|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,838.93 |
| Max. Negotiated Rate |
$5,118.57 |
| Rate for Payer: Aetna Commercial |
$4,606.71
|
| Rate for Payer: ASR ASR |
$4,965.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,203.37
|
| Rate for Payer: BCN Commercial |
$4,203.37
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Commercial |
$4,811.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Healthscope Commercial |
$4,965.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,118.57
|
| Rate for Payer: Mclaren Commercial |
$4,606.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Nomi Health Commercial |
$4,197.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,504.34
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$5,118.57 |
| Rate for Payer: Aetna Commercial |
$4,606.71
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,965.01
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,220.26
|
| Rate for Payer: BCN Commercial |
$4,220.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Commercial |
$4,811.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,965.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,118.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,606.71
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Nomi Health Commercial |
$4,197.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,484.89
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,588.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,504.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,242.09
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,416.47
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,054.00
|
| Rate for Payer: BCN Commercial |
$2,054.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Commercial |
$2,341.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,416.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,491.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,242.09
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Nomi Health Commercial |
$2,042.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,182.80
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,746.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,192.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,868.41 |
| Max. Negotiated Rate |
$2,491.21 |
| Rate for Payer: Aetna Commercial |
$2,242.09
|
| Rate for Payer: ASR ASR |
$2,416.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.78
|
| Rate for Payer: BCN Commercial |
$2,045.78
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Commercial |
$2,341.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Healthscope Commercial |
$2,416.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,491.21
|
| Rate for Payer: Mclaren Commercial |
$2,242.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Nomi Health Commercial |
$2,042.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,192.26
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,374.02 |
| Max. Negotiated Rate |
$1,832.02 |
| Rate for Payer: Aetna Commercial |
$1,648.82
|
| Rate for Payer: ASR ASR |
$1,777.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,504.45
|
| Rate for Payer: BCN Commercial |
$1,504.45
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Commercial |
$1,722.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Healthscope Commercial |
$1,777.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.02
|
| Rate for Payer: Mclaren Commercial |
$1,648.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,557.22
|
| Rate for Payer: Nomi Health Commercial |
$1,502.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,612.18
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,832.02 |
| Rate for Payer: Aetna Commercial |
$1,648.82
|
| 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 |
$1,777.06
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,510.50
|
| Rate for Payer: BCN Commercial |
$1,510.50
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Commercial |
$1,722.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,777.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,648.82
|
| 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 |
$1,557.22
|
| Rate for Payer: Nomi Health Commercial |
$1,502.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.80
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,612.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,553.07 |
| Max. Negotiated Rate |
$4,737.42 |
| Rate for Payer: Aetna Commercial |
$4,263.68
|
| Rate for Payer: ASR ASR |
$4,595.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,890.37
|
| Rate for Payer: BCN Commercial |
$3,890.37
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Commercial |
$4,453.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Healthscope Commercial |
$4,595.30
|
| Rate for Payer: Healthscope Whirlpool |
$4,737.42
|
| Rate for Payer: Mclaren Commercial |
$4,263.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$3,884.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,168.93
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$793.79 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$4,263.68
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,595.30
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,906.00
|
| Rate for Payer: BCN Commercial |
$3,906.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Commercial |
$4,453.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,595.30
|
| Rate for Payer: Healthscope Whirlpool |
$4,737.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,263.68
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$3,884.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$992.24
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$793.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,168.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,077.64 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.95
|
| Rate for Payer: BCN Commercial |
$1,179.95
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| 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 |
$1,393.75
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.69
|
| Rate for Payer: BCN Commercial |
$1,184.69
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| 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 |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.80
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,077.64 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.95
|
| Rate for Payer: BCN Commercial |
$1,179.95
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| 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 |
$1,393.75
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.69
|
| Rate for Payer: BCN Commercial |
$1,184.69
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| 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 |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.80
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$663.74 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| Rate for Payer: ASR ASR |
$858.43
|
| Rate for Payer: BCBS Trust/PPO |
$726.75
|
| Rate for Payer: BCN Commercial |
$726.75
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| 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 |
$858.43
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$729.67
|
| Rate for Payer: BCN Commercial |
$729.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| 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 |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| 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 |
$752.36
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$601.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
| 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 VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,041.15
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,041.15 |
| Rate for Payer: Aetna Commercial |
$937.03
|
| 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 |
$1,009.92
