|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
IP
|
$16.70
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$16.70 |
| Rate for Payer: Aetna Commercial |
$15.03
|
| Rate for Payer: ASR ASR |
$16.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.71
|
| Rate for Payer: BCN Commercial |
$13.71
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$15.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$16.20
|
| Rate for Payer: Healthscope Whirlpool |
$16.70
|
| Rate for Payer: Mclaren Commercial |
$15.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$13.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.70
|
|
|
HC US AAA SCREENING
|
Facility
|
IP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$280.77 |
| Max. Negotiated Rate |
$374.36 |
| Rate for Payer: Aetna Commercial |
$336.92
|
| Rate for Payer: ASR ASR |
$363.13
|
| Rate for Payer: BCBS Trust/PPO |
$307.42
|
| Rate for Payer: BCN Commercial |
$307.42
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Commercial |
$351.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Healthscope Commercial |
$363.13
|
| Rate for Payer: Healthscope Whirlpool |
$374.36
|
| Rate for Payer: Mclaren Commercial |
$336.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.21
|
| Rate for Payer: Nomi Health Commercial |
$306.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.44
|
|
|
HC US AAA SCREENING
|
Facility
|
OP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$374.36 |
| Rate for Payer: Aetna Commercial |
$336.92
|
| 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 |
$363.13
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$308.66
|
| Rate for Payer: BCN Commercial |
$308.66
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Commercial |
$351.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$363.13
|
| Rate for Payer: Healthscope Whirlpool |
$374.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$336.92
|
| 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 |
$318.21
|
| Rate for Payer: Nomi Health Commercial |
$306.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| 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 |
$328.01
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$262.43
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.44
|
| 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 US ABDOMEN COMPLETE
|
Facility
|
OP
|
$969.94
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$969.94 |
| Rate for Payer: Aetna Commercial |
$872.95
|
| 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 |
$940.84
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$799.72
|
| Rate for Payer: BCN Commercial |
$799.72
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$775.95
|
| Rate for Payer: Cash Price |
$775.95
|
| Rate for Payer: Cofinity Commercial |
$911.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$940.84
|
| Rate for Payer: Healthscope Whirlpool |
$969.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$872.95
|
| 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 |
$824.45
|
| Rate for Payer: Nomi Health Commercial |
$795.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.46
|
| 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 |
$705.76
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$564.61
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.55
|
| 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 US ABDOMEN COMPLETE
|
Facility
|
IP
|
$969.94
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$727.46 |
| Max. Negotiated Rate |
$969.94 |
| Rate for Payer: Aetna Commercial |
$872.95
|
| Rate for Payer: ASR ASR |
$940.84
|
| Rate for Payer: BCBS Trust/PPO |
$796.51
|
| Rate for Payer: BCN Commercial |
$796.51
|
| Rate for Payer: Cash Price |
$775.95
|
| Rate for Payer: Cofinity Commercial |
$911.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.95
|
| Rate for Payer: Healthscope Commercial |
$940.84
|
| Rate for Payer: Healthscope Whirlpool |
$969.94
|
| Rate for Payer: Mclaren Commercial |
$872.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.45
|
| Rate for Payer: Nomi Health Commercial |
$795.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.55
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
OP
|
$832.99
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$832.99 |
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$808.00
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$686.80
|
| Rate for Payer: BCN Commercial |
$686.80
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$783.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$808.00
|
| Rate for Payer: Healthscope Whirlpool |
$832.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$749.69
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| 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 |
$380.72
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$304.58
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.03
|
| 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 US ABDOMEN LIMITED
|
Facility
|
IP
|
$832.99
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$624.74 |
| Max. Negotiated Rate |
$832.99 |
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$808.00
|
| Rate for Payer: BCBS Trust/PPO |
$684.05
|
| Rate for Payer: BCN Commercial |
$684.05
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$783.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Healthscope Commercial |
$808.00
|
| Rate for Payer: Healthscope Whirlpool |
$832.99
|
| Rate for Payer: Mclaren Commercial |
$749.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.03
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
OP
|
$614.24
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$614.24 |
| Rate for Payer: Aetna Commercial |
$552.82
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$595.81
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$506.44
