|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,729.01
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,119.73 |
| Max. Negotiated Rate |
$5,729.01 |
| Rate for Payer: Aetna Commercial |
$5,156.11
|
| Rate for Payer: Aetna Medicare |
$2,119.73
|
| Rate for Payer: ASR ASR |
$5,557.14
|
| Rate for Payer: BCBS Complete |
$2,291.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,723.57
|
| Rate for Payer: BCN Commercial |
$4,723.57
|
| 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: MI Amish Medical Board Commercial |
$4,583.21
|
| 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: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,019.76
|
| Rate for Payer: Priority Health Narrow Network |
$4,016.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,041.53
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$5,006.62
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,754.97 |
| Max. Negotiated Rate |
$5,006.62 |
| Rate for Payer: Aetna Commercial |
$4,505.96
|
| Rate for Payer: ASR ASR |
$4,856.42
|
| Rate for Payer: BCBS Trust/PPO |
$4,111.44
|
| Rate for Payer: BCN Commercial |
$4,111.44
|
| Rate for Payer: Cash Price |
$4,005.30
|
| Rate for Payer: Cofinity Commercial |
$4,706.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.30
|
| Rate for Payer: Healthscope Commercial |
$4,856.42
|
| Rate for Payer: Healthscope Whirlpool |
$5,006.62
|
| Rate for Payer: Mclaren Commercial |
$4,505.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.63
|
| Rate for Payer: Nomi Health Commercial |
$4,105.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,754.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,405.83
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$5,006.62
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$5,053.36 |
| Rate for Payer: Aetna Commercial |
$4,505.96
|
| 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 |
$4,856.42
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,127.96
|
| Rate for Payer: BCN Commercial |
$4,127.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$4,005.30
|
| Rate for Payer: Cash Price |
$4,005.30
|
| Rate for Payer: Cofinity Commercial |
$4,706.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$4,856.42
|
| Rate for Payer: Healthscope Whirlpool |
$5,006.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,260.23
|
| Rate for Payer: Mclaren Commercial |
$4,505.96
|
| 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 |
$4,255.63
|
| Rate for Payer: Nomi Health Commercial |
$4,105.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,754.97
|
| 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 |
$4,386.80
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,509.64
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,405.83
|
| 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 VERSACROSS KIT
|
Facility
|
OP
|
$3,714.23
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,374.27 |
| Max. Negotiated Rate |
$3,714.23 |
| Rate for Payer: Aetna Commercial |
$3,342.81
|
| Rate for Payer: Aetna Medicare |
$1,374.27
|
| Rate for Payer: ASR ASR |
$3,602.80
|
| Rate for Payer: BCBS Complete |
$1,485.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,062.38
|
| Rate for Payer: BCN Commercial |
$3,062.38
|
| Rate for Payer: Cash Price |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,491.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,971.38
|
| Rate for Payer: Healthscope Commercial |
$3,602.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,714.23
|
| Rate for Payer: Mclaren Commercial |
$3,342.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,971.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,157.10
|
| Rate for Payer: Nomi Health Commercial |
$3,045.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,785.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,254.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,603.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,268.52
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,714.23
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,785.67 |
| Max. Negotiated Rate |
$3,714.23 |
| Rate for Payer: Aetna Commercial |
$3,342.81
|
| Rate for Payer: ASR ASR |
$3,602.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,050.13
|
| Rate for Payer: BCN Commercial |
$3,050.13
|
| Rate for Payer: Cash Price |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,491.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,971.38
|
| Rate for Payer: Healthscope Commercial |
$3,602.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,714.23
|
| Rate for Payer: Mclaren Commercial |
$3,342.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,157.10
|
| Rate for Payer: Nomi Health Commercial |
$3,045.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,785.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,268.52
|
|
|
HC VERSAPAP SUPPLY
|
