|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$608.92
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$456.69 |
| Max. Negotiated Rate |
$608.92 |
| Rate for Payer: Aetna Commercial |
$548.03
|
| Rate for Payer: ASR ASR |
$590.65
|
| Rate for Payer: BCBS Trust/PPO |
$500.05
|
| Rate for Payer: BCN Commercial |
$500.05
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cofinity Commercial |
$572.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.14
|
| Rate for Payer: Healthscope Commercial |
$590.65
|
| Rate for Payer: Healthscope Whirlpool |
$608.92
|
| Rate for Payer: Mclaren Commercial |
$548.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.58
|
| Rate for Payer: Nomi Health Commercial |
$499.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$535.85
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$608.92
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$608.92 |
| Rate for Payer: Aetna Commercial |
$548.03
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$590.65
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$502.05
|
| Rate for Payer: BCN Commercial |
$502.05
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cofinity Commercial |
$572.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$590.65
|
| Rate for Payer: Healthscope Whirlpool |
$608.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$548.03
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.58
|
| Rate for Payer: Nomi Health Commercial |
$499.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.69
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$533.54
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$426.85
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$535.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$447.83
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$538.81 |
| Rate for Payer: Aetna Commercial |
$403.05
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$434.40
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$369.24
|
| Rate for Payer: BCN Commercial |
$369.24
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cofinity Commercial |
$420.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$434.40
|
| Rate for Payer: Healthscope Whirlpool |
$447.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$403.05
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$367.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.87
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$459.42
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$367.53
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$447.83
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$335.87 |
| Max. Negotiated Rate |
$447.83 |
| Rate for Payer: Aetna Commercial |
$403.05
|
| Rate for Payer: ASR ASR |
$434.40
|
| Rate for Payer: BCBS Trust/PPO |
$367.76
|
| Rate for Payer: BCN Commercial |
$367.76
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cofinity Commercial |
$420.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.26
|
| Rate for Payer: Healthscope Commercial |
$434.40
|
| Rate for Payer: Healthscope Whirlpool |
$447.83
|
| Rate for Payer: Mclaren Commercial |
$403.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$367.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.09
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$520.60 |
| Rate for Payer: Aetna Commercial |
$468.54
|
| 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 |
$504.98
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$429.23
|
| Rate for Payer: BCN Commercial |
$429.23
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$489.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$504.98
|
| Rate for Payer: Healthscope Whirlpool |
$520.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$468.54
|
| 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 |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| 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 |
$516.31
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$413.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.13
|
| 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 XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$390.45 |
| Max. Negotiated Rate |
$520.60 |
| Rate for Payer: Aetna Commercial |
$468.54
|
| Rate for Payer: ASR ASR |
$504.98
|
| Rate for Payer: BCBS Trust/PPO |
$427.52
|
| Rate for Payer: BCN Commercial |
$427.52
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$489.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$504.98
|
| Rate for Payer: Healthscope Whirlpool |
$520.60
|
| Rate for Payer: Mclaren Commercial |
$468.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.13
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$624.65 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Trust/PPO |
$683.95
|
| Rate for Payer: BCN Commercial |
$683.95
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$686.70
|
| Rate for Payer: BCN Commercial |
$686.70
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$459.42
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$367.53
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$326.90
|
| Rate for Payer: BCN Commercial |
$326.90
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$265.10
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$212.08
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$297.36 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Trust/PPO |
$325.59
|
| Rate for Payer: BCN Commercial |
$325.59
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Trust/PPO |
$299.35
|
| Rate for Payer: BCN Commercial |
$299.35
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$300.55
|
| Rate for Payer: BCN Commercial |
$300.55
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$265.10
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$212.08
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$297.36 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Trust/PPO |
$325.59
|
| Rate for Payer: BCN Commercial |
$325.59
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$326.90
|
| Rate for Payer: BCN Commercial |
$326.90
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.68
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$228.55
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Trust/PPO |
$299.35
|