|
| Rate for Payer: BCCCP Commercial |
$95.65
|
| Rate for Payer: BCN Commercial |
$506.44
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$595.81
|
| Rate for Payer: Healthscope Whirlpool |
$614.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$552.82
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$538.20
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$430.58
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
IP
|
$614.24
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$460.68 |
| Max. Negotiated Rate |
$614.24 |
| Rate for Payer: Aetna Commercial |
$552.82
|
| Rate for Payer: ASR ASR |
$595.81
|
| Rate for Payer: BCBS Trust/PPO |
$504.41
|
| Rate for Payer: BCN Commercial |
$504.41
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Healthscope Commercial |
$595.81
|
| Rate for Payer: Healthscope Whirlpool |
$614.24
|
| Rate for Payer: Mclaren Commercial |
$552.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.53
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
OP
|
$573.70
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$573.70 |
| Rate for Payer: Aetna Commercial |
$516.33
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$556.49
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$473.02
|
| Rate for Payer: BCCCP Commercial |
$79.63
|
| Rate for Payer: BCN Commercial |
$473.02
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$458.96
|
| Rate for Payer: Cash Price |
$458.96
|
| Rate for Payer: Cofinity Commercial |
$539.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$556.49
|
| Rate for Payer: Healthscope Whirlpool |
$573.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$516.33
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.64
|
| Rate for Payer: Nomi Health Commercial |
$470.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.27
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$502.68
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$402.16
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
IP
|
$573.70
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$430.27 |
| Max. Negotiated Rate |
$573.70 |
| Rate for Payer: Aetna Commercial |
$516.33
|
| Rate for Payer: ASR ASR |
$556.49
|
| Rate for Payer: BCBS Trust/PPO |
$471.12
|
| Rate for Payer: BCN Commercial |
$471.12
|
| Rate for Payer: Cash Price |
$458.96
|
| Rate for Payer: Cofinity Commercial |
$539.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.96
|
| Rate for Payer: Healthscope Commercial |
$556.49
|
| Rate for Payer: Healthscope Whirlpool |
$573.70
|
| Rate for Payer: Mclaren Commercial |
$516.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.64
|
| Rate for Payer: Nomi Health Commercial |
$470.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.86
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| 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 |
$555.64
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$472.29
|
| Rate for Payer: BCCCP Commercial |
$95.65
|
| Rate for Payer: BCN Commercial |
$472.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| 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 |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| 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 |
$501.90
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$401.55
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
| 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 US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Trust/PPO |
$470.40
|
| Rate for Payer: BCN Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Trust/PPO |
$470.40
|
| Rate for Payer: BCN Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$472.29
|
| Rate for Payer: BCCCP Commercial |
$79.63
|
| Rate for Payer: BCN Commercial |
$472.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$501.90
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$401.55
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC US CHEST
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| 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 |
$555.64
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$472.29
|
| Rate for Payer: BCN Commercial |
$472.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| 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 |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| 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 |
$368.61
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$294.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
| 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 US CHEST
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$572.82 |
| Rate for Payer: Aetna Commercial |
$515.54
|
| Rate for Payer: ASR ASR |
$555.64
|
| Rate for Payer: BCBS Trust/PPO |
$470.40
|
| Rate for Payer: BCN Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$538.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$555.64
|
| Rate for Payer: Healthscope Whirlpool |
$572.82
|
| Rate for Payer: Mclaren Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.08
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
IP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$438.80 |
| Max. Negotiated Rate |
$585.07 |
| Rate for Payer: Aetna Commercial |
$526.56
|
| Rate for Payer: ASR ASR |
$567.52
|
| Rate for Payer: BCBS Trust/PPO |
$480.46
|
| Rate for Payer: BCN Commercial |
$480.46
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Commercial |
$549.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Healthscope Commercial |
$567.52
|
| Rate for Payer: Healthscope Whirlpool |
$585.07
|
| Rate for Payer: Mclaren Commercial |
$526.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Nomi Health Commercial |
$479.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.86
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
OP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$216.48 |
