|
INFLAMMATORY BOWEL DISEASE WITH MCC
|
Facility
|
IP
|
$21,738.90
|
|
|
Service Code
|
MSDRG 385
|
| Min. Negotiated Rate |
$12,491.54 |
| Max. Negotiated Rate |
$21,738.90 |
| Rate for Payer: Aetna Medicare |
$13,148.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,436.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,436.24
|
| Rate for Payer: BCBS MAPPO |
$13,148.99
|
| Rate for Payer: BCN Medicare Advantage |
$13,148.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,148.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,148.99
|
| Rate for Payer: Mclaren Medicare |
$13,148.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,806.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,121.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,463.89
|
| Rate for Payer: PACE Medicare |
$12,491.54
|
| Rate for Payer: PACE SWMI |
$13,148.99
|
| Rate for Payer: PHP Commercial |
$14,463.89
|
| Rate for Payer: PHP Medicare Advantage |
$13,148.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21,738.90
|
| Rate for Payer: Priority Health Medicare |
$13,148.99
|
| Rate for Payer: Priority Health Narrow Network |
$17,391.12
|
| Rate for Payer: Railroad Medicare Medicare |
$13,148.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,148.99
|
| Rate for Payer: UHC Exchange |
$20,380.93
|
| Rate for Payer: UHCCP DNSP |
$13,148.99
|
| Rate for Payer: VA VA |
$13,148.99
|
|
|
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$10,324.04
|
|
|
Service Code
|
MSDRG 387
|
| Min. Negotiated Rate |
$6,327.64 |
| Max. Negotiated Rate |
$10,324.04 |
| Rate for Payer: Aetna Medicare |
$6,660.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,325.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,325.84
|
| Rate for Payer: BCBS MAPPO |
$6,660.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,660.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,660.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,660.67
|
| Rate for Payer: Mclaren Medicare |
$6,660.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,993.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,659.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,326.74
|
| Rate for Payer: PACE Medicare |
$6,327.64
|
| Rate for Payer: PACE SWMI |
$6,660.67
|
| Rate for Payer: PHP Commercial |
$7,326.74
|
| Rate for Payer: PHP Medicare Advantage |
$6,660.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,360.24
|
| Rate for Payer: Priority Health Medicare |
$6,660.67
|
| Rate for Payer: Priority Health Narrow Network |
$7,488.20
|
| Rate for Payer: Railroad Medicare Medicare |
$6,660.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,660.67
|
| Rate for Payer: UHC Exchange |
$10,324.04
|
| Rate for Payer: UHCCP DNSP |
$6,660.67
|
| Rate for Payer: VA VA |
$6,660.67
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,641.79
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,731.34 |
| Max. Negotiated Rate |
$3,641.79 |
| Rate for Payer: Aetna Commercial |
$3,277.61
|
| Rate for Payer: ASR ASR |
$3,532.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,990.64
|
| Rate for Payer: BCN Commercial |
$2,990.64
|
| Rate for Payer: Cash Price |
$2,913.43
|
| Rate for Payer: Cofinity Commercial |
$3,423.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.43
|
| Rate for Payer: Healthscope Commercial |
$3,532.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.79
|
| Rate for Payer: Mclaren Commercial |
$3,277.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.52
|
| Rate for Payer: Nomi Health Commercial |
$2,986.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.78
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,641.79
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$3,641.79 |
| Rate for Payer: Aetna Commercial |
$3,277.61
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.80
|
| Rate for Payer: ASR ASR |
$3,532.54
|
| Rate for Payer: BCBS Complete |
$17.05
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,002.66
|
| Rate for Payer: BCN Commercial |
$3,002.66
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$2,913.43
|
| Rate for Payer: Cash Price |
$2,913.43
|
| Rate for Payer: Cofinity Commercial |
$3,423.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$3,532.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.04
|
| Rate for Payer: Mclaren Commercial |
$3,277.61
|
| Rate for Payer: Mclaren Medicaid |
$31.04
|
| Rate for Payer: Mclaren Medicare |
$31.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Meridian Medicaid |
$17.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.52
|
| Rate for Payer: Nomi Health Commercial |
$2,986.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.34
|
| Rate for Payer: PACE Medicare |
$29.49
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Commercial |
$34.14
|
| Rate for Payer: PHP Medicaid |
$16.64
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.65
|
| Rate for Payer: Priority Health Medicare |
