|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.22 |
| Max. Negotiated Rate |
$401.88 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: ASR ASR |
$389.82
|
| Rate for Payer: ASR Commercial |
$389.82
|
| Rate for Payer: BCBS Trust/PPO |
$327.49
|
| Rate for Payer: BCN Commercial |
$311.58
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$377.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Healthscope Commercial |
$401.88
|
| Rate for Payer: Healthscope Whirlpool |
$389.82
|
| Rate for Payer: Mclaren Commercial |
$361.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: Nomi Health Commercial |
$329.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.65
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$401.88 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$389.82
|
| Rate for Payer: ASR Commercial |
$389.82
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$329.10
|
| Rate for Payer: BCN Commercial |
$311.58
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$377.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$401.88
|
| Rate for Payer: Healthscope Whirlpool |
$389.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$361.69
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: Nomi Health Commercial |
$329.54
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.13
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$281.72
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$1,867.06
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$2,012.27
|
| Rate for Payer: ASR Commercial |
$2,012.27
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,698.82
|
| Rate for Payer: BCN Commercial |
$1,608.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,950.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,074.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,012.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$1,867.06
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: Nomi Health Commercial |
$1,701.10
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,817.69
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,454.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,825.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,348.43 |
| Max. Negotiated Rate |
$2,074.51 |
| Rate for Payer: Aetna Commercial |
$1,867.06
|
| Rate for Payer: ASR ASR |
$2,012.27
|
| Rate for Payer: ASR Commercial |
$2,012.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.52
|
| Rate for Payer: BCN Commercial |
$1,608.37
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,950.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Healthscope Commercial |
$2,074.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,012.27
|
| Rate for Payer: Mclaren Commercial |
$1,867.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: Nomi Health Commercial |
$1,701.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,825.57
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$219.07
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.40 |
| Max. Negotiated Rate |
$219.07 |
| Rate for Payer: Aetna Commercial |
$197.16
|
| Rate for Payer: ASR ASR |
$212.50
|
| Rate for Payer: ASR Commercial |
$212.50
|
| Rate for Payer: BCBS Trust/PPO |
$178.52
|
| Rate for Payer: BCN Commercial |
$169.84
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.26
|
| Rate for Payer: Healthscope Commercial |
$219.07
|
| Rate for Payer: Healthscope Whirlpool |
$212.50
|
| Rate for Payer: Mclaren Commercial |
$197.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: Nomi Health Commercial |
$179.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.78
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
OP
|
$219.07
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Aetna Commercial |
$197.16
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$212.50
|
| Rate for Payer: ASR Commercial |
$212.50
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$179.40
|
| Rate for Payer: BCN Commercial |
$169.84
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$219.07
|
| Rate for Payer: Healthscope Whirlpool |
$212.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$197.16
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: Nomi Health Commercial |
$179.64
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.95
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$153.57
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.57 |
| Max. Negotiated Rate |
$480.87 |
| Rate for Payer: Aetna Commercial |
$432.78
|
| Rate for Payer: ASR ASR |
$466.44
|
| Rate for Payer: ASR Commercial |
$466.44
|
| Rate for Payer: BCBS Trust/PPO |
$391.86
|
| Rate for Payer: BCN Commercial |
$372.82
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$452.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Healthscope Commercial |
$480.87
|
| Rate for Payer: Healthscope Whirlpool |
$466.44
|
| Rate for Payer: Mclaren Commercial |
$432.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: Nomi Health Commercial |
$394.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.17
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.60 |
| Max. Negotiated Rate |
$603.23 |
| Rate for Payer: Aetna Commercial |
$432.78
|
| Rate for Payer: Aetna Medicare |
$389.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: ASR ASR |
$466.44
|
| Rate for Payer: ASR Commercial |
$466.44
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCBS Trust/PPO |
$393.78
|
| Rate for Payer: BCN Commercial |
$372.82
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$452.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$480.87
|
| Rate for Payer: Healthscope Whirlpool |
$466.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.18
|
| Rate for Payer: Mclaren Commercial |
$432.78
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: Nomi Health Commercial |
$394.31
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$428.10
|
| Rate for Payer: PHP Medicaid |
$208.60
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.34
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health Narrow Network |
$337.09
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$603.23
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP DNSP |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: VA VA |
$389.18
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.75 |
| Max. Negotiated Rate |
$309.38 |
| Rate for Payer: Aetna Commercial |
$278.44
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: ASR ASR |
$300.10
|
| Rate for Payer: ASR Commercial |
$300.10
|
| Rate for Payer: BCBS Complete |
$123.75
|
| Rate for Payer: BCBS Trust/PPO |
$253.35
|
| Rate for Payer: BCN Commercial |
$239.86
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$290.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$309.38
|
| Rate for Payer: Healthscope Whirlpool |
$300.10
|
| Rate for Payer: Mclaren Commercial |
$278.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.08
|
| Rate for Payer: Priority Health Narrow Network |
$216.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.25
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$201.10 |
| Max. Negotiated Rate |
$309.38 |
| Rate for Payer: Aetna Commercial |
$278.44
|
| Rate for Payer: ASR ASR |
$300.10
|
| Rate for Payer: ASR Commercial |
$300.10
|
| Rate for Payer: BCBS Trust/PPO |
$252.11
|
| Rate for Payer: BCN Commercial |
$239.86
