|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$915.65 |
| Max. Negotiated Rate |
$1,408.69 |
| Rate for Payer: Aetna Commercial |
$1,267.82
|
| Rate for Payer: ASR ASR |
$1,366.43
|
| Rate for Payer: ASR Commercial |
$1,366.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.94
|
| Rate for Payer: BCN Commercial |
$1,092.16
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,324.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,408.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,366.43
|
| Rate for Payer: Mclaren Commercial |
$1,267.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.65
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$710.50
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.22
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$608.21
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Trust/PPO |
$707.03
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,020.74
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$663.48 |
| Max. Negotiated Rate |
$1,020.74 |
| Rate for Payer: Aetna Commercial |
$918.67
|
| Rate for Payer: ASR ASR |
$990.12
|
| Rate for Payer: ASR Commercial |
$990.12
|
| Rate for Payer: BCBS Trust/PPO |
$831.80
|
| Rate for Payer: BCN Commercial |
$791.38
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cofinity Commercial |
$959.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.59
|
| Rate for Payer: Healthscope Commercial |
$1,020.74
|
| Rate for Payer: Healthscope Whirlpool |
$990.12
|
| Rate for Payer: Mclaren Commercial |
$918.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.63
|
| Rate for Payer: Nomi Health Commercial |
$837.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$898.25
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,020.74
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,020.74 |
| Rate for Payer: Aetna Commercial |
$918.67
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$990.12
|
| Rate for Payer: ASR Commercial |
$990.12
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$835.88
|
| Rate for Payer: BCN Commercial |
$791.38
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cofinity Commercial |
$959.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,020.74
|
| Rate for Payer: Healthscope Whirlpool |
$990.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$918.67
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.63
|
| Rate for Payer: Nomi Health Commercial |
$837.01
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.37
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$715.54
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$898.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,279.47 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,618.83
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,651.32
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,116.72
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,693.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$557.92 |
| Max. Negotiated Rate |
$858.34 |
| Rate for Payer: Aetna Commercial |
$772.51
|
| Rate for Payer: ASR ASR |
$832.59
|
| Rate for Payer: ASR Commercial |
$832.59
|
| Rate for Payer: BCBS Trust/PPO |
$699.46
|
| Rate for Payer: BCN Commercial |
$665.47
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$806.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Healthscope Commercial |
$858.34
|
| Rate for Payer: Healthscope Whirlpool |
$832.59
|
| Rate for Payer: Mclaren Commercial |
$772.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: Nomi Health Commercial |
$703.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.34
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$343.34 |
| Max. Negotiated Rate |
$858.34 |
| Rate for Payer: Aetna Commercial |
$772.51
|
| Rate for Payer: Aetna Medicare |
$429.17
|
| Rate for Payer: ASR ASR |
$832.59
|
| Rate for Payer: ASR Commercial |
$832.59
|
| Rate for Payer: BCBS Complete |
$343.34
|
| Rate for Payer: BCBS Trust/PPO |
$702.89
|
| Rate for Payer: BCN Commercial |
$665.47
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$806.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Healthscope Commercial |
$858.34
|
| Rate for Payer: Healthscope Whirlpool |
$832.59
|
| Rate for Payer: Mclaren Commercial |
$772.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: Nomi Health Commercial |
$703.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.08
|
| Rate for Payer: Priority Health Narrow Network |
$601.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.34
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,316.93 |
| Max. Negotiated Rate |
$5,102.97 |
| Rate for Payer: Aetna Commercial |
$4,592.67
|
| Rate for Payer: ASR ASR |
$4,949.88
|
| Rate for Payer: ASR Commercial |
$4,949.88
|
| Rate for Payer: BCBS Trust/PPO |
$4,158.41
|
| Rate for Payer: BCN Commercial |
$3,956.33
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$4,796.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Healthscope Commercial |
$5,102.97
|
| Rate for Payer: Healthscope Whirlpool |
$4,949.88
|
| Rate for Payer: Mclaren Commercial |
$4,592.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: Nomi Health Commercial |
$4,184.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,490.61
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$5,102.97 |
| Rate for Payer: Aetna Commercial |
$4,592.67
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$4,949.88
|
| Rate for Payer: ASR Commercial |
$4,949.88
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,178.82
|
| Rate for Payer: BCN Commercial |
$3,956.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$4,796.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$5,102.97
|
| Rate for Payer: Healthscope Whirlpool |
$4,949.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$4,592.67