$31.04
|
| Rate for Payer: Priority Health Narrow Network |
$26.92
|
| Rate for Payer: Railroad Medicare Medicare |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.04
|
| Rate for Payer: UHC Exchange |
$48.11
|
| Rate for Payer: UHC Medicaid |
$16.23
|
| Rate for Payer: UHCCP DNSP |
$31.04
|
| Rate for Payer: UHCCP Medicaid |
$16.23
|
| Rate for Payer: VA VA |
$31.04
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,818.98
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.62 |
| Max. Negotiated Rate |
$1,818.98 |
| Rate for Payer: Aetna Commercial |
$1,637.08
|
| Rate for Payer: Aetna Medicare |
$26.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.55
|
| Rate for Payer: ASR ASR |
$1,764.41
|
| Rate for Payer: BCBS Complete |
$14.30
|
| Rate for Payer: BCBS MAPPO |
$26.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,499.75
|
| Rate for Payer: BCN Commercial |
$1,499.75
|
| Rate for Payer: BCN Medicare Advantage |
$26.04
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cofinity Commercial |
$1,709.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.04
|
| Rate for Payer: Healthscope Commercial |
$1,764.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.04
|
| Rate for Payer: Mclaren Commercial |
$1,637.08
|
| Rate for Payer: Mclaren Medicaid |
$26.04
|
| Rate for Payer: Mclaren Medicare |
$26.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.34
|
| Rate for Payer: Meridian Medicaid |
$14.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,546.13
|
| Rate for Payer: Nomi Health Commercial |
$1,491.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,364.23
|
| Rate for Payer: PACE Medicare |
$24.74
|
| Rate for Payer: PACE SWMI |
$26.04
|
| Rate for Payer: PHP Commercial |
$28.64
|
| Rate for Payer: PHP Medicaid |
$13.96
|
| Rate for Payer: PHP Medicare Advantage |
$26.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.95
|
| Rate for Payer: Priority Health Medicare |
$26.04
|
| Rate for Payer: Priority Health Narrow Network |
$19.16
|
| Rate for Payer: Railroad Medicare Medicare |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.04
|
| Rate for Payer: UHC Exchange |
$40.36
|
| Rate for Payer: UHC Medicaid |
$13.62
|
| Rate for Payer: UHCCP DNSP |
$26.04
|
| Rate for Payer: UHCCP Medicaid |
$13.62
|
| Rate for Payer: VA VA |
$26.04
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,818.98
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,364.23 |
| Max. Negotiated Rate |
$1,818.98 |
| Rate for Payer: Aetna Commercial |
$1,637.08
|
| Rate for Payer: ASR ASR |
$1,764.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,493.74
|
| Rate for Payer: BCN Commercial |
$1,493.74
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cofinity Commercial |
$1,709.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.18
|
| Rate for Payer: Healthscope Commercial |
$1,764.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.98
|
| Rate for Payer: Mclaren Commercial |
$1,637.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,546.13
|
| Rate for Payer: Nomi Health Commercial |
$1,491.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,364.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.70
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC
|
Facility
|
IP
|
$20,944.80
|
|
|
Service Code
|
MSDRG 351
|
| Min. Negotiated Rate |
$12,096.11 |
| Max. Negotiated Rate |
$20,944.80 |
| Rate for Payer: Aetna Medicare |
$12,732.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,915.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,915.94
|
| Rate for Payer: BCBS MAPPO |
$12,732.75
|
| Rate for Payer: BCN Medicare Advantage |
$12,732.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,732.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,732.75
|
| Rate for Payer: Mclaren Medicare |
$12,732.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,369.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,642.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,006.02
|
| Rate for Payer: PACE Medicare |
$12,096.11
|
| Rate for Payer: PACE SWMI |
$12,732.75
|
| Rate for Payer: PHP Commercial |
$14,006.02
|
| Rate for Payer: PHP Medicare Advantage |
$12,732.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20,944.80
|
| Rate for Payer: Priority Health Medicare |
$12,732.75
|
| Rate for Payer: Priority Health Narrow Network |
$16,755.84
|
| Rate for Payer: Railroad Medicare Medicare |
$12,732.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,732.75
|
| Rate for Payer: UHC Exchange |
$19,735.76
|
| Rate for Payer: UHCCP DNSP |
$12,732.75
|
| Rate for Payer: VA VA |
$12,732.75
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC
|
Facility
|
IP
|
$34,235.72
|
|
|
Service Code
|
MSDRG 350
|
| Min. Negotiated Rate |
$18,714.27 |
| Max. Negotiated Rate |
$34,235.72 |
| Rate for Payer: Aetna Medicare |
$19,699.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,624.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,624.04