Facility
|
IP
|
$61.20
|
|
| Hospital Charge Code |
27000711
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$50.26
|
| Rate for Payer: BCN Commercial |
$50.26
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$59.36
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC VERSAPAP SUPPLY
|
Facility
|
OP
|
$61.20
|
|
| Hospital Charge Code |
27000711
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.64 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$22.64
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$50.46
|
| Rate for Payer: BCN Commercial |
$50.46
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$59.36
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.62
|
| Rate for Payer: Priority Health Narrow Network |
$42.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,838.93
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,380.40 |
| Max. Negotiated Rate |
$11,838.93 |
| Rate for Payer: Aetna Commercial |
$10,655.04
|
| Rate for Payer: Aetna Medicare |
$4,380.40
|
| Rate for Payer: ASR ASR |
$11,483.76
|
| Rate for Payer: BCBS Complete |
$4,735.57
|
| Rate for Payer: BCBS Trust/PPO |
$9,761.20
|
| Rate for Payer: BCN Commercial |
$9,761.20
|
| Rate for Payer: Cash Price |
$9,471.14
|
| Rate for Payer: Cofinity Commercial |
$11,128.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,471.14
|
| Rate for Payer: Healthscope Commercial |
$11,483.76
|
| Rate for Payer: Healthscope Whirlpool |
$11,838.93
|
| Rate for Payer: Mclaren Commercial |
$10,655.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,471.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,063.09
|
| Rate for Payer: Nomi Health Commercial |
$9,707.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,879.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,373.27
|
| Rate for Payer: Priority Health Narrow Network |
$8,299.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,418.26
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,838.93
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,879.20 |
| Max. Negotiated Rate |
$11,838.93 |
| Rate for Payer: Aetna Commercial |
$10,655.04
|
| Rate for Payer: ASR ASR |
$11,483.76
|
| Rate for Payer: BCBS Trust/PPO |
$9,722.13
|
| Rate for Payer: BCN Commercial |
$9,722.13
|
| Rate for Payer: Cash Price |
$9,471.14
|
| Rate for Payer: Cofinity Commercial |
$11,128.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,471.14
|
| Rate for Payer: Healthscope Commercial |
$11,483.76
|
| Rate for Payer: Healthscope Whirlpool |
$11,838.93
|
| Rate for Payer: Mclaren Commercial |
$10,655.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,063.09
|
| Rate for Payer: Nomi Health Commercial |
$9,707.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,879.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,418.26
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$11,830.21
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$11,830.21 |
| Rate for Payer: Aetna Commercial |
$10,647.19
|
| Rate for Payer: Aetna Medicare |
$7,230.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: ASR ASR |
$11,475.30
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,754.01
|
| Rate for Payer: BCN Commercial |
$9,754.01
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Cash Price |
$9,464.17
|
| Rate for Payer: Cash Price |
$9,464.17
|
| Rate for Payer: Cofinity Commercial |
$11,120.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,464.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Healthscope Commercial |
$11,475.30
|
| Rate for Payer: Healthscope Whirlpool |
$11,830.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,230.12
|
| Rate for Payer: Mclaren Commercial |
$10,647.19
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$3,970.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,055.68
|
| Rate for Payer: Nomi Health Commercial |
$9,700.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,872.66
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Commercial |
$7,953.13
|
| Rate for Payer: PHP Medicaid |
$3,875.34
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,365.63
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Narrow Network |
$8,292.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,410.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Exchange |
$11,206.69
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP DNSP |
$7,230.12
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$11,830.21
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,872.66 |
| Max. Negotiated Rate |
$11,830.21 |
| Rate for Payer: Aetna Commercial |
$10,647.19
|
| Rate for Payer: ASR ASR |
$11,475.30
|
| Rate for Payer: BCBS Trust/PPO |
$9,714.97
|
| Rate for Payer: BCN Commercial |
$9,714.97
|
| Rate for Payer: Cash Price |
$9,464.17
|
| Rate for Payer: Cofinity Commercial |
$11,120.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,464.17
|
