|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,008.81
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,506.17 |
| Max. Negotiated Rate |
$5,008.81 |
| Rate for Payer: Aetna Commercial |
$4,507.93
|
| Rate for Payer: ASR ASR |
$4,858.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,883.33
|
| Rate for Payer: BCN Commercial |
$3,883.33
|
| Rate for Payer: Cash Price |
$4,007.05
|
| Rate for Payer: Cofinity Commercial |
$4,708.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,007.05
|
| Rate for Payer: Healthscope Commercial |
$5,008.81
|
| Rate for Payer: Healthscope Whirlpool |
$4,858.55
|
| Rate for Payer: Mclaren Commercial |
$4,507.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,257.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,506.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,407.75
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$847.02
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$847.02 |
| Rate for Payer: Aetna Commercial |
$762.32
|
| 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 |
$821.61
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$656.69
|
| Rate for Payer: BCN Commercial |
$656.69
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$677.62
|
| Rate for Payer: Cash Price |
$677.62
|
| Rate for Payer: Cofinity Commercial |
$796.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$847.02
|
| Rate for Payer: Healthscope Whirlpool |
$821.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$762.32
|
| 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 |
$719.97
|
| 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 |
$592.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.58
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$174.86
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$745.38
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$847.02
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$592.91 |
| Max. Negotiated Rate |
$847.02 |
| Rate for Payer: Aetna Commercial |
$762.32
|
| Rate for Payer: ASR ASR |
$821.61
|
| Rate for Payer: BCBS Trust/PPO |
$656.69
|
| Rate for Payer: BCN Commercial |
$656.69
|
| Rate for Payer: Cash Price |
$677.62
|
| Rate for Payer: Cofinity Commercial |
$796.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.62
|
| Rate for Payer: Healthscope Commercial |
$847.02
|
| Rate for Payer: Healthscope Whirlpool |
$821.61
|
| Rate for Payer: Mclaren Commercial |
$762.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$719.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$745.38
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$710.39
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$710.39 |
| Rate for Payer: Aetna Commercial |
$639.35
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$689.08
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$550.77
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$568.31
|
| Rate for Payer: Cash Price |
$568.31
|
| Rate for Payer: Cofinity Commercial |
$667.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$710.39
|
| Rate for Payer: Healthscope Whirlpool |
$689.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$639.35
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$603.83
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.95
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.14
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$710.39
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$497.27 |
| Max. Negotiated Rate |
$710.39 |
| Rate for Payer: Aetna Commercial |
$639.35
|
| Rate for Payer: ASR ASR |
$689.08
|
| Rate for Payer: BCBS Trust/PPO |
$550.77
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: Cash Price |
$568.31
|
| Rate for Payer: Cofinity Commercial |
$667.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.31
|
| Rate for Payer: Healthscope Commercial |
$710.39
|
| Rate for Payer: Healthscope Whirlpool |
$689.08
|
| Rate for Payer: Mclaren Commercial |
$639.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$603.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.14
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$924.02
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$924.02 |
| Rate for Payer: Aetna Commercial |
$831.62
|
| 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 |
$896.30
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$716.39
|
| Rate for Payer: BCN Commercial |
$716.39
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$739.22
|
| Rate for Payer: Cash Price |
$739.22
|
| Rate for Payer: Cofinity Commercial |
$868.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$924.02
|
| Rate for Payer: Healthscope Whirlpool |
$896.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$831.62
|
| 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 |
$785.42
|
| 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 |
$646.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.58
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$174.86
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.14
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$924.02
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$646.81 |
| Max. Negotiated Rate |
$924.02 |
| Rate for Payer: Aetna Commercial |
$831.62
|
| Rate for Payer: ASR ASR |
$896.30
|
| Rate for Payer: BCBS Trust/PPO |
$716.39
|
| Rate for Payer: BCN Commercial |
$716.39
|
| Rate for Payer: Cash Price |
$739.22
|
| Rate for Payer: Cofinity Commercial |
$868.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.22
|
| Rate for Payer: Healthscope Commercial |
$924.02
|
| Rate for Payer: Healthscope Whirlpool |
$896.30
|
| Rate for Payer: Mclaren Commercial |
$831.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$785.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.14
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$774.97
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$542.48 |
| Max. Negotiated Rate |
$774.97 |
| Rate for Payer: Aetna Commercial |
$697.47
|
| Rate for Payer: ASR ASR |
$751.72
|
| Rate for Payer: BCBS Trust/PPO |
$600.83
|
| Rate for Payer: BCN Commercial |
$600.83
|
| Rate for Payer: Cash Price |
$619.98
