|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$428.40 |
| 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 Complete |
$428.40
|
| 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: Priority Health HMO/PPO/Tiered Network |
$974.61
|
| Rate for Payer: Priority Health Narrow Network |
$760.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,841.43 |
| Max. Negotiated Rate |
$2,630.61 |
| Rate for Payer: Aetna Commercial |
$2,367.55
|
| Rate for Payer: ASR ASR |
$2,551.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.51
|
| Rate for Payer: BCN Commercial |
$2,039.51
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,472.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,630.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.69
|
| Rate for Payer: Mclaren Commercial |
$2,367.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.94
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$2,630.61 |
| Rate for Payer: Aetna Commercial |
$2,367.55
|
| 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 |
$2,551.69
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.51
|
| Rate for Payer: BCN Commercial |
$2,039.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,472.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,630.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$2,367.55
|
| 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 |
$2,236.02
|
| 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 |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,393.86
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,867.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$428.40 |
| 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 Complete |
$428.40
|
| 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: Priority Health HMO/PPO/Tiered Network |
$974.61
|
| Rate for Payer: Priority Health Narrow Network |
$760.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
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
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,841.43 |
| Max. Negotiated Rate |
$2,630.61 |
| Rate for Payer: Aetna Commercial |
$2,367.55
|
| Rate for Payer: ASR ASR |
$2,551.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.51
|
| Rate for Payer: BCN Commercial |
$2,039.51
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,472.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,630.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.69
|
| Rate for Payer: Mclaren Commercial |
$2,367.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.94
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$2,630.61 |
| Rate for Payer: Aetna Commercial |
$2,367.55
|
| 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 |
$2,551.69
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.51
|
| Rate for Payer: BCN Commercial |
$2,039.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,472.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,630.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,551.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$2,367.55
|
| 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 |
$2,236.02
|
| 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 |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,393.86
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,867.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,314.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,704.61 |
| Max. Negotiated Rate |
$4,261.53 |
| Rate for Payer: Aetna Commercial |
$3,835.38
|
| Rate for Payer: ASR ASR |
$4,133.68
|
| Rate for Payer: BCBS Complete |
$1,704.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,303.96
|
| Rate for Payer: BCN Commercial |
$3,303.96
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$4,005.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Healthscope Commercial |
$4,261.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,133.68
|
| Rate for Payer: Mclaren Commercial |
$3,835.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,025.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,750.15
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,983.07 |
| Max. Negotiated Rate |
$4,261.53 |
| Rate for Payer: Aetna Commercial |
$3,835.38
|
| Rate for Payer: ASR ASR |
$4,133.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,303.96
|
| Rate for Payer: BCN Commercial |
$3,303.96
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$4,005.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Healthscope Commercial |
$4,261.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,133.68
|
| Rate for Payer: Mclaren Commercial |
$3,835.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,750.15
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$5,796.29
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,318.52 |
| Max. Negotiated Rate |
$5,796.29 |
| Rate for Payer: Aetna Commercial |
$5,216.66
|
| Rate for Payer: ASR ASR |
$5,622.40
|
| Rate for Payer: BCBS Complete |
$2,318.52
|
| Rate for Payer: BCBS Trust/PPO |
$4,493.86
|
| Rate for Payer: BCN Commercial |
$4,493.86
|
| Rate for Payer: Cash Price |
$4,637.03
|
| Rate for Payer: Cofinity Commercial |
$5,448.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
| Rate for Payer: Healthscope Commercial |
$5,796.29
|
| Rate for Payer: Healthscope Whirlpool |
$5,622.40
|
| Rate for Payer: Mclaren Commercial |
$5,216.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,274.62
|
| Rate for Payer: Priority Health Narrow Network |
$4,115.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,100.74
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,796.29
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,057.40 |
| Max. Negotiated Rate |
$5,796.29 |
| Rate for Payer: Aetna Commercial |
$5,216.66
|
| Rate for Payer: ASR ASR |
$5,622.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,493.86
|
| Rate for Payer: BCN Commercial |
$4,493.86
|
| Rate for Payer: Cash Price |
$4,637.03
|
| Rate for Payer: Cofinity Commercial |
$5,448.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
| Rate for Payer: Healthscope Commercial |
$5,796.29
|
| Rate for Payer: Healthscope Whirlpool |
$5,622.40
|
| Rate for Payer: Mclaren Commercial |
$5,216.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,100.74
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,080.84
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,956.59 |
| Max. Negotiated Rate |
$7,080.84 |
| Rate for Payer: Aetna Commercial |
$6,372.76
|
| Rate for Payer: ASR ASR |
$6,868.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,489.78
|
| Rate for Payer: BCN Commercial |
$5,489.78
|
| Rate for Payer: Cash Price |
$5,664.67
|
| Rate for Payer: Cofinity Commercial |
$6,655.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
| Rate for Payer: Healthscope Commercial |
$7,080.84
|
| Rate for Payer: Healthscope Whirlpool |
$6,868.41
|
| Rate for Payer: Mclaren Commercial |
$6,372.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,231.14
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,080.84
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,832.34 |
| Max. Negotiated Rate |
$7,080.84 |
| Rate for Payer: Aetna Commercial |
$6,372.76
|
| Rate for Payer: ASR ASR |
$6,868.41
|
| Rate for Payer: BCBS Complete |
$2,832.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,489.78
|
| Rate for Payer: BCN Commercial |
$5,489.78
|
| Rate for Payer: Cash Price |
$5,664.67
|
| Rate for Payer: Cofinity Commercial |
$6,655.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
| Rate for Payer: Healthscope Commercial |
$7,080.84
|
| Rate for Payer: Healthscope Whirlpool |
$6,868.41
|
| Rate for Payer: Mclaren Commercial |
$6,372.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,443.56
|
| Rate for Payer: Priority Health Narrow Network |
$5,027.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,231.14
