|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
OP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$1,118.72 |
| Rate for Payer: Aetna Commercial |
$1,006.85
|
| 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 |
$1,085.16
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$867.34
|
| Rate for Payer: BCN Commercial |
$867.34
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$1,051.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$1,118.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$1,006.85
|
| 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 |
$950.91
|
| 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 |
$783.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.04
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$794.29
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.47
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
IP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$783.10 |
| Max. Negotiated Rate |
$1,118.72 |
| Rate for Payer: Aetna Commercial |
$1,006.85
|
| Rate for Payer: ASR ASR |
$1,085.16
|
| Rate for Payer: BCBS Trust/PPO |
$867.34
|
| Rate for Payer: BCN Commercial |
$867.34
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$1,051.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.98
|
| Rate for Payer: Healthscope Commercial |
$1,118.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.16
|
| Rate for Payer: Mclaren Commercial |
$1,006.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$950.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.47
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
OP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$377.64 |
| Rate for Payer: Aetna Commercial |
$288.13
|
| 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 |
$310.54
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$248.20
|
| Rate for Payer: BCN Commercial |
$248.20
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$300.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$320.14
|
| Rate for Payer: Healthscope Whirlpool |
$310.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$288.13
|
| 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 |
$272.12
|
| 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 |
$224.10
|
| 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 |
$281.72
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
IP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$224.10 |
| Max. Negotiated Rate |
$320.14 |
| Rate for Payer: Aetna Commercial |
$288.13
|
| Rate for Payer: ASR ASR |
$310.54
|
| Rate for Payer: BCBS Trust/PPO |
$248.20
|
| Rate for Payer: BCN Commercial |
$248.20
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$300.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.11
|
| Rate for Payer: Healthscope Commercial |
$320.14
|
| Rate for Payer: Healthscope Whirlpool |
$310.54
|
| Rate for Payer: Mclaren Commercial |
$288.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.72
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$1,159.24 |
| Rate for Payer: Aetna Commercial |
$1,043.32
|
| 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 |
$1,124.46
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$898.76
|
| Rate for Payer: BCN Commercial |
$898.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$1,089.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$1,159.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,124.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$1,043.32
|
| 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 |
$985.35
|
| 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 |
$811.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,054.91
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$823.06
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,020.13
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$811.47 |
| Max. Negotiated Rate |
$1,159.24 |
| Rate for Payer: Aetna Commercial |
$1,043.32
|
| Rate for Payer: ASR ASR |
$1,124.46
|
| Rate for Payer: BCBS Trust/PPO |
$898.76
|
| Rate for Payer: BCN Commercial |
$898.76
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$1,089.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.39
|
| Rate for Payer: Healthscope Commercial |
$1,159.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,124.46
|
| Rate for Payer: Mclaren Commercial |
$1,043.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,020.13
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
IP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.40 |
| Max. Negotiated Rate |
$984.86 |
| Rate for Payer: Aetna Commercial |
$886.37
|
| Rate for Payer: ASR ASR |
$955.31
|
| Rate for Payer: BCBS Trust/PPO |
$763.56
|
| Rate for Payer: BCN Commercial |
$763.56
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$925.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.89
|
| Rate for Payer: Healthscope Commercial |
$984.86
|
| Rate for Payer: Healthscope Whirlpool |
$955.31
|
| Rate for Payer: Mclaren Commercial |
$886.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$866.68
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
OP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$984.86 |
| Rate for Payer: Aetna Commercial |
$886.37
|
| 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 |
$955.31
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$763.56
|
| Rate for Payer: BCN Commercial |
$763.56
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$925.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$984.86
|
| Rate for Payer: Healthscope Whirlpool |
$955.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$886.37
|
| 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 |
$837.13
|
| 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 |
$689.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.22
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$699.25
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$866.68
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
IP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$643.52 |
| Max. Negotiated Rate |
$919.32 |
| Rate for Payer: Aetna Commercial |
$827.39
|
| Rate for Payer: ASR ASR |
$891.74
|
| Rate for Payer: BCBS Trust/PPO |
$712.75
|
| Rate for Payer: BCN Commercial |
$712.75
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$864.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.46
|
| Rate for Payer: Healthscope Commercial |
$919.32
|
| Rate for Payer: Healthscope Whirlpool |
$891.74
|
| Rate for Payer: Mclaren Commercial |
$827.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.00
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
OP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.73 |
| Max. Negotiated Rate |
$1,072.35 |
| Rate for Payer: Aetna Commercial |
$827.39
|
| Rate for Payer: ASR ASR |
$891.74
|
| Rate for Payer: BCBS Complete |
$367.73
|
| Rate for Payer: BCBS Trust/PPO |
$712.75
|
| Rate for Payer: BCN Commercial |
$712.75
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$864.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.46
|
| Rate for Payer: Healthscope Commercial |
$919.32
|
| Rate for Payer: Healthscope Whirlpool |
$891.74
|
| Rate for Payer: Mclaren Commercial |
$827.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.00