| Rate for Payer: BCN Commercial |
$299.35
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$300.55
|
| Rate for Payer: BCN Commercial |
$300.55
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.68
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$228.55
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$425.08 |
| Max. Negotiated Rate |
$566.77 |
| Rate for Payer: Aetna Commercial |
$510.09
|
| Rate for Payer: ASR ASR |
$549.77
|
| Rate for Payer: BCBS Trust/PPO |
$465.43
|
| Rate for Payer: BCN Commercial |
$465.43
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$532.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$549.77
|
| Rate for Payer: Healthscope Whirlpool |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$510.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.76
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$209.70 |
| Max. Negotiated Rate |
$566.77 |
| Rate for Payer: Aetna Commercial |
$510.09
|
| Rate for Payer: Aetna Medicare |
$209.70
|
| Rate for Payer: ASR ASR |
$549.77
|
| Rate for Payer: BCBS Complete |
$226.71
|
| Rate for Payer: BCBS Trust/PPO |
$467.30
|
| Rate for Payer: BCN Commercial |
$467.30
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$532.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$549.77
|
| Rate for Payer: Healthscope Whirlpool |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$510.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$496.60
|
| Rate for Payer: Priority Health Narrow Network |
$397.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.76
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.23 |
| Max. Negotiated Rate |
$268.31 |
| Rate for Payer: Aetna Commercial |
$241.48
|
| Rate for Payer: ASR ASR |
$260.26
|
| Rate for Payer: BCBS Trust/PPO |
$220.34
|
| Rate for Payer: BCN Commercial |
$220.34
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Commercial |
$252.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Healthscope Commercial |
$260.26
|
| Rate for Payer: Healthscope Whirlpool |
$268.31
|
| Rate for Payer: Mclaren Commercial |
$241.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Nomi Health Commercial |
$220.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.11
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$99.27 |
| Max. Negotiated Rate |
$268.31 |
| Rate for Payer: Aetna Commercial |
$241.48
|
| Rate for Payer: Aetna Medicare |
$99.27
|
| Rate for Payer: ASR ASR |
$260.26
|
| Rate for Payer: BCBS Complete |
$107.32
|
| Rate for Payer: BCBS Trust/PPO |
$221.22
|
| Rate for Payer: BCN Commercial |
$221.22
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Commercial |
$252.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Healthscope Commercial |
$260.26
|
| Rate for Payer: Healthscope Whirlpool |
$268.31
|
| Rate for Payer: Mclaren Commercial |
$241.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Nomi Health Commercial |
$220.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$235.09
|
| Rate for Payer: Priority Health Narrow Network |
$188.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.11
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$655.74 |
| Rate for Payer: Aetna Commercial |
$590.17
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$636.07
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$540.66
|
| Rate for Payer: BCN Commercial |
$540.66
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$616.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$636.07
|
| Rate for Payer: Healthscope Whirlpool |
$655.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$590.17
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$315.96
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$252.76
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$491.81 |
| Max. Negotiated Rate |
$655.74 |
| Rate for Payer: Aetna Commercial |
$590.17
|
| Rate for Payer: ASR ASR |
$636.07
|
| Rate for Payer: BCBS Trust/PPO |
$538.49
|
| Rate for Payer: BCN Commercial |
$538.49
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$616.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$636.07
|
| Rate for Payer: Healthscope Whirlpool |
$655.74
|
| Rate for Payer: Mclaren Commercial |
$590.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.05
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$375.62 |
| Max. Negotiated Rate |
$500.82 |
| Rate for Payer: Aetna Commercial |
$450.74
|
| Rate for Payer: ASR ASR |
$485.80
|
| Rate for Payer: BCBS Trust/PPO |
$411.27
|
| Rate for Payer: BCN Commercial |
$411.27
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Commercial |
$470.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Healthscope Commercial |
$485.80
|
| Rate for Payer: Healthscope Whirlpool |
$500.82
|
| Rate for Payer: Mclaren Commercial |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Nomi Health Commercial |
$410.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.72
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$185.30 |
| Max. Negotiated Rate |
$500.82 |
| Rate for Payer: Aetna Commercial |
$450.74
|
| Rate for Payer: Aetna Medicare |
$185.30
|
| Rate for Payer: ASR ASR |
$485.80
|
| Rate for Payer: BCBS Complete |
$200.33
|
| Rate for Payer: BCBS Trust/PPO |
$412.93
|
| Rate for Payer: BCN Commercial |
$412.93
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Commercial |
$470.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Healthscope Commercial |
$485.80
|
| Rate for Payer: Healthscope Whirlpool |
$500.82
|
| Rate for Payer: Mclaren Commercial |
$450.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Nomi Health Commercial |
$410.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$438.82
|
| Rate for Payer: Priority Health Narrow Network |
$351.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.72
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$491.81 |
| Max. Negotiated Rate |
$655.74 |
| Rate for Payer: Aetna Commercial |
$590.17
|
| Rate for Payer: ASR ASR |
$636.07
|
| Rate for Payer: BCBS Trust/PPO |
$538.49
|
| Rate for Payer: BCN Commercial |
$538.49
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$616.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$636.07
|
| Rate for Payer: Healthscope Whirlpool |
$655.74
|
| Rate for Payer: Mclaren Commercial |
$590.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.05
|
|