| Rate for Payer: Healthscope Commercial |
$11,475.30
|
| Rate for Payer: Healthscope Whirlpool |
$11,830.21
|
| Rate for Payer: Mclaren Commercial |
$10,647.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,055.68
|
| Rate for Payer: Nomi Health Commercial |
$9,700.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,872.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,410.58
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$11,679.94
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$11,679.94 |
| Rate for Payer: Aetna Commercial |
$10,511.95
|
| Rate for Payer: Aetna Medicare |
$7,230.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: ASR ASR |
$11,329.54
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,630.11
|
| Rate for Payer: BCN Commercial |
$9,630.11
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Cash Price |
$9,343.95
|
| Rate for Payer: Cash Price |
$9,343.95
|
| Rate for Payer: Cofinity Commercial |
$10,979.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,343.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Healthscope Commercial |
$11,329.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,679.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,230.12
|
| Rate for Payer: Mclaren Commercial |
$10,511.95
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$3,970.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,927.95
|
| Rate for Payer: Nomi Health Commercial |
$9,577.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,759.95
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Commercial |
$7,953.13
|
| Rate for Payer: PHP Medicaid |
$3,875.34
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,233.96
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Narrow Network |
$8,187.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,278.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Exchange |
$11,206.69
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP DNSP |
$7,230.12
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$11,679.94
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,759.95 |
| Max. Negotiated Rate |
$11,679.94 |
| Rate for Payer: Aetna Commercial |
$10,511.95
|
| Rate for Payer: ASR ASR |
$11,329.54
|
| Rate for Payer: BCBS Trust/PPO |
$9,591.57
|
| Rate for Payer: BCN Commercial |
$9,591.57
|
| Rate for Payer: Cash Price |
$9,343.95
|
| Rate for Payer: Cofinity Commercial |
$10,979.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,343.95
|
| Rate for Payer: Healthscope Commercial |
$11,329.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,679.94
|
| Rate for Payer: Mclaren Commercial |
$10,511.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,927.95
|
| Rate for Payer: Nomi Health Commercial |
$9,577.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,759.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,278.35
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
OP
|
$1,276.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$472.13 |
| Max. Negotiated Rate |
$1,276.04 |
| Rate for Payer: Aetna Commercial |
$1,148.44
|
| Rate for Payer: Aetna Medicare |
$472.13
|
| Rate for Payer: ASR ASR |
$1,237.76
|
| Rate for Payer: BCBS Complete |
$510.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,052.09
|
| Rate for Payer: BCN Commercial |
$1,052.09
|
| Rate for Payer: Cash Price |
$1,020.83
|
| Rate for Payer: Cofinity Commercial |
$1,199.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.83
|
| Rate for Payer: Healthscope Commercial |
$1,237.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.04
|
| Rate for Payer: Mclaren Commercial |
$1,148.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,020.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,084.63
|
| Rate for Payer: Nomi Health Commercial |
$1,046.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$957.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,118.07
|
| Rate for Payer: Priority Health Narrow Network |
$894.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,122.92
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
IP
|
$1,276.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.03 |
| Max. Negotiated Rate |
$1,276.04 |
| Rate for Payer: Aetna Commercial |
$1,148.44
|
| Rate for Payer: ASR ASR |
$1,237.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,047.88
|
| Rate for Payer: BCN Commercial |
$1,047.88
|
| Rate for Payer: Cash Price |
$1,020.83
|
| Rate for Payer: Cofinity Commercial |
$1,199.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.83
|
| Rate for Payer: Healthscope Commercial |
$1,237.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.04
|
| Rate for Payer: Mclaren Commercial |
$1,148.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,084.63
|
| Rate for Payer: Nomi Health Commercial |
$1,046.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$957.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,122.92