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: Nomi Health Commercial |
$4,184.44
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,471.22
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$3,577.18
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,490.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,546.53 |
| Max. Negotiated Rate |
$5,456.20 |
| Rate for Payer: Aetna Commercial |
$4,910.58
|
| Rate for Payer: ASR ASR |
$5,292.51
|
| Rate for Payer: ASR Commercial |
$5,292.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,446.26
|
| Rate for Payer: BCN Commercial |
$4,230.19
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$5,128.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Healthscope Commercial |
$5,456.20
|
| Rate for Payer: Healthscope Whirlpool |
$5,292.51
|
| Rate for Payer: Mclaren Commercial |
$4,910.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: Nomi Health Commercial |
$4,474.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,801.46
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,182.48 |
| Max. Negotiated Rate |
$5,456.20 |
| Rate for Payer: Aetna Commercial |
$4,910.58
|
| Rate for Payer: Aetna Medicare |
$2,728.10
|
| Rate for Payer: ASR ASR |
$5,292.51
|
| Rate for Payer: ASR Commercial |
$5,292.51
|
| Rate for Payer: BCBS Complete |
$2,182.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,468.08
|
| Rate for Payer: BCN Commercial |
$4,230.19
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$5,128.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Healthscope Commercial |
$5,456.20
|
| Rate for Payer: Healthscope Whirlpool |
$5,292.51
|
| Rate for Payer: Mclaren Commercial |
$4,910.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: Nomi Health Commercial |
$4,474.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,780.72
|
| Rate for Payer: Priority Health Narrow Network |
$3,824.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,801.46
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$4,291.39
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$4,625.16
|
| Rate for Payer: ASR Commercial |
$4,625.16
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,904.69
|
| Rate for Payer: BCN Commercial |
$3,696.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$4,482.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$4,768.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,625.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$4,291.39
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: Nomi Health Commercial |
$3,909.93
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,177.91
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$3,342.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,196.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,099.34 |
| Max. Negotiated Rate |
$4,768.21 |
| Rate for Payer: Aetna Commercial |
$4,291.39
|
| Rate for Payer: ASR ASR |
$4,625.16
|
| Rate for Payer: ASR Commercial |
$4,625.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,885.61
|
| Rate for Payer: BCN Commercial |
$3,696.79
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$4,482.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Healthscope Commercial |
$4,768.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,625.16
|
| Rate for Payer: Mclaren Commercial |
$4,291.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: Nomi Health Commercial |
$3,909.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,196.02
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,366.91 |
| Max. Negotiated Rate |
$3,641.40 |
| Rate for Payer: Aetna Commercial |
$3,277.26
|
| Rate for Payer: ASR ASR |
$3,532.16
|
| Rate for Payer: ASR Commercial |
$3,532.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.38
|
| Rate for Payer: BCN Commercial |
$2,823.18
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,422.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,641.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,532.16
|
| Rate for Payer: Mclaren Commercial |
$3,277.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Nomi Health Commercial |
$2,985.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.43
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,456.56 |
| Max. Negotiated Rate |
$3,641.40 |
| Rate for Payer: Aetna Commercial |
$3,277.26
|
| Rate for Payer: Aetna Medicare |
$1,820.70
|
| Rate for Payer: ASR ASR |
$3,532.16
|
| Rate for Payer: ASR Commercial |
$3,532.16
|
| Rate for Payer: BCBS Complete |
$1,456.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,981.94
|
| Rate for Payer: BCN Commercial |
$2,823.18
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,422.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,641.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,532.16
|
| Rate for Payer: Mclaren Commercial |
$3,277.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Nomi Health Commercial |
$2,985.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,190.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.43
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,544.41 |
| Max. Negotiated Rate |
$11,606.79 |
| Rate for Payer: Aetna Commercial |
$10,446.11
|
| Rate for Payer: ASR ASR |
$11,258.59
|
| Rate for Payer: ASR Commercial |
$11,258.59
|
| Rate for Payer: BCBS Trust/PPO |
$9,458.37
|
| Rate for Payer: BCN Commercial |
$8,998.74
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$10,910.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Healthscope Commercial |
$11,606.79
|
| Rate for Payer: Healthscope Whirlpool |
$11,258.59
|
| Rate for Payer: Mclaren Commercial |
$10,446.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: Nomi Health Commercial |
$9,517.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,213.98
