|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: ASR ASR |
$20.37
|
| Rate for Payer: BCBS Trust/PPO |
$16.28
|
| Rate for Payer: BCN Commercial |
$16.28
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$19.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$21.00
|
| Rate for Payer: Healthscope Whirlpool |
$20.37
|
| Rate for Payer: Mclaren Commercial |
$18.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.48
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$20.37
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$16.28
|
| Rate for Payer: BCN Commercial |
$16.28
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$19.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$21.00
|
| Rate for Payer: Healthscope Whirlpool |
$20.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$18.90
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$87.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.48
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ABBY RETRACTOR
|
Facility
|
IP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.96 |
| Max. Negotiated Rate |
$259.95 |
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: ASR ASR |
$252.15
|
| Rate for Payer: BCBS Trust/PPO |
$201.54
|
| Rate for Payer: BCN Commercial |
$201.54
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$244.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Healthscope Commercial |
$259.95
|
| Rate for Payer: Healthscope Whirlpool |
$252.15
|
| Rate for Payer: Mclaren Commercial |
$233.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.76
|
|
|
HC ABBY RETRACTOR
|
Facility
|
OP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.98 |
| Max. Negotiated Rate |
$259.95 |
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: ASR ASR |
$252.15
|
| Rate for Payer: BCBS Complete |
$103.98
|
| Rate for Payer: BCBS Trust/PPO |
$201.54
|
| Rate for Payer: BCN Commercial |
$201.54
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$244.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Healthscope Commercial |
$259.95
|
| Rate for Payer: Healthscope Whirlpool |
$252.15
|
| Rate for Payer: Mclaren Commercial |
$233.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.55
|
| Rate for Payer: Priority Health Narrow Network |
$184.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.76
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,006.03 |
| Max. Negotiated Rate |
$2,515.07 |
| Rate for Payer: Aetna Commercial |
$2,263.56
|
| Rate for Payer: ASR ASR |
$2,439.62
|
| Rate for Payer: BCBS Complete |
$1,006.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.93
|
| Rate for Payer: BCN Commercial |
$1,949.93
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$2,364.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Healthscope Commercial |
$2,515.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,439.62
|
| Rate for Payer: Mclaren Commercial |
$2,263.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,785.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,213.26
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,760.55 |
| Max. Negotiated Rate |
$2,515.07 |
| Rate for Payer: Aetna Commercial |
$2,263.56
|
| Rate for Payer: ASR ASR |
$2,439.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.93
|
| Rate for Payer: BCN Commercial |
$1,949.93
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$2,364.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Healthscope Commercial |
$2,515.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,439.62
|
| Rate for Payer: Mclaren Commercial |
$2,263.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,213.26
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$618.41 |
| Max. Negotiated Rate |
$1,546.02 |
| Rate for Payer: Aetna Commercial |
$1,391.42
|
| Rate for Payer: ASR ASR |
$1,499.64
|
| Rate for Payer: BCBS Complete |
$618.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.63
|
| Rate for Payer: BCN Commercial |
$1,198.63
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,453.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Healthscope Commercial |
$1,546.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.64
|
| Rate for Payer: Mclaren Commercial |
$1,391.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.50
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,082.21 |
| Max. Negotiated Rate |
$1,546.02 |
| Rate for Payer: Aetna Commercial |
$1,391.42
|
| Rate for Payer: ASR ASR |
$1,499.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.63
|
| Rate for Payer: BCN Commercial |
$1,198.63
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,453.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Healthscope Commercial |
$1,546.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.64
|
| Rate for Payer: Mclaren Commercial |
$1,391.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.50
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,761.75 |
| Max. Negotiated Rate |
$3,945.36 |
| Rate for Payer: Aetna Commercial |
$3,550.82
|
| Rate for Payer: ASR ASR |
$3,827.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,058.84
|
| Rate for Payer: BCN Commercial |
$3,058.84
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$3,708.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Healthscope Commercial |
$3,945.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,827.00
|
| Rate for Payer: Mclaren Commercial |
$3,550.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.92
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$3,945.36 |
| Rate for Payer: Aetna Commercial |
$3,550.82
|
| Rate for Payer: Aetna Medicare |
$1,716.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: ASR ASR |
$3,827.00
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,058.84
|
| Rate for Payer: BCN Commercial |
$3,058.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$3,708.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$3,945.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,827.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$3,550.82
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: PHP Medicaid |
$938.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,839.50
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,841.41 |
| Max. Negotiated Rate |
$2,630.58 |
| Rate for Payer: Aetna Commercial |
$2,367.52
|
| Rate for Payer: ASR ASR |
$2,551.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.49
|
| Rate for Payer: BCN Commercial |
$2,039.49
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,472.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Healthscope Commercial |
$2,630.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.66
|
| Rate for Payer: Mclaren Commercial |
$2,367.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.91
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$2,630.58 |
| Rate for Payer: Aetna Commercial |
$2,367.52
|
| Rate for Payer: Aetna Medicare |
$1,716.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: ASR ASR |
$2,551.66
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.49