|
| Rate for Payer: Cofinity Commercial |
$728.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.98
|
| Rate for Payer: Healthscope Commercial |
$774.97
|
| Rate for Payer: Healthscope Whirlpool |
$751.72
|
| Rate for Payer: Mclaren Commercial |
$697.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$658.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$681.97
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$774.97
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$774.97 |
| Rate for Payer: Aetna Commercial |
$697.47
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$751.72
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$600.83
|
| Rate for Payer: BCN Commercial |
$600.83
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$619.98
|
| Rate for Payer: Cash Price |
$619.98
|
| Rate for Payer: Cofinity Commercial |
$728.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$774.97
|
| Rate for Payer: Healthscope Whirlpool |
$751.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$697.47
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$658.72
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.95
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$681.97
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC ARTHROCENTESIS
|
Facility
|
OP
|
$370.48
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$148.19 |
| Max. Negotiated Rate |
$370.48 |
| Rate for Payer: Aetna Commercial |
$333.43
|
| Rate for Payer: ASR ASR |
$359.37
|
| Rate for Payer: BCBS Complete |
$148.19
|
| Rate for Payer: BCBS Trust/PPO |
$287.23
|
| Rate for Payer: BCN Commercial |
$287.23
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$348.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$370.48
|
| Rate for Payer: Healthscope Whirlpool |
$359.37
|
| Rate for Payer: Mclaren Commercial |
$333.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.14
|
| Rate for Payer: Priority Health Narrow Network |
$263.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.02
|
|
|
HC ARTHROCENTESIS
|
Facility
|
IP
|
$370.48
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$259.34 |
| Max. Negotiated Rate |
$370.48 |
| Rate for Payer: Aetna Commercial |
$333.43
|
| Rate for Payer: ASR ASR |
$359.37
|
| Rate for Payer: BCBS Trust/PPO |
$287.23
|
| Rate for Payer: BCN Commercial |
$287.23
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$348.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$370.48
|
| Rate for Payer: Healthscope Whirlpool |
$359.37
|
| Rate for Payer: Mclaren Commercial |
$333.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.02
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
IP
|
$333.67
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.57 |
| Max. Negotiated Rate |
$333.67 |
| Rate for Payer: Aetna Commercial |
$300.30
|
| Rate for Payer: ASR ASR |
$323.66
|
| Rate for Payer: BCBS Trust/PPO |
$258.69
|
| Rate for Payer: BCN Commercial |
$258.69
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$313.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Healthscope Commercial |
$333.67
|
| Rate for Payer: Healthscope Whirlpool |
$323.66
|
| Rate for Payer: Mclaren Commercial |
$300.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.63
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
OP
|
$333.67
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$377.64 |
| Rate for Payer: Aetna Commercial |
$300.30
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$323.66
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$258.69
|
| Rate for Payer: BCN Commercial |
$258.69
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$313.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$333.67
|
| Rate for Payer: Healthscope Whirlpool |
$323.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$300.30
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.62
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.63
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$429.05 |
| Rate for Payer: Aetna Commercial |
$386.14
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$416.18
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$332.64
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$429.05
|
| Rate for Payer: Healthscope Whirlpool |
$416.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$386.14
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.56
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.34 |
| Max. Negotiated Rate |
$429.05 |
| Rate for Payer: Aetna Commercial |
$386.14
|
| Rate for Payer: ASR ASR |
$416.18
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$332.64
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$429.05
|
| Rate for Payer: Healthscope Whirlpool |
$416.18
|
| Rate for Payer: Mclaren Commercial |
$386.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.56
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,434.49
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,004.14 |
| Max. Negotiated Rate |
$1,434.49 |
| Rate for Payer: Aetna Commercial |
$1,291.04
|
| Rate for Payer: ASR ASR |
$1,391.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.16
|
| Rate for Payer: BCN Commercial |
$1,112.16
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cofinity Commercial |
$1,348.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,147.59
|
| Rate for Payer: Healthscope Commercial |
$1,434.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,391.46
|
| Rate for Payer: Mclaren Commercial |
$1,291.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,219.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,262.35
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,434.49
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,434.49 |
| Rate for Payer: Aetna Commercial |
$1,291.04
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,391.46
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.16
|
| Rate for Payer: BCN Commercial |
$1,112.16
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cofinity Commercial |
$1,348.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,147.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,434.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,391.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$1,291.04