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,642.72 |
| Max. Negotiated Rate |
$11,606.79 |
| Rate for Payer: Aetna Commercial |
$10,446.11
|
| Rate for Payer: Aetna Medicare |
$5,803.40
|
| Rate for Payer: ASR ASR |
$11,258.59
|
| Rate for Payer: ASR Commercial |
$11,258.59
|
| Rate for Payer: BCBS Complete |
$4,642.72
|
| Rate for Payer: BCBS Trust/PPO |
$9,504.80
|
| Rate for Payer: BCN Commercial |
$8,998.74
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$10,910.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Healthscope Commercial |
$11,606.79
|
| Rate for Payer: Healthscope Whirlpool |
$11,258.59
|
| Rate for Payer: Mclaren Commercial |
$10,446.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: Nomi Health Commercial |
$9,517.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,169.87
|
| Rate for Payer: Priority Health Narrow Network |
$8,136.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,213.98
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$11,266.87
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,323.47 |
| Max. Negotiated Rate |
$11,266.87 |
| Rate for Payer: Aetna Commercial |
$10,140.18
|
| Rate for Payer: ASR ASR |
$10,928.86
|
| Rate for Payer: ASR Commercial |
$10,928.86
|
| Rate for Payer: BCBS Trust/PPO |
$9,181.37
|
| Rate for Payer: BCN Commercial |
$8,735.20
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cofinity Commercial |
$10,590.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,013.50
|
| Rate for Payer: Healthscope Commercial |
$11,266.87
|
| Rate for Payer: Healthscope Whirlpool |
$10,928.86
|
| Rate for Payer: Mclaren Commercial |
$10,140.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,576.84
|
| Rate for Payer: Nomi Health Commercial |
$9,238.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,323.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,914.85
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$11,266.87
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,734.39 |
| Max. Negotiated Rate |
$11,266.87 |
| Rate for Payer: Aetna Commercial |
$10,140.18
|
| Rate for Payer: Aetna Medicare |
$6,967.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: ASR ASR |
$10,928.86
|
| Rate for Payer: ASR Commercial |
$10,928.86
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCBS Trust/PPO |
$9,226.44
|
| Rate for Payer: BCN Commercial |
$8,735.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cofinity Commercial |
$10,590.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,013.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$11,266.87
|
| Rate for Payer: Healthscope Whirlpool |
$10,928.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,967.14
|
| Rate for Payer: Mclaren Commercial |
$10,140.18
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,576.84
|
| Rate for Payer: Nomi Health Commercial |
$9,238.83
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$7,663.85
|
| Rate for Payer: PHP Medicaid |
$3,734.39
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,323.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,872.03
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health Narrow Network |
$7,898.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,914.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$10,799.07
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP DNSP |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$11,123.75
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,734.39 |
| Max. Negotiated Rate |
$11,123.75 |
| Rate for Payer: Aetna Commercial |
$10,011.38
|
| Rate for Payer: Aetna Medicare |
$6,967.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: ASR ASR |
$10,790.04
|
| Rate for Payer: ASR Commercial |
$10,790.04
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCBS Trust/PPO |
$9,109.24
|
| Rate for Payer: BCN Commercial |
$8,624.24
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cofinity Commercial |
$10,456.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,899.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$11,123.75
|
| Rate for Payer: Healthscope Whirlpool |
$10,790.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,967.14
|
| Rate for Payer: Mclaren Commercial |
$10,011.38
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,455.19
|
| Rate for Payer: Nomi Health Commercial |
$9,121.48
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$7,663.85
|
| Rate for Payer: PHP Medicaid |
$3,734.39
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,230.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,746.63
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health Narrow Network |
$7,797.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,788.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$10,799.07
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP DNSP |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$11,123.75
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,230.44 |
| Max. Negotiated Rate |
$11,123.75 |
| Rate for Payer: Aetna Commercial |
$10,011.38
|
| Rate for Payer: ASR ASR |
$10,790.04
|
| Rate for Payer: ASR Commercial |
$10,790.04
|
| Rate for Payer: BCBS Trust/PPO |
$9,064.74
|
| Rate for Payer: BCN Commercial |
$8,624.24
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cofinity Commercial |
$10,456.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,899.00
|
| Rate for Payer: Healthscope Commercial |
$11,123.75
|
| Rate for Payer: Healthscope Whirlpool |
$10,790.04
|
| Rate for Payer: Mclaren Commercial |
$10,011.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,455.19
|
| Rate for Payer: Nomi Health Commercial |
$9,121.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,230.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,788.90
|
|
