|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,628.34 |
| Max. Negotiated Rate |
$2,505.14 |
| Rate for Payer: Aetna Commercial |
$2,254.63
|
| Rate for Payer: ASR ASR |
$2,429.99
|
| Rate for Payer: ASR Commercial |
$2,429.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,041.44
|
| Rate for Payer: BCN Commercial |
$1,942.24
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$2,354.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Healthscope Commercial |
$2,505.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,429.99
|
| Rate for Payer: Mclaren Commercial |
$2,254.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: Nomi Health Commercial |
$2,054.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,204.52
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,002.06 |
| Max. Negotiated Rate |
$2,505.14 |
| Rate for Payer: Aetna Commercial |
$2,254.63
|
| Rate for Payer: Aetna Medicare |
$1,252.57
|
| Rate for Payer: ASR ASR |
$2,429.99
|
| Rate for Payer: ASR Commercial |
$2,429.99
|
| Rate for Payer: BCBS Complete |
$1,002.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,051.46
|
| Rate for Payer: BCN Commercial |
$1,942.24
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$2,354.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Healthscope Commercial |
$2,505.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,429.99
|
| Rate for Payer: Mclaren Commercial |
$2,254.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: Nomi Health Commercial |
$2,054.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,195.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,756.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,204.52
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$104.89 |
| Max. Negotiated Rate |
$262.22 |
| Rate for Payer: Aetna Commercial |
$236.00
|
| Rate for Payer: Aetna Medicare |
$131.11
|
| Rate for Payer: ASR ASR |
$254.35
|
| Rate for Payer: ASR Commercial |
$254.35
|
| Rate for Payer: BCBS Complete |
$104.89
|
| Rate for Payer: BCBS Trust/PPO |
$214.73
|
| Rate for Payer: BCN Commercial |
$203.30
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Healthscope Commercial |
$262.22
|
| Rate for Payer: Healthscope Whirlpool |
$254.35
|
| Rate for Payer: Mclaren Commercial |
$236.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: Nomi Health Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.76
|
| Rate for Payer: Priority Health Narrow Network |
$183.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.75
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$262.22 |
| Rate for Payer: Aetna Commercial |
$236.00
|
| Rate for Payer: ASR ASR |
$254.35
|
| Rate for Payer: ASR Commercial |
$254.35
|
| Rate for Payer: BCBS Trust/PPO |
$213.68
|
| Rate for Payer: BCN Commercial |
$203.30
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Healthscope Commercial |
$262.22
|
| Rate for Payer: Healthscope Whirlpool |
$254.35
|
| Rate for Payer: Mclaren Commercial |
$236.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: Nomi Health Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.75
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$19.67 |
| Rate for Payer: Aetna Commercial |
$17.70
|
| Rate for Payer: ASR ASR |
$19.08
|
| Rate for Payer: ASR Commercial |
$19.08
|
| Rate for Payer: BCBS Trust/PPO |
$16.03
|
| Rate for Payer: BCN Commercial |
$15.25
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Healthscope Commercial |
$19.67
|
| Rate for Payer: Healthscope Whirlpool |
$19.08
|
| Rate for Payer: Mclaren Commercial |
$17.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$16.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.31
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$19.67 |
| Rate for Payer: Aetna Commercial |
$17.70
|
| Rate for Payer: Aetna Medicare |
$3.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: ASR ASR |
$19.08
|
| Rate for Payer: ASR Commercial |
$19.08
|
| Rate for Payer: BCBS Complete |
$2.05
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.11
|
| Rate for Payer: BCN Commercial |
$15.25
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$19.67
|
| Rate for Payer: Healthscope Whirlpool |
$19.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.64
|
| Rate for Payer: Mclaren Commercial |
$17.70
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Mclaren Medicare |
$3.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$16.13
|
| Rate for Payer: PACE Medicare |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: PHP Medicaid |
$1.95
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.23
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow Network |
$13.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.64
|
| Rate for Payer: UHC Exchange |
$5.64
|
| Rate for Payer: UHC Medicare Advantage |
$3.64
|
| Rate for Payer: UHCCP DNSP |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: VA VA |
$3.64
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$47.41
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna Commercial |
$185.40
|
| Rate for Payer: ASR ASR |
$199.82
|
| Rate for Payer: ASR Commercial |
$199.82
|
| Rate for Payer: BCBS Trust/PPO |
$167.87
|
| Rate for Payer: BCN Commercial |
$159.71
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$193.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$206.00
|
| Rate for Payer: Healthscope Whirlpool |
$199.82
|
| Rate for Payer: Mclaren Commercial |
$185.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.28
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna Commercial |
$185.40
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$199.82
|
| Rate for Payer: ASR Commercial |
$199.82
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$168.69
|
| Rate for Payer: BCN Commercial |
$159.71
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$193.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$206.00
|
| Rate for Payer: Healthscope Whirlpool |
$199.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$185.40
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.50
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$144.41
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$95.88 |
| Rate for Payer: Aetna Commercial |
$86.29
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$93.00
|
| Rate for Payer: ASR Commercial |
$93.00
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$78.52
|
| Rate for Payer: BCN Commercial |
$74.34
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$90.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$95.88
|
| Rate for Payer: Healthscope Whirlpool |
$93.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$86.29