| Max. Negotiated Rate |
$585.07 |
| Rate for Payer: Aetna Commercial |
$526.56
|
| Rate for Payer: Aetna Medicare |
$216.48
|
| Rate for Payer: ASR ASR |
$567.52
|
| Rate for Payer: BCBS Complete |
$234.03
|
| Rate for Payer: BCBS Trust/PPO |
$482.39
|
| Rate for Payer: BCN Commercial |
$482.39
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Commercial |
$549.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Healthscope Commercial |
$567.52
|
| Rate for Payer: Healthscope Whirlpool |
$585.07
|
| Rate for Payer: Mclaren Commercial |
$526.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$468.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Nomi Health Commercial |
$479.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$512.64
|
| Rate for Payer: Priority Health Narrow Network |
$410.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.86
|
|
|
HC US CRANIAL
|
Facility
|
OP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$842.88 |
| Rate for Payer: Aetna Commercial |
$758.59
|
| 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 |
$817.59
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$694.95
|
| Rate for Payer: BCN Commercial |
$694.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Commercial |
$792.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$817.59
|
| Rate for Payer: Healthscope Whirlpool |
$842.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$758.59
|
| 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 |
$716.45
|
| Rate for Payer: Nomi Health Commercial |
$691.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| 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 |
$738.53
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$590.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$741.73
|
| 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 US CRANIAL
|
Facility
|
IP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$632.16 |
| Max. Negotiated Rate |
$842.88 |
| Rate for Payer: Aetna Commercial |
$758.59
|
| Rate for Payer: ASR ASR |
$817.59
|
| Rate for Payer: BCBS Trust/PPO |
$692.17
|
| Rate for Payer: BCN Commercial |
$692.17
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Commercial |
$792.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Healthscope Commercial |
$817.59
|
| Rate for Payer: Healthscope Whirlpool |
$842.88
|
| Rate for Payer: Mclaren Commercial |
$758.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.45
|
| Rate for Payer: Nomi Health Commercial |
$691.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$741.73
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,031.66 |
| Rate for Payer: Aetna Commercial |
$928.49
|
| 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 |
$1,000.71
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$850.60
|
| Rate for Payer: BCN Commercial |
$850.60
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Commercial |
$969.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,000.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$928.49
|
| 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 |
$876.91
|
| Rate for Payer: Nomi Health Commercial |
$845.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| 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 |
$370.43
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$296.34
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$907.86
|
| 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 US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$773.75 |
| Max. Negotiated Rate |
$1,031.66 |
| Rate for Payer: Aetna Commercial |
$928.49
|
| Rate for Payer: ASR ASR |
$1,000.71
|
| Rate for Payer: BCBS Trust/PPO |
$847.20
|
| Rate for Payer: BCN Commercial |
$847.20
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Commercial |
$969.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Healthscope Commercial |
$1,000.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.66
|
| Rate for Payer: Mclaren Commercial |
$928.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.91
|
| Rate for Payer: Nomi Health Commercial |
$845.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$907.86
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,332.98 |
| Max. Negotiated Rate |
$1,777.31 |
| Rate for Payer: Aetna Commercial |
$1,599.58
|
| Rate for Payer: ASR ASR |
$1,723.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,459.53
|
| Rate for Payer: BCN Commercial |
$1,459.53
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Commercial |
$1,670.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Healthscope Commercial |
$1,723.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,777.31
|
| Rate for Payer: Mclaren Commercial |
$1,599.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,510.71
|
| Rate for Payer: Nomi Health Commercial |
$1,457.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,564.03
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,777.31 |
| Rate for Payer: Aetna Commercial |
$1,599.58
|
| 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 |
$1,723.99
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,465.39
|
| Rate for Payer: BCN Commercial |
$1,465.39
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Commercial |
$1,670.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,723.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,777.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,599.58
|
| 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 |
$1,510.71
|
| Rate for Payer: Nomi Health Commercial |
$1,457.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| 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 |
$542.34
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$433.87
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,564.03
|
| 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
|
|