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$858.43
|
| Rate for Payer: BCN Commercial |
$858.43
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$832.92
|
| Rate for Payer: Cash Price |
$832.92
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,009.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$937.03
|
| 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 |
$884.98
|
| Rate for Payer: Nomi Health Commercial |
$853.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.86
|
| 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 |
$752.36
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$601.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$916.21
|
| 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 VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,041.15
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$780.86 |
| Max. Negotiated Rate |
$1,041.15 |
| Rate for Payer: Aetna Commercial |
$937.03
|
| Rate for Payer: ASR ASR |
$1,009.92
|
| Rate for Payer: BCBS Trust/PPO |
$854.99
|
| Rate for Payer: BCN Commercial |
$854.99
|
| Rate for Payer: Cash Price |
$832.92
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.92
|
| Rate for Payer: Healthscope Commercial |
$1,009.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.15
|
| Rate for Payer: Mclaren Commercial |
$937.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.98
|
| Rate for Payer: Nomi Health Commercial |
$853.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$916.21
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$11.55
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,213.53 |
| Max. Negotiated Rate |
$8,284.71 |
| Rate for Payer: Aetna Commercial |
$7,456.24
|
| Rate for Payer: ASR ASR |
$8,036.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,803.40
|
| Rate for Payer: BCN Commercial |
$6,803.40
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,787.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Healthscope Commercial |
$8,036.17
|
| Rate for Payer: Healthscope Whirlpool |
$8,284.71
|
| Rate for Payer: Mclaren Commercial |
$7,456.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,290.54
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,284.71 |
| Rate for Payer: Aetna Commercial |
$7,456.24
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$8,036.17
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,830.74
|
| Rate for Payer: BCN Commercial |
$6,830.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,787.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$8,036.17
|
| Rate for Payer: Healthscope Whirlpool |
$8,284.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,456.24
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,259.06
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,807.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,290.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$875.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$323.94 |
| Max. Negotiated Rate |
$875.51 |
| Rate for Payer: Aetna Commercial |
$787.96
|
| Rate for Payer: Aetna Medicare |
$323.94
|
| Rate for Payer: ASR ASR |
$849.24
|
| Rate for Payer: BCBS Complete |
$350.20
|
| Rate for Payer: BCBS Trust/PPO |
$721.86
|
| Rate for Payer: BCN Commercial |
$721.86
|
| Rate for Payer: Cash Price |
$700.41
|
| Rate for Payer: Cofinity Commercial |
$822.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.41
|
| Rate for Payer: Healthscope Commercial |
$849.24
|
| Rate for Payer: Healthscope Whirlpool |
$875.51
|
| Rate for Payer: Mclaren Commercial |
$787.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$700.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$744.18
|
| Rate for Payer: Nomi Health Commercial |
$717.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$656.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$767.12
|
| Rate for Payer: Priority Health Narrow Network |
$613.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$770.45
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$875.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$656.63 |
| Max. Negotiated Rate |
$875.51 |
| Rate for Payer: Aetna Commercial |
$787.96
|
| Rate for Payer: ASR ASR |
$849.24
|
| Rate for Payer: BCBS Trust/PPO |
$718.97
|
| Rate for Payer: BCN Commercial |
$718.97
|
| Rate for Payer: Cash Price |
$700.41
|
| Rate for Payer: Cofinity Commercial |
$822.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.41
|
| Rate for Payer: Healthscope Commercial |
$849.24
|
| Rate for Payer: Healthscope Whirlpool |
$875.51
|
| Rate for Payer: Mclaren Commercial |
$787.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$744.18
|
| Rate for Payer: Nomi Health Commercial |
$717.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$656.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$770.45
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,358.12
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$5,358.12 |
| Rate for Payer: Aetna Commercial |
$4,822.31
|
| Rate for Payer: Aetna Medicare |
$3,260.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: ASR ASR |
$5,197.38
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,417.77
|
| Rate for Payer: BCN Commercial |
$4,417.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$4,286.50
|
| Rate for Payer: Cash Price |
$4,286.50
|
| Rate for Payer: Cofinity Commercial |
$5,036.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,286.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$5,197.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,358.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,260.23
|
| Rate for Payer: Mclaren Commercial |
$4,822.31
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$1,790.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,554.40
|
| Rate for Payer: Nomi Health Commercial |
$4,393.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,018.59
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$3,586.25
|
| Rate for Payer: PHP Medicaid |
$1,747.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,694.78
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,756.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,715.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$5,053.36
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP DNSP |
$3,260.23
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,358.12
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,018.59 |
| Max. Negotiated Rate |
$5,358.12 |
| Rate for Payer: Aetna Commercial |
$4,822.31
|
| Rate for Payer: ASR ASR |
$5,197.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,400.09
|
| Rate for Payer: BCN Commercial |
$4,400.09
|
| Rate for Payer: Cash Price |
$4,286.50
|
| Rate for Payer: Cofinity Commercial |
$5,036.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,286.50
|
| Rate for Payer: Healthscope Commercial |
$5,197.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,358.12
|
| Rate for Payer: Mclaren Commercial |
$4,822.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,554.40
|
| Rate for Payer: Nomi Health Commercial |
$4,393.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,018.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,715.15
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,729.01
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,296.76 |
| Max. Negotiated Rate |
$5,729.01 |
| Rate for Payer: Aetna Commercial |
$5,156.11
|
| Rate for Payer: ASR ASR |
$5,557.14
|
| Rate for Payer: BCBS Trust/PPO |
$4,704.66
|
| Rate for Payer: BCN Commercial |
$4,704.66
|
| Rate for Payer: Cash Price |
$4,583.21
|
| Rate for Payer: Cofinity Commercial |
$5,385.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,583.21
|
| Rate for Payer: Healthscope Commercial |
$5,557.14
|
| Rate for Payer: Healthscope Whirlpool |
$5,729.01
|
| Rate for Payer: Mclaren Commercial |
$5,156.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,869.66
|
| Rate for Payer: Nomi Health Commercial |
$4,697.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,041.53
|
|
