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$652.31
|
| Rate for Payer: BCN Commercial |
$652.31
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$632.93
|
| Rate for Payer: Cash Price |
$632.93
|
| Rate for Payer: Cofinity Commercial |
$743.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$767.43
|
| Rate for Payer: Healthscope Whirlpool |
$791.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$736.41
|
| Rate for Payer: Mclaren Commercial |
$712.04
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$404.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.49
|
| Rate for Payer: Nomi Health Commercial |
$648.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.37
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$810.05
|
| Rate for Payer: PHP Medicaid |
$394.72
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$773.55
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Narrow Network |
$618.84
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$696.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$1,141.44
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP DNSP |
$736.41
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$791.16
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$593.37 |
| Max. Negotiated Rate |
$791.16 |
| Rate for Payer: Aetna Commercial |
$712.04
|
| Rate for Payer: ASR ASR |
$767.43
|
| Rate for Payer: BCBS Trust/PPO |
$649.70
|
| Rate for Payer: BCN Commercial |
$649.70
|
| Rate for Payer: Cash Price |
$632.93
|
| Rate for Payer: Cofinity Commercial |
$743.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.93
|
| Rate for Payer: Healthscope Commercial |
$767.43
|
| Rate for Payer: Healthscope Whirlpool |
$791.16
|
| Rate for Payer: Mclaren Commercial |
$712.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.49
|
| Rate for Payer: Nomi Health Commercial |
$648.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$696.22
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
OP
|
$342.77
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$308.49
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$332.49
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$282.61
|
| Rate for Payer: BCN Commercial |
$282.61
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$274.22
|
| Rate for Payer: Cash Price |
$274.22
|
| Rate for Payer: Cofinity Commercial |
$322.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$332.49
|
| Rate for Payer: Healthscope Whirlpool |
$342.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$308.49
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.35
|
| Rate for Payer: Nomi Health Commercial |
$281.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.08
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$269.95
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$215.96
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$301.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
IP
|
$342.77
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.08 |
| Max. Negotiated Rate |
$342.77 |
| Rate for Payer: Aetna Commercial |
$308.49
|
| Rate for Payer: ASR ASR |
$332.49
|
| Rate for Payer: BCBS Trust/PPO |
$281.48
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: Cash Price |
$274.22
|
| Rate for Payer: Cofinity Commercial |
$322.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.22
|
| Rate for Payer: Healthscope Commercial |
$332.49
|
| Rate for Payer: Healthscope Whirlpool |
$342.77
|
| Rate for Payer: Mclaren Commercial |
$308.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.35
|
| Rate for Payer: Nomi Health Commercial |
$281.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$301.64
|
|
|
HC TYMPANIC MEMBRANE REPAIR W/WO PREP OF PERF W/WO PATCH
|
Facility
|
OP
|
$4,370.70
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
76100523
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,370.70 |
| Rate for Payer: Aetna Commercial |
$3,933.63
|
| Rate for Payer: Aetna Commercial |
$5,900.44
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: ASR ASR |
$6,359.37
|
| Rate for Payer: ASR ASR |
$4,239.58
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,405.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,603.64
|
| Rate for Payer: BCN Commercial |
$3,603.64
|
| Rate for Payer: BCN Commercial |
$5,405.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,496.56
|
| Rate for Payer: Cash Price |
$3,496.56
|
| Rate for Payer: Cash Price |
$5,244.84
|
| Rate for Payer: Cash Price |
$5,244.84
|
| Rate for Payer: Cofinity Commercial |
$4,108.46
|
| Rate for Payer: Cofinity Commercial |
$6,162.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,496.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,244.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$4,239.58
|
| Rate for Payer: Healthscope Commercial |
$6,359.37
|
| Rate for Payer: Healthscope Whirlpool |
$6,556.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,370.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$5,900.44
|
| Rate for Payer: Mclaren Commercial |
$3,933.63
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,572.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,715.09
|
| Rate for Payer: Nomi Health Commercial |
$3,583.97
|
| Rate for Payer: Nomi Health Commercial |
$5,375.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,917.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,278.03
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,829.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,744.41
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,063.86
|
| Rate for Payer: Priority Health Narrow Network |
$4,595.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,846.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,769.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC TYMPANIC MEMBRANE REPAIR W/WO PREP OF PERF W/WO PATCH
|
Facility
|
IP
|
$4,370.70
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
76100523
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,278.03 |
| Max. Negotiated Rate |
$4,370.70 |
| Rate for Payer: Aetna Commercial |
$3,933.63
|
| Rate for Payer: Aetna Commercial |
$5,900.44
|
| Rate for Payer: ASR ASR |
$4,239.58
|
| Rate for Payer: ASR ASR |
$6,359.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,589.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,383.83
|
| Rate for Payer: BCN Commercial |
$3,589.22
|
| Rate for Payer: BCN Commercial |
$5,383.83
|
| Rate for Payer: Cash Price |
$5,244.84
|
| Rate for Payer: Cash Price |
$3,496.56
|
| Rate for Payer: Cofinity Commercial |
$6,162.69
|
| Rate for Payer: Cofinity Commercial |
$4,108.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,496.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,244.84
|
| Rate for Payer: Healthscope Commercial |