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: ASR ASR |
$1,236.75
|
| Rate for Payer: BCBS Trust/PPO |
$988.51
|
| Rate for Payer: BCN Commercial |
$988.51
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,198.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,236.75
|
| Rate for Payer: Mclaren Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,122.00
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: ASR ASR |
$1,236.75
|
| Rate for Payer: BCBS Complete |
$510.00
|
| Rate for Payer: BCBS Trust/PPO |
$988.51
|
| Rate for Payer: BCN Commercial |
$988.51
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,198.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,236.75
|
| Rate for Payer: Mclaren Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.25
|
| Rate for Payer: Priority Health Narrow Network |
$905.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,122.00
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$5,899.37
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,805.46 |
| Max. Negotiated Rate |
$6,411.01 |
| Rate for Payer: Aetna Commercial |
$5,309.43
|
| Rate for Payer: Aetna Medicare |
$5,128.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: ASR ASR |
$5,722.39
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,573.78
|
| Rate for Payer: BCN Commercial |
$4,573.78
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cofinity Commercial |
$5,545.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$5,899.37
|
| Rate for Payer: Healthscope Whirlpool |
$5,722.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
| Rate for Payer: Mclaren Commercial |
$5,309.43
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$5,641.69
|
| Rate for Payer: PHP Medicaid |
$2,805.46
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,368.43
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$4,188.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,191.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$5,899.37
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,129.56 |
| Max. Negotiated Rate |
$5,899.37 |
| Rate for Payer: Aetna Commercial |
$5,309.43
|
| Rate for Payer: ASR ASR |
$5,722.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,573.78
|
| Rate for Payer: BCN Commercial |
$4,573.78
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cofinity Commercial |
$5,545.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
| Rate for Payer: Healthscope Commercial |
$5,899.37
|
| Rate for Payer: Healthscope Whirlpool |
$5,722.39
|
| Rate for Payer: Mclaren Commercial |
$5,309.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,191.45
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,725.45
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,107.82 |
| Max. Negotiated Rate |
$8,725.45 |
| Rate for Payer: Aetna Commercial |
$7,852.90
|
| Rate for Payer: ASR ASR |
$8,463.69
|
| Rate for Payer: BCBS Trust/PPO |
$6,764.84
|
| Rate for Payer: BCN Commercial |
$6,764.84
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cofinity Commercial |
$8,201.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
| Rate for Payer: Healthscope Commercial |
$8,725.45
|
| Rate for Payer: Healthscope Whirlpool |
$8,463.69
|
| Rate for Payer: Mclaren Commercial |
$7,852.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,678.40
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,725.45
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$8,725.45 |
| Rate for Payer: Aetna Commercial |
$7,852.90
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$8,463.69
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$6,764.84
|
| Rate for Payer: BCN Commercial |
$6,764.84
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cofinity Commercial |
$8,201.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$8,725.45
|
| Rate for Payer: Healthscope Whirlpool |
$8,463.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$7,852.90
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.00
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,678.40
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: ASR ASR |
$25.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.16
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
| Rate for Payer: Healthscope Commercial |
$26.00
|
| Rate for Payer: Healthscope Whirlpool |
$25.22
|
| Rate for Payer: Mclaren Commercial |
$23.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.88
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$23.40
|
| Rate for Payer: ASR ASR |
$25.22
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$20.16
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
| Rate for Payer: Healthscope Commercial |
$26.00
|
| Rate for Payer: Healthscope Whirlpool |
$25.22
|
| Rate for Payer: Mclaren Commercial |
$23.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.66
|
| Rate for Payer: Priority Health Narrow Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.88
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$488.86
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$174.29 |
| Max. Negotiated Rate |
$488.86 |
| Rate for Payer: Aetna Commercial |
$439.97
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$474.19
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$379.01
|
| Rate for Payer: BCN Commercial |
$379.01
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$459.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$488.86
|
| Rate for Payer: Healthscope Whirlpool |
$474.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$439.97
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.86
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$174.29
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.20
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$488.86
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.20 |
| Max. Negotiated Rate |
$488.86 |
| Rate for Payer: Aetna Commercial |
$439.97
|
| Rate for Payer: ASR ASR |
$474.19
|
| Rate for Payer: BCBS Trust/PPO |
$379.01
|
| Rate for Payer: BCN Commercial |
$379.01
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$459.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Healthscope Commercial |
$488.86
|
| Rate for Payer: Healthscope Whirlpool |
$474.19
|
| Rate for Payer: Mclaren Commercial |
$439.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.20
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$391.99
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$391.99 |
| Rate for Payer: Aetna Commercial |
$352.79
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$380.23
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$303.91
|
| Rate for Payer: BCN Commercial |
$303.91
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$313.59
|
| Rate for Payer: Cash Price |
$313.59
|
| Rate for Payer: Cofinity Commercial |
$368.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$391.99
|
| Rate for Payer: Healthscope Whirlpool |
$380.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$352.79
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.19
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.86
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$174.29
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.95
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$391.99
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.39 |
| Max. Negotiated Rate |
$391.99 |
| Rate for Payer: Aetna Commercial |
$352.79
|
| Rate for Payer: ASR ASR |
$380.23
|
| Rate for Payer: BCBS Trust/PPO |
$303.91
|
| Rate for Payer: BCN Commercial |
$303.91
|
| Rate for Payer: Cash Price |
$313.59
|
| Rate for Payer: Cofinity Commercial |
$368.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.59
|
| Rate for Payer: Healthscope Commercial |
$391.99
|
| Rate for Payer: Healthscope Whirlpool |
$380.23
|
| Rate for Payer: Mclaren Commercial |
$352.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.95
|
|