|
| Rate for Payer: BCBS MAPPO |
$19,699.23
|
| Rate for Payer: BCN Medicare Advantage |
$19,699.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,699.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,699.23
|
| Rate for Payer: Mclaren Medicare |
$19,699.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,684.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,654.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,669.15
|
| Rate for Payer: PACE Medicare |
$18,714.27
|
| Rate for Payer: PACE SWMI |
$19,699.23
|
| Rate for Payer: PHP Commercial |
$21,669.15
|
| Rate for Payer: PHP Medicare Advantage |
$19,699.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34,235.72
|
| Rate for Payer: Priority Health Medicare |
$19,699.23
|
| Rate for Payer: Priority Health Narrow Network |
$27,388.57
|
| Rate for Payer: Railroad Medicare Medicare |
$19,699.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,699.23
|
| Rate for Payer: UHC Exchange |
$30,533.81
|
| Rate for Payer: UHCCP DNSP |
$19,699.23
|
| Rate for Payer: VA VA |
$19,699.23
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,044.17
|
|
|
Service Code
|
MSDRG 352
|
| Min. Negotiated Rate |
$9,655.87 |
| Max. Negotiated Rate |
$16,044.17 |
| Rate for Payer: Aetna Medicare |
$10,164.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,705.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,705.09
|
| Rate for Payer: BCBS MAPPO |
$10,164.07
|
| Rate for Payer: BCN Medicare Advantage |
$10,164.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,164.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,164.07
|
| Rate for Payer: Mclaren Medicare |
$10,164.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,672.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,688.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,180.48
|
| Rate for Payer: PACE Medicare |
$9,655.87
|
| Rate for Payer: PACE SWMI |
$10,164.07
|
| Rate for Payer: PHP Commercial |
$11,180.48
|
| Rate for Payer: PHP Medicare Advantage |
$10,164.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16,044.17
|
| Rate for Payer: Priority Health Medicare |
$10,164.07
|
| Rate for Payer: Priority Health Narrow Network |
$12,835.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10,164.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,164.07
|
| Rate for Payer: UHC Exchange |
$15,754.31
|
| Rate for Payer: UHCCP DNSP |
$10,164.07
|
| Rate for Payer: VA VA |
$10,164.07
|
|
|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$10,686.47
|
|
|
Service Code
|
APR-DRG 2283
|
| Min. Negotiated Rate |
$9,661.85 |
| Max. Negotiated Rate |
$10,686.47 |
| Rate for Payer: BCBS Complete |
$10,686.47
|
| Rate for Payer: Mclaren Medicaid |
$10,177.59
|
| Rate for Payer: Meridian Medicaid |
$10,686.47
|
| Rate for Payer: PHP Medicaid |
$9,661.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,177.59
|
| Rate for Payer: UHC Medicaid |
$10,177.59
|
| Rate for Payer: UHCCP Medicaid |
$10,177.59
|
|
|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$6,657.65
|
|
|
Service Code
|
APR-DRG 2281
|
| Min. Negotiated Rate |
$6,019.32 |
| Max. Negotiated Rate |
$6,657.65 |
| Rate for Payer: BCBS Complete |
$6,657.65
|
| Rate for Payer: Mclaren Medicaid |
$6,340.62
|
| Rate for Payer: Meridian Medicaid |
$6,657.65
|
| Rate for Payer: PHP Medicaid |
$6,019.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,340.62
|
| Rate for Payer: UHC Medicaid |
$6,340.62
|
| Rate for Payer: UHCCP Medicaid |
$6,340.62
|
|
|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$18,738.11
|
|
|
Service Code
|
APR-DRG 2284
|
| Min. Negotiated Rate |
$16,941.49 |
| Max. Negotiated Rate |
$18,738.11 |
| Rate for Payer: BCBS Complete |
$18,738.11
|
| Rate for Payer: Mclaren Medicaid |
$17,845.81
|
| Rate for Payer: Meridian Medicaid |
$18,738.11
|
| Rate for Payer: PHP Medicaid |
$16,941.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,845.81
|
| Rate for Payer: UHC Medicaid |
$17,845.81
|
| Rate for Payer: UHCCP Medicaid |
$17,845.81
|
|
|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$9,094.67
|
|
|
Service Code
|
APR-DRG 2282
|
| Min. Negotiated Rate |
$8,222.67 |
| Max. Negotiated Rate |
$9,094.67 |
| Rate for Payer: BCBS Complete |
$9,094.67
|
| Rate for Payer: Mclaren Medicaid |
$8,661.59
|
| Rate for Payer: Meridian Medicaid |
$9,094.67
|
| Rate for Payer: PHP Medicaid |
$8,222.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,661.59
|
| Rate for Payer: UHC Medicaid |
$8,661.59
|
| Rate for Payer: UHCCP Medicaid |
$8,661.59
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$25,930.90
|
|
|
Service Code
|
APR-DRG 1763
|
| Min. Negotiated Rate |
$23,444.64 |
| Max. Negotiated Rate |
$25,930.90 |
| Rate for Payer: BCBS Complete |
$25,930.90
|
| Rate for Payer: Mclaren Medicaid |
$24,696.10
|
| Rate for Payer: Meridian Medicaid |
$25,930.90
|
| Rate for Payer: PHP Medicaid |
$23,444.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,696.10