|
| Rate for Payer: BCN Commercial |
$2,039.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,472.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,630.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$2,367.52
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: PHP Medicaid |
$938.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,839.50
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.62
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.13
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.71 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.71 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.62
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.13
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.71 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.62
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.13
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.62
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$882.13
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$869.71 |
| Max. Negotiated Rate |
$1,242.44 |
| Rate for Payer: Aetna Commercial |
$1,118.20
|
| Rate for Payer: ASR ASR |
$1,205.17
|
| Rate for Payer: BCBS Trust/PPO |
$963.26
|
| Rate for Payer: BCN Commercial |
$963.26
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,167.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,242.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,205.17
|
| Rate for Payer: Mclaren Commercial |
$1,118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.35
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,873.62 |
| Max. Negotiated Rate |
$8,390.89 |
| Rate for Payer: Aetna Commercial |
$7,551.80
|
| Rate for Payer: ASR ASR |
$8,139.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,505.46
|
| Rate for Payer: BCN Commercial |
$6,505.46
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$7,887.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Healthscope Commercial |
$8,390.89
|
| Rate for Payer: Healthscope Whirlpool |
$8,139.16
|
| Rate for Payer: Mclaren Commercial |
$7,551.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,383.98
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,631.15 |
| Max. Negotiated Rate |
$8,390.89 |
| Rate for Payer: Aetna Commercial |
$7,551.80
|
| Rate for Payer: Aetna Medicare |
$6,638.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,297.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,297.88
|
| Rate for Payer: ASR ASR |
$8,139.16
|
| Rate for Payer: BCBS Complete |
$3,813.04
|
| Rate for Payer: BCBS MAPPO |
$6,638.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,505.46
|
| Rate for Payer: BCN Commercial |
$6,505.46
|
| Rate for Payer: BCN Medicare Advantage |
$6,638.30
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$7,887.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,638.30
|
| Rate for Payer: Healthscope Commercial |
$8,390.89
|
| Rate for Payer: Healthscope Whirlpool |
$8,139.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,638.30
|
| Rate for Payer: Mclaren Commercial |
$7,551.80
|
| Rate for Payer: Mclaren Medicaid |
$3,631.15
|
| Rate for Payer: Mclaren Medicare |
$6,638.30
|
| Rate for Payer: Meridian Medicaid |
$3,813.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,970.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,634.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: PACE Medicare |
$6,306.38
|
| Rate for Payer: PACE SWMI |
$6,638.30
|
| Rate for Payer: PHP Commercial |
$7,302.13
|
| Rate for Payer: PHP Medicaid |
$3,631.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,638.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,631.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,635.71
|
| Rate for Payer: Priority Health Medicare |
$6,638.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,957.53
|
| Rate for Payer: Railroad Medicare Medicare |
$6,638.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,383.98
|
| Rate for Payer: UHC Medicare Advantage |
$6,837.45
|
| Rate for Payer: VA VA |
$6,638.30
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,650.15 |
| Max. Negotiated Rate |
$14,623.31 |
| Rate for Payer: Aetna Commercial |
$5,978.76
|
| Rate for Payer: Aetna Medicare |
$11,698.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,623.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,623.31
|
| Rate for Payer: ASR ASR |
$6,443.78
|
| Rate for Payer: BCBS Complete |
$6,719.70
|
| Rate for Payer: BCBS MAPPO |
$11,698.65
|
| Rate for Payer: BCBS Trust/PPO |
$5,150.37
|
| Rate for Payer: BCN Commercial |
$5,150.37
|
| Rate for Payer: BCN Medicare Advantage |
$11,698.65
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$6,244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,698.65
|
| Rate for Payer: Healthscope Commercial |
$6,643.07
|
| Rate for Payer: Healthscope Whirlpool |
$6,443.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,698.65
|
| Rate for Payer: Mclaren Commercial |
$5,978.76
|
| Rate for Payer: Mclaren Medicaid |
$6,399.16
|
| Rate for Payer: Mclaren Medicare |
$11,698.65
|
| Rate for Payer: Meridian Medicaid |
$6,719.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,283.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,453.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: PACE Medicare |
$11,113.72
|
| Rate for Payer: PACE SWMI |
$11,698.65
|
| Rate for Payer: PHP Commercial |
$12,868.52
|
| Rate for Payer: PHP Medicaid |
$6,399.16
|
| Rate for Payer: PHP Medicare Advantage |
$11,698.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,399.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,045.19
|
| Rate for Payer: Priority Health Medicare |
$11,698.65
|
| Rate for Payer: Priority Health Narrow Network |
$4,716.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11,698.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,845.90
|
| Rate for Payer: UHC Medicare Advantage |
$12,049.61
|
| Rate for Payer: VA VA |
$11,698.65
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,650.15 |
| Max. Negotiated Rate |
$6,643.07 |
| Rate for Payer: Aetna Commercial |
$5,978.76
|
| Rate for Payer: ASR ASR |
$6,443.78
|
| Rate for Payer: BCBS Trust/PPO |
$5,150.37
|
| Rate for Payer: BCN Commercial |
$5,150.37
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$6,244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Healthscope Commercial |
$6,643.07
|
| Rate for Payer: Healthscope Whirlpool |
$6,443.78
|
| Rate for Payer: Mclaren Commercial |
$5,978.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,845.90
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$749.70 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: ASR ASR |
$1,038.87
|
| Rate for Payer: BCBS Trust/PPO |
$830.35
|
| Rate for Payer: BCN Commercial |
$830.35
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$1,006.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.87
|
| Rate for Payer: Mclaren Commercial |
$963.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
|
