|
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 |
$89.99 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$189.26
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$203.98
|
| Rate for Payer: ASR Commercial |
$203.98
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$172.21
|
| Rate for Payer: BCCCP Commercial |
$110.97
|
| Rate for Payer: BCN Commercial |
$163.04
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| 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 |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$210.29
|
| Rate for Payer: Healthscope Whirlpool |
$203.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$189.26
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$172.44
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| 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 |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$147.41
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
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 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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| 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 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 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 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 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 TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| 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: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
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
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
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
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| 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: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$775.65
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.47 |
| Max. Negotiated Rate |
$929.61 |
| Rate for Payer: Aetna Commercial |
$698.08
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$752.38
|
| Rate for Payer: ASR Commercial |
$752.38
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$635.18
|
| Rate for Payer: BCN Commercial |
$601.36
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cofinity Commercial |
$729.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$775.65
|
| Rate for Payer: Healthscope Whirlpool |
$752.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$698.08
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.30
|
| Rate for Payer: Nomi Health Commercial |
$636.03
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.63
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$561.30
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$775.65
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$504.17 |
| Max. Negotiated Rate |
$775.65 |
| Rate for Payer: Aetna Commercial |
$698.08
|
| Rate for Payer: ASR ASR |
$752.38
|
| Rate for Payer: ASR Commercial |
$752.38
|
| Rate for Payer: BCBS Trust/PPO |
$632.08
|
| Rate for Payer: BCN Commercial |
$601.36
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cofinity Commercial |
$729.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.52
|
| Rate for Payer: Healthscope Commercial |
$775.65
|
| Rate for Payer: Healthscope Whirlpool |
$752.38
|
| Rate for Payer: Mclaren Commercial |
$698.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.30
|
| Rate for Payer: Nomi Health Commercial |
$636.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.57
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$302.44
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$325.97
|
| Rate for Payer: ASR Commercial |
$325.97
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$275.19
|
| Rate for Payer: BCN Commercial |
$260.54
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$315.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$336.05
|
| Rate for Payer: Healthscope Whirlpool |
$325.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$302.44
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.86
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$195.89
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
IP
|
$336.05
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.43 |
| Max. Negotiated Rate |
$336.05 |
| Rate for Payer: Aetna Commercial |
$302.44
|
| Rate for Payer: ASR ASR |
$325.97
|
| Rate for Payer: ASR Commercial |
$325.97
|
| Rate for Payer: BCBS Trust/PPO |
$273.85
|
| Rate for Payer: BCN Commercial |
$260.54
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$315.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$336.05
|
| Rate for Payer: Healthscope Whirlpool |
$325.97
|
| Rate for Payer: Mclaren Commercial |
$302.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.72
|
|
|
HC TYMPANIC MEMBRANE REPAIR W/WO PREP OF PERF W/WO PATCH
|
Facility
|
OP
|
$4,285.00
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
76100523
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$777.91 |
| Max. Negotiated Rate |
$4,285.00 |
| Rate for Payer: Aetna Commercial |
$3,856.50
|
| Rate for Payer: Aetna Medicare |
$1,451.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: ASR ASR |
$4,156.45
|
| Rate for Payer: ASR Commercial |
$4,156.45
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$3,508.99
|
| Rate for Payer: BCN Commercial |
$3,322.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,428.00
|
| Rate for Payer: Cash Price |
$3,428.00
|
| Rate for Payer: Cofinity Commercial |
$4,027.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,428.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$4,285.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,156.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,451.33
|
| Rate for Payer: Mclaren Commercial |
$3,856.50
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,642.25
|
| Rate for Payer: Nomi Health Commercial |
$3,513.70
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$1,596.46
|
| Rate for Payer: PHP Medicaid |
$777.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,754.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,003.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,770.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Exchange |
$2,249.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP DNSP |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$777.91
|
| Rate for Payer: VA VA |
$1,451.33
|
|
|
HC TYMPANIC MEMBRANE REPAIR W/WO PREP OF PERF W/WO PATCH
|
Facility
|
IP
|
$4,285.00
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
76100523
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,785.25 |
| Max. Negotiated Rate |
$4,285.00 |
| Rate for Payer: Aetna Commercial |
$3,856.50
|
| Rate for Payer: ASR ASR |
$4,156.45
|
| Rate for Payer: ASR Commercial |
$4,156.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,491.85
|
| Rate for Payer: BCN Commercial |
$3,322.16
|
| Rate for Payer: Cash Price |
$3,428.00
|
| Rate for Payer: Cofinity Commercial |
$4,027.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,428.00
|
| Rate for Payer: Healthscope Commercial |
$4,285.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,156.45
|
| Rate for Payer: Mclaren Commercial |
$3,856.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,642.25
|
| Rate for Payer: Nomi Health Commercial |
$3,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,770.80
|
|
|
HC TYMPANOMETRY
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$59.61 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$38.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.46
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: PHP Medicaid |
$20.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$20.42
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$59.61
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP DNSP |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: VA VA |
$38.46
|
|
|
HC TYMPANOMETRY
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.74
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$237.62 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$121.95
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.48
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$104.39
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Trust/PPO |
$121.35
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
OP
|
$1,342.32
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.44 |
| Max. Negotiated Rate |
$1,342.32 |
| Rate for Payer: Aetna Commercial |
$1,208.09
|
| Rate for Payer: Aetna Medicare |
$498.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: ASR ASR |
$1,302.05
|
| Rate for Payer: ASR Commercial |
$1,302.05
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.23
|
| Rate for Payer: BCN Commercial |
$1,040.70
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,261.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,342.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$498.95
|
| Rate for Payer: Mclaren Commercial |
$1,208.09
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$548.84
|
| Rate for Payer: PHP Medicaid |
$267.44
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,176.14
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$940.97
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$773.37
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP DNSP |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
IP
|
$1,342.32
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$872.51 |
| Max. Negotiated Rate |
$1,342.32 |
| Rate for Payer: Aetna Commercial |
$1,208.09
|
| Rate for Payer: ASR ASR |
$1,302.05
|
| Rate for Payer: ASR Commercial |
$1,302.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.86
|
| Rate for Payer: BCN Commercial |
$1,040.70
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,261.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Healthscope Commercial |
$1,342.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.05
|
| Rate for Payer: Mclaren Commercial |
$1,208.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.24
|
|