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$290.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$309.38
|
| Rate for Payer: Healthscope Whirlpool |
$300.10
|
| Rate for Payer: Mclaren Commercial |
$278.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.25
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: ASR Commercial |
$17.81
|
| Rate for Payer: BCBS Trust/PPO |
$14.96
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: Aetna Medicare |
$9.18
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: ASR Commercial |
$17.81
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.04
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.09
|
| Rate for Payer: Priority Health Narrow Network |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: Aetna Medicare |
$12.24
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.45
|
| Rate for Payer: Priority Health Narrow Network |
$17.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.95
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$29.07 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: ASR ASR |
$28.20
|
| Rate for Payer: ASR Commercial |
$28.20
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Trust/PPO |
$23.81
|
| Rate for Payer: BCN Commercial |
$22.54
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$27.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Healthscope Commercial |
$29.07
|
| Rate for Payer: Healthscope Whirlpool |
$28.20
|
| Rate for Payer: Mclaren Commercial |
$26.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: Nomi Health Commercial |
$23.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$20.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.58
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$29.07 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: ASR ASR |
$28.20
|
| Rate for Payer: ASR Commercial |
$28.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.69
|
| Rate for Payer: BCN Commercial |
$22.54
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$27.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Healthscope Commercial |
$29.07
|
| Rate for Payer: Healthscope Whirlpool |
$28.20
|
| Rate for Payer: Mclaren Commercial |
$26.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: Nomi Health Commercial |
$23.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.58
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$210.29 |
| Rate for Payer: Aetna Commercial |
$189.26
|
| Rate for Payer: ASR ASR |
$203.98
|
| Rate for Payer: ASR Commercial |
$203.98
|
| Rate for Payer: BCBS Trust/PPO |
$171.37
|
| Rate for Payer: BCN Commercial |
$163.04
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$197.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Healthscope Commercial |
$210.29
|
| Rate for Payer: Healthscope Whirlpool |
$203.98
|
| Rate for Payer: Mclaren Commercial |
$189.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$172.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.06
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$89.58 |
| Max. Negotiated Rate |
$259.04 |
| Rate for Payer: Aetna Commercial |
$189.26
|
| Rate for Payer: Aetna Medicare |
$167.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: ASR ASR |
$203.98
|
| Rate for Payer: ASR Commercial |
$203.98
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCBS Trust/PPO |
$172.21
|
| Rate for Payer: BCN Commercial |
$163.04
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$197.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$210.29
|
| Rate for Payer: Healthscope Whirlpool |
$203.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.12
|
| Rate for Payer: Mclaren Commercial |
$189.26
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$172.44
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$183.83
|
| Rate for Payer: PHP Medicaid |
$89.58
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.26
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health Narrow Network |
$147.41
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$259.04
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP DNSP |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: VA VA |
$167.12
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,709.33 |
| Max. Negotiated Rate |
$4,168.20 |
| Rate for Payer: Aetna Commercial |
$3,751.38
|
| Rate for Payer: ASR ASR |
$4,043.15
|
| Rate for Payer: ASR Commercial |
$4,043.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,396.67
|
| Rate for Payer: BCN Commercial |
$3,231.61
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$3,918.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Healthscope Commercial |
$4,168.20
|
| Rate for Payer: Healthscope Whirlpool |
$4,043.15
|
| Rate for Payer: Mclaren Commercial |
$3,751.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: Nomi Health Commercial |
$3,417.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,668.02
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,667.28 |
| Max. Negotiated Rate |
$4,168.20 |
| Rate for Payer: Aetna Commercial |
$3,751.38
|
| Rate for Payer: Aetna Medicare |
$2,084.10
|
| Rate for Payer: ASR ASR |
$4,043.15
|
| Rate for Payer: ASR Commercial |
$4,043.15
|
| Rate for Payer: BCBS Complete |
$1,667.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,413.34
|
| Rate for Payer: BCN Commercial |
$3,231.61
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$3,918.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Healthscope Commercial |
$4,168.20
|
| Rate for Payer: Healthscope Whirlpool |
$4,043.15
|
| Rate for Payer: Mclaren Commercial |
$3,751.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: Nomi Health Commercial |
$3,417.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,652.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,921.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,668.02
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,468.80 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,304.80
|
| Rate for Payer: Aetna Medicare |
$1,836.00
|
| Rate for Payer: ASR ASR |
$3,561.84
|
| Rate for Payer: ASR Commercial |
$3,561.84
|
| Rate for Payer: BCBS Complete |
$1,468.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,007.00
|
| Rate for Payer: BCN Commercial |
$2,846.90
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,451.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,561.84
|
| Rate for Payer: Mclaren Commercial |
$3,304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: Nomi Health Commercial |
$3,011.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,217.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,574.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,231.36
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,386.80 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,304.80
|
| Rate for Payer: ASR ASR |
$3,561.84
|
| Rate for Payer: ASR Commercial |
$3,561.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,992.31
|
| Rate for Payer: BCN Commercial |
$2,846.90
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,451.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,561.84
|
| Rate for Payer: Mclaren Commercial |
$3,304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: Nomi Health Commercial |
$3,011.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,231.36
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,474.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
|