$4,239.58
|
| Rate for Payer: Healthscope Commercial |
$6,359.37
|
| Rate for Payer: Healthscope Whirlpool |
$6,556.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,370.70
|
| Rate for Payer: Mclaren Commercial |
$5,900.44
|
| Rate for Payer: Mclaren Commercial |
$3,933.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,572.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,715.09
|
| Rate for Payer: Nomi Health Commercial |
$5,375.96
|
| Rate for Payer: Nomi Health Commercial |
$3,583.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,278.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,917.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,769.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,846.22
|
|
|
HC TYMPANOMETRY
|
Facility
|
IP
|
$34.96
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$31.46
|
| Rate for Payer: ASR ASR |
$33.91
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$28.71
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$32.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$33.91
|
| Rate for Payer: Healthscope Whirlpool |
$34.96
|
| Rate for Payer: Mclaren Commercial |
$31.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.76
|
|
|
HC TYMPANOMETRY
|
Facility
|
OP
|
$34.96
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$57.69 |
| Rate for Payer: Aetna Commercial |
$31.46
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: ASR ASR |
$33.91
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$28.82
|
| Rate for Payer: BCN Commercial |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$32.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$33.91
|
| Rate for Payer: Healthscope Whirlpool |
$34.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.22
|
| Rate for Payer: Mclaren Commercial |
$31.46
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$20.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.22
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Medicaid |
$19.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$30.63
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health Narrow Network |
$24.51
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$57.69
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP DNSP |
$37.22
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$106.48 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$125.24
|
| Rate for Payer: BCN Commercial |
$125.24
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$147.34
|
| Rate for Payer: Healthscope Whirlpool |
$151.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.09
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$106.48
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$113.92 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: BCBS Trust/PPO |
$124.74
|
| Rate for Payer: BCN Commercial |
$124.74
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$147.34
|
| Rate for Payer: Healthscope Whirlpool |
$151.90
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
OP
|
$1,369.17
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,369.17 |
| Rate for Payer: Aetna Commercial |
$1,232.25
|
| Rate for Payer: Aetna Commercial |
$1,848.38
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$1,992.14
|
| Rate for Payer: ASR ASR |
$1,328.09
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.88
|
| Rate for Payer: BCN Commercial |
$1,128.88
|
| Rate for Payer: BCN Commercial |
$1,693.32
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cash Price |
$1,643.00
|
| Rate for Payer: Cash Price |
$1,643.00
|
| Rate for Payer: Cofinity Commercial |
$1,287.02
|
| Rate for Payer: Cofinity Commercial |
$1,930.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,643.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,328.09
|
| Rate for Payer: Healthscope Commercial |
$1,992.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,053.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,369.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$1,848.38
|
| Rate for Payer: Mclaren Commercial |
$1,232.25
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,745.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Nomi Health Commercial |
$1,684.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,540.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,199.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,799.50
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$959.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,439.68
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,204.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,807.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
IP
|
$1,369.17
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,026.88 |
| Max. Negotiated Rate |
$1,369.17 |
| Rate for Payer: Aetna Commercial |
$1,232.25
|
| Rate for Payer: Aetna Commercial |
$1,848.38
|
| Rate for Payer: ASR ASR |
$1,328.09
|
| Rate for Payer: ASR ASR |
$1,992.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.54
|
| Rate for Payer: BCN Commercial |
$1,124.36
|
| Rate for Payer: BCN Commercial |
$1,686.54
|
| Rate for Payer: Cash Price |
$1,643.00
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cofinity Commercial |
$1,930.53
|
| Rate for Payer: Cofinity Commercial |
$1,287.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,643.00
|
| Rate for Payer: Healthscope Commercial |
$1,328.09
|
| Rate for Payer: Healthscope Commercial |
$1,992.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,053.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,369.17
|
| Rate for Payer: Mclaren Commercial |
$1,848.38
|
| Rate for Payer: Mclaren Commercial |
$1,232.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,745.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,684.08
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,540.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,807.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,204.87
|
|
|
HC TYPE III HOME STUDY
|
Facility
|
IP
|
$694.43
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$520.82 |
| Max. Negotiated Rate |
$694.43 |
| Rate for Payer: Aetna Commercial |
$624.99
|
| Rate for Payer: ASR ASR |
$673.60
|
| Rate for Payer: BCBS Trust/PPO |
$570.27
|
| Rate for Payer: BCN Commercial |
$570.27
|
| Rate for Payer: Cash Price |
$555.54
|
| Rate for Payer: Cofinity Commercial |
$652.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.54
|
| Rate for Payer: Healthscope Commercial |
$673.60
|
| Rate for Payer: Healthscope Whirlpool |
$694.43
|
| Rate for Payer: Mclaren Commercial |
$624.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$590.27
|
| Rate for Payer: Nomi Health Commercial |
$569.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$611.10
|
|