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$6,388.10
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$11,206.69 |
| Rate for Payer: Aetna Commercial |
$5,749.29
|
| Rate for Payer: Aetna Medicare |
$7,230.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: ASR ASR |
$6,196.46
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$5,266.99
|
| Rate for Payer: BCN Commercial |
$5,266.99
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Cash Price |
$5,110.48
|
| Rate for Payer: Cash Price |
$5,110.48
|
| Rate for Payer: Cofinity Commercial |
$6,004.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Healthscope Commercial |
$6,196.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,388.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,230.12
|
| Rate for Payer: Mclaren Commercial |
$5,749.29
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$3,970.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.89
|
| Rate for Payer: Nomi Health Commercial |
$5,238.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.07
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Commercial |
$7,953.13
|
| Rate for Payer: PHP Medicaid |
$3,875.34
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,597.25
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,478.06
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,621.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Exchange |
$11,206.69
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP DNSP |
$7,230.12
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$6,388.10
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,791.07 |
| Max. Negotiated Rate |
$6,388.10 |
| Rate for Payer: Aetna Commercial |
$5,749.29
|
| Rate for Payer: ASR ASR |
$6,196.46
|
| Rate for Payer: BCBS Trust/PPO |
$5,245.91
|
| Rate for Payer: BCN Commercial |
$5,245.91
|
| Rate for Payer: Cash Price |
$5,110.48
|
| Rate for Payer: Cofinity Commercial |
$6,004.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.48
|
| Rate for Payer: Healthscope Commercial |
$6,196.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,388.10
|
| Rate for Payer: Mclaren Commercial |
$5,749.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.89
|
| Rate for Payer: Nomi Health Commercial |
$5,238.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,621.53
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$5,110.48
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,832.86 |
| Max. Negotiated Rate |
$5,110.48 |
| Rate for Payer: Aetna Commercial |
$4,599.43
|
| Rate for Payer: ASR ASR |
$4,957.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,196.73
|
| Rate for Payer: BCN Commercial |
$4,196.73
|
| Rate for Payer: Cash Price |
$4,088.38
|
| Rate for Payer: Cofinity Commercial |
$4,803.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,088.38
|
| Rate for Payer: Healthscope Commercial |
$4,957.17
|
| Rate for Payer: Healthscope Whirlpool |
$5,110.48
|
| Rate for Payer: Mclaren Commercial |
$4,599.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,343.91
|
| Rate for Payer: Nomi Health Commercial |
$4,190.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,832.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,497.22
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$5,110.48
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,582.45 |
| Max. Negotiated Rate |
$11,206.69 |
| Rate for Payer: Aetna Commercial |
$4,599.43
|
| Rate for Payer: Aetna Medicare |
$7,230.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: ASR ASR |
$4,957.17
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,213.59
|
| Rate for Payer: BCN Commercial |
$4,213.59
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Cash Price |
$4,088.38
|
| Rate for Payer: Cash Price |
$4,088.38
|
| Rate for Payer: Cofinity Commercial |
$4,803.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,088.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Healthscope Commercial |
$4,957.17
|
| Rate for Payer: Healthscope Whirlpool |
$5,110.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,230.12
|
| Rate for Payer: Mclaren Commercial |
$4,599.43
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$3,970.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,343.91
|
| Rate for Payer: Nomi Health Commercial |
$4,190.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,832.86
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Commercial |
$7,953.13
|
| Rate for Payer: PHP Medicaid |
$3,875.34
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,477.80
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Narrow Network |
$3,582.45
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,497.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Exchange |
$11,206.69
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP DNSP |
$7,230.12
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