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: Nomi Health Commercial |
$78.62
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.01
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$67.21
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$62.32 |
| Max. Negotiated Rate |
$95.88 |
| Rate for Payer: Aetna Commercial |
$86.29
|
| Rate for Payer: ASR ASR |
$93.00
|
| Rate for Payer: ASR Commercial |
$93.00
|
| Rate for Payer: BCBS Trust/PPO |
$78.13
|
| Rate for Payer: BCN Commercial |
$74.34
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$90.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Healthscope Commercial |
$95.88
|
| Rate for Payer: Healthscope Whirlpool |
$93.00
|
| Rate for Payer: Mclaren Commercial |
$86.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: Nomi Health Commercial |
$78.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.37
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: ASR Commercial |
$125.14
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$105.65
|
| Rate for Payer: BCN Commercial |
$100.02
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$129.01
|
| Rate for Payer: Healthscope Whirlpool |
$125.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.04
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$90.44
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$83.86 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: ASR Commercial |
$125.14
|
| Rate for Payer: BCBS Trust/PPO |
$105.13
|
| Rate for Payer: BCN Commercial |
$100.02
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$129.01
|
| Rate for Payer: Healthscope Whirlpool |
$125.14
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$97.80 |
| Rate for Payer: Aetna Commercial |
$88.02
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$94.87
|
| Rate for Payer: ASR Commercial |
$94.87
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$80.09
|
| Rate for Payer: BCN Commercial |
$75.82
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$91.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$94.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$88.02
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.69
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$68.56
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$27.75
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP DNSP |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$63.57 |
| Max. Negotiated Rate |
$97.80 |
| Rate for Payer: Aetna Commercial |
$88.02
|
| Rate for Payer: ASR ASR |
$94.87
|
| Rate for Payer: ASR Commercial |
$94.87
|
| Rate for Payer: BCBS Trust/PPO |
$79.70
|
| Rate for Payer: BCN Commercial |
$75.82
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$91.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$94.87
|
| Rate for Payer: Mclaren Commercial |
$88.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.06
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$84.53 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Aetna Commercial |
$117.05
|
| Rate for Payer: ASR ASR |
$126.15
|
| Rate for Payer: ASR Commercial |
$126.15
|
| Rate for Payer: BCBS Trust/PPO |
$105.98
|
| Rate for Payer: BCN Commercial |
$100.83
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$122.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$130.05
|
| Rate for Payer: Healthscope Whirlpool |
$126.15
|
| Rate for Payer: Mclaren Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.44
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Aetna Commercial |
$117.05
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$126.15
|
| Rate for Payer: ASR Commercial |
$126.15
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$106.50
|
| Rate for Payer: BCN Commercial |
$100.83
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$122.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$130.05
|
| Rate for Payer: Healthscope Whirlpool |
$126.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.95
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$91.17
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$126.48 |
| Rate for Payer: Aetna Commercial |
$113.83
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$122.69
|
| Rate for Payer: ASR Commercial |
$122.69
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$103.57
|
| Rate for Payer: BCN Commercial |
$98.06
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$118.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$126.48
|
| Rate for Payer: Healthscope Whirlpool |
$122.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$113.83
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: Nomi Health Commercial |
$103.71
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.82
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$82.21 |
| Max. Negotiated Rate |
$126.48 |
| Rate for Payer: Aetna Commercial |
$113.83
|
| Rate for Payer: ASR ASR |
$122.69
|
| Rate for Payer: ASR Commercial |
$122.69
|
| Rate for Payer: BCBS Trust/PPO |
$103.07
|
| Rate for Payer: BCN Commercial |
$98.06
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$118.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Healthscope Commercial |
$126.48
|
| Rate for Payer: Healthscope Whirlpool |
$122.69
|
| Rate for Payer: Mclaren Commercial |
$113.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: Nomi Health Commercial |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.30
|
|
|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.89
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$15.26
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.11
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Mclaren Medicaid |
$14.53
|
| Rate for Payer: Mclaren Medicare |
$27.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Meridian Medicaid |
$15.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$29.82
|
| Rate for Payer: PHP Medicaid |
$14.53
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.11
|
| Rate for Payer: UHC Exchange |
$42.02
|
| Rate for Payer: UHC Medicare Advantage |
$27.11
|
| Rate for Payer: UHCCP DNSP |
$27.11
|
| Rate for Payer: UHCCP Medicaid |
$14.53
|
| Rate for Payer: VA VA |
$27.11
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,100.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,100.93
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,411.02
|
| Rate for Payer: PHP Medicaid |
$1,662.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$4,806.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP DNSP |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,474.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
|
|
HC WALNUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