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,219.32
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,305.39
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,018.49
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,262.35
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,063.45
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,063.45 |
| Rate for Payer: Aetna Commercial |
$957.10
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,031.55
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$824.49
|
| Rate for Payer: BCN Commercial |
$824.49
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cofinity Commercial |
$999.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,063.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$957.10
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.93
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$967.74
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$755.05
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.84
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,063.45
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$744.42 |
| Max. Negotiated Rate |
$1,063.45 |
| Rate for Payer: Aetna Commercial |
$957.10
|
| Rate for Payer: ASR ASR |
$1,031.55
|
| Rate for Payer: BCBS Trust/PPO |
$824.49
|
| Rate for Payer: BCN Commercial |
$824.49
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cofinity Commercial |
$999.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.76
|
| Rate for Payer: Healthscope Commercial |
$1,063.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.55
|
| Rate for Payer: Mclaren Commercial |
$957.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.84
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$322.73
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$377.64 |
| Rate for Payer: Aetna Commercial |
$290.46
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$313.05
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$250.21
|
| Rate for Payer: BCN Commercial |
$250.21
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cofinity Commercial |
$303.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$322.73
|
| Rate for Payer: Healthscope Whirlpool |
$313.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$290.46
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.32
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.00
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$322.73
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$225.91 |
| Max. Negotiated Rate |
$322.73 |
| Rate for Payer: Aetna Commercial |
$290.46
|
| Rate for Payer: ASR ASR |
$313.05
|
| Rate for Payer: BCBS Trust/PPO |
$250.21
|
| Rate for Payer: BCN Commercial |
$250.21
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cofinity Commercial |
$303.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.18
|
| Rate for Payer: Healthscope Commercial |
$322.73
|
| Rate for Payer: Healthscope Whirlpool |
$313.05
|
| Rate for Payer: Mclaren Commercial |
$290.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.00
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
IP
|
$413.01
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$289.11 |
| Max. Negotiated Rate |
$413.01 |
| Rate for Payer: Aetna Commercial |
$371.71
|
| Rate for Payer: ASR ASR |
$400.62
|
| Rate for Payer: BCBS Trust/PPO |
$320.21
|
| Rate for Payer: BCN Commercial |
$320.21
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cofinity Commercial |
$388.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.41
|
| Rate for Payer: Healthscope Commercial |
$413.01
|
| Rate for Payer: Healthscope Whirlpool |
$400.62
|
| Rate for Payer: Mclaren Commercial |
$371.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$363.45
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
OP
|
$413.01
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$413.01 |
| Rate for Payer: Aetna Commercial |
$371.71
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$400.62
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$320.21
|
| Rate for Payer: BCN Commercial |
$320.21
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cofinity Commercial |
$388.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$413.01
|
| Rate for Payer: Healthscope Whirlpool |
$400.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$371.71
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.06
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$363.45
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,204.67
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$843.27 |
| Max. Negotiated Rate |
$1,204.67 |
| Rate for Payer: Aetna Commercial |
$1,084.20
|
| Rate for Payer: ASR ASR |
$1,168.53
|
| Rate for Payer: BCBS Trust/PPO |
$933.98
|
| Rate for Payer: BCN Commercial |
$933.98
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cofinity Commercial |
$1,132.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.74
|
| Rate for Payer: Healthscope Commercial |
$1,204.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.53
|
| Rate for Payer: Mclaren Commercial |
$1,084.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,023.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.11
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,204.67
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$1,204.67 |
| Rate for Payer: Aetna Commercial |
$1,084.20
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$1,168.53
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$933.98
|
| Rate for Payer: BCN Commercial |
$933.98
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cofinity Commercial |
$1,132.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$1,204.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$1,084.20
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,023.97
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,096.25
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$855.32
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.11
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