HC VEST SUPPLY
|
Facility
|
IP
|
$474.00
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna Commercial |
$426.60
|
| Rate for Payer: ASR ASR |
$459.78
|
| Rate for Payer: BCBS Trust/PPO |
$389.25
|
| Rate for Payer: BCN Commercial |
$389.25
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$445.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.20
|
| Rate for Payer: Healthscope Commercial |
$459.78
|
| Rate for Payer: Healthscope Whirlpool |
$474.00
|
| Rate for Payer: Mclaren Commercial |
$426.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.90
|
| Rate for Payer: Nomi Health Commercial |
$388.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$417.12
|
|
|
HC VEST SUPPLY
|
Facility
|
OP
|
$474.00
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$175.38 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna Commercial |
$426.60
|
| Rate for Payer: Aetna Medicare |
$175.38
|
| Rate for Payer: ASR ASR |
$459.78
|
| Rate for Payer: BCBS Complete |
$189.60
|
| Rate for Payer: BCBS Trust/PPO |
$390.81
|
| Rate for Payer: BCN Commercial |
$390.81
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$445.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.20
|
| Rate for Payer: Healthscope Commercial |
$459.78
|
| Rate for Payer: Healthscope Whirlpool |
$474.00
|
| Rate for Payer: Mclaren Commercial |
$426.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$379.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.90
|
| Rate for Payer: Nomi Health Commercial |
$388.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$415.32
|
| Rate for Payer: Priority Health Narrow Network |
$332.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$417.12
|
|
|
HC VIABAHN 2
|
Facility
|
OP
|
$8,276.28
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,062.22 |
| Max. Negotiated Rate |
$8,276.28 |
| Rate for Payer: Aetna Commercial |
$7,448.65
|
| Rate for Payer: Aetna Medicare |
$3,062.22
|
| Rate for Payer: ASR ASR |
$8,027.99
|
| Rate for Payer: BCBS Complete |
$3,310.51
|
| Rate for Payer: BCBS Trust/PPO |
$6,823.79
|
| Rate for Payer: BCN Commercial |
$6,823.79
|
| Rate for Payer: Cash Price |
$6,621.02
|
| Rate for Payer: Cofinity Commercial |
$7,779.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,621.02
|
| Rate for Payer: Healthscope Commercial |
$8,027.99
|
| Rate for Payer: Healthscope Whirlpool |
$8,276.28
|
| Rate for Payer: Mclaren Commercial |
$7,448.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,621.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,034.84
|
| Rate for Payer: Nomi Health Commercial |
$6,786.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,207.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,251.68
|
| Rate for Payer: Priority Health Narrow Network |
$5,801.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,283.13
|
|
|
HC VIABAHN 2
|
Facility
|
IP
|
$8,276.28
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,207.21 |
| Max. Negotiated Rate |
$8,276.28 |
| Rate for Payer: Aetna Commercial |
$7,448.65
|
| Rate for Payer: ASR ASR |
$8,027.99
|
| Rate for Payer: BCBS Trust/PPO |
$6,796.48
|
| Rate for Payer: BCN Commercial |
$6,796.48
|
| Rate for Payer: Cash Price |
$6,621.02
|
| Rate for Payer: Cofinity Commercial |
$7,779.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,621.02
|
| Rate for Payer: Healthscope Commercial |
$8,027.99
|
| Rate for Payer: Healthscope Whirlpool |
$8,276.28
|
| Rate for Payer: Mclaren Commercial |
$7,448.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,034.84
|
| Rate for Payer: Nomi Health Commercial |
$6,786.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,207.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,283.13
|
|
|
HC VISCOSITY
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.67
|
| Rate for Payer: BCBS Trust/PPO |
$59.50
|
| Rate for Payer: BCN Commercial |
$59.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.67
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.67
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.67
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Mclaren Medicaid |
$11.67
|
| Rate for Payer: Mclaren Medicare |
$11.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.25
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.67
|
| Rate for Payer: PHP Commercial |
$12.84
|
| Rate for Payer: PHP Medicaid |
$6.26
|
| Rate for Payer: PHP Medicare Advantage |
$11.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.24
|
| Rate for Payer: Priority Health Medicare |
$11.67
|
| Rate for Payer: Priority Health Narrow Network |
$50.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.67
|
| Rate for Payer: UHC Exchange |
$18.09
|
| Rate for Payer: UHC Medicaid |
$6.10
|
| Rate for Payer: UHCCP DNSP |
$11.67
|
| Rate for Payer: UHCCP Medicaid |
$6.10
|
| Rate for Payer: VA VA |
$11.67
|
|
|
HC VISCOSITY
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
|