|
| Rate for Payer: UHC Medicaid |
$24,696.10
|
| Rate for Payer: UHCCP Medicaid |
$24,696.10
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$20,751.70
|
|
|
Service Code
|
APR-DRG 1762
|
| Min. Negotiated Rate |
$18,762.02 |
| Max. Negotiated Rate |
$20,751.70 |
| Rate for Payer: BCBS Complete |
$20,751.70
|
| Rate for Payer: Mclaren Medicaid |
$19,763.52
|
| Rate for Payer: Meridian Medicaid |
$20,751.70
|
| Rate for Payer: PHP Medicaid |
$18,762.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,763.52
|
| Rate for Payer: UHC Medicaid |
$19,763.52
|
| Rate for Payer: UHCCP Medicaid |
$19,763.52
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$10,124.08
|
|
|
Service Code
|
APR-DRG 1761
|
| Min. Negotiated Rate |
$9,153.38 |
| Max. Negotiated Rate |
$10,124.08 |
| Rate for Payer: BCBS Complete |
$10,124.08
|
| Rate for Payer: Mclaren Medicaid |
$9,641.98
|
| Rate for Payer: Meridian Medicaid |
$10,124.08
|
| Rate for Payer: PHP Medicaid |
$9,153.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,641.98
|
| Rate for Payer: UHC Medicaid |
$9,641.98
|
| Rate for Payer: UHCCP Medicaid |
$9,641.98
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$38,242.96
|
|
|
Service Code
|
APR-DRG 1764
|
| Min. Negotiated Rate |
$34,576.21 |
| Max. Negotiated Rate |
$38,242.96 |
| Rate for Payer: BCBS Complete |
$38,242.96
|
| Rate for Payer: Mclaren Medicaid |
$36,421.86
|
| Rate for Payer: Meridian Medicaid |
$38,242.96
|
| Rate for Payer: PHP Medicaid |
$34,576.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$36,421.86
|
| Rate for Payer: UHC Medicaid |
$36,421.86
|
| Rate for Payer: UHCCP Medicaid |
$36,421.86
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.73 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Trust/PPO |
$94.96
|
| Rate for Payer: BCN Commercial |
$94.96
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.73 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Trust/PPO |
$94.96
|
| Rate for Payer: BCN Commercial |
$94.96
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.79 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: Aetna Medicare |
$42.79
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Complete |
$46.26
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.32
|
| Rate for Payer: Priority Health Narrow Network |
$81.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.79 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: Aetna Medicare |
$42.79
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Complete |
$46.26
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.32
|
| Rate for Payer: Priority Health Narrow Network |
$81.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$63.93
|
|
|
Service Code
|
NDC 169633910
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.95 |
| Max. Negotiated Rate |
$63.93 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: ASR ASR |
$62.02
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$60.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Healthscope Commercial |
$62.02
|
| Rate for Payer: Healthscope Whirlpool |
$63.93
|
| Rate for Payer: Mclaren Commercial |
$57.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.34
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.26
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$63.93
|
|
|
Service Code
|
NDC 169633910
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$63.93 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$23.66
|
| Rate for Payer: ASR ASR |
$62.02
|
| Rate for Payer: BCBS Complete |
$25.57
|
| Rate for Payer: BCBS Trust/PPO |
$52.71
|
| Rate for Payer: BCN Commercial |
$52.71
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$60.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Healthscope Commercial |
$62.02
|
| Rate for Payer: Healthscope Whirlpool |
$63.93
|
| Rate for Payer: Mclaren Commercial |
$57.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.34
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.02
|
| Rate for Payer: Priority Health Narrow Network |
$44.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.26
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.73 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Trust/PPO |
$94.96
|
| Rate for Payer: BCN Commercial |
$94.96
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.79 |
| Max. Negotiated Rate |
$115.64 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: Aetna Medicare |
$42.79
|
| Rate for Payer: ASR ASR |
$112.17
|
| Rate for Payer: BCBS Complete |
$46.26
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$108.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$112.17
|
| Rate for Payer: Healthscope Whirlpool |
$115.64
|
| Rate for Payer: Mclaren Commercial |
$104.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.32
|
| Rate for Payer: Priority Health Narrow Network |
$81.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.76
|
|