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$419.14 |
| Max. Negotiated Rate |
$1,072.35 |
| Rate for Payer: Aetna Commercial |
$943.06
|
| Rate for Payer: ASR ASR |
$1,016.41
|
| Rate for Payer: BCBS Complete |
$419.14
|
| Rate for Payer: BCBS Trust/PPO |
$812.40
|
| Rate for Payer: BCN Commercial |
$812.40
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$1,047.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.41
|
| Rate for Payer: Mclaren Commercial |
$943.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.11
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$733.50 |
| Max. Negotiated Rate |
$1,047.85 |
| Rate for Payer: Aetna Commercial |
$943.06
|
| Rate for Payer: ASR ASR |
$1,016.41
|
| Rate for Payer: BCBS Trust/PPO |
$812.40
|
| Rate for Payer: BCN Commercial |
$812.40
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$1,047.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.41
|
| Rate for Payer: Mclaren Commercial |
$943.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.11
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
OP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,246.87 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,603.12
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$1,727.80
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.00
|
| Rate for Payer: BCN Commercial |
$1,381.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,674.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,781.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,727.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,603.12
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,620.93
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,567.49
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,246.87 |
| Max. Negotiated Rate |
$1,781.24 |
| Rate for Payer: Aetna Commercial |
$1,603.12
|
| Rate for Payer: ASR ASR |
$1,727.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.00
|
| Rate for Payer: BCN Commercial |
$1,381.00
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,674.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Healthscope Commercial |
$1,781.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,727.80
|
| Rate for Payer: Mclaren Commercial |
$1,603.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,567.49
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$4,016.66 |
| Rate for Payer: Aetna Commercial |
$3,614.99
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$3,896.16
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,114.12
|
| Rate for Payer: BCN Commercial |
$3,114.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$3,775.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$4,016.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,896.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$3,614.99
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,655.16
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,851.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,534.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
IP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,811.66 |
| Max. Negotiated Rate |
$4,016.66 |
| Rate for Payer: Aetna Commercial |
$3,614.99
|
| Rate for Payer: ASR ASR |
$3,896.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,114.12
|
| Rate for Payer: BCN Commercial |
$3,114.12
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$3,775.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Healthscope Commercial |
$4,016.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,896.16
|
| Rate for Payer: Mclaren Commercial |
$3,614.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,534.66
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$904.13 |
| Rate for Payer: Aetna Commercial |
$813.72
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$877.01
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$700.97
|
| Rate for Payer: BCN Commercial |
$700.97
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$849.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$904.13
|
| Rate for Payer: Healthscope Whirlpool |
$877.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$813.72
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$822.76
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$641.93
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.63
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$632.89 |
| Max. Negotiated Rate |
$904.13 |
| Rate for Payer: Aetna Commercial |
$813.72
|
| Rate for Payer: ASR ASR |
$877.01
|
| Rate for Payer: BCBS Trust/PPO |
$700.97
|
| Rate for Payer: BCN Commercial |
$700.97
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$849.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Healthscope Commercial |
$904.13
|
| Rate for Payer: Healthscope Whirlpool |
$877.01
|
| Rate for Payer: Mclaren Commercial |
$813.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.63
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$519.06 |
| Max. Negotiated Rate |
$741.52 |
| Rate for Payer: Aetna Commercial |
$667.37
|
| Rate for Payer: ASR ASR |
$719.27
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$574.90
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$697.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Healthscope Commercial |
$741.52
|
| Rate for Payer: Healthscope Whirlpool |
$719.27
|
| Rate for Payer: Mclaren Commercial |
$667.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.54
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$741.52 |
| Rate for Payer: Aetna Commercial |
$667.37
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$719.27
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$574.90
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$697.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$741.52
|
| Rate for Payer: Healthscope Whirlpool |
$719.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$667.37
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.78
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$526.48
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.54
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,187.42 |
| Max. Negotiated Rate |
$4,553.46 |
| Rate for Payer: Aetna Commercial |
$4,098.11
|
| Rate for Payer: ASR ASR |
$4,416.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,530.30
|
| Rate for Payer: BCN Commercial |
$3,530.30
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$4,280.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Healthscope Commercial |
$4,553.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,416.86
|
| Rate for Payer: Mclaren Commercial |
$4,098.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,007.04
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,501.51 |
| Max. Negotiated Rate |
$4,553.46 |
| Rate for Payer: Aetna Commercial |
$4,098.11
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$4,416.86
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,530.30
|
| Rate for Payer: BCN Commercial |
$3,530.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$4,280.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,553.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,416.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$4,098.11
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,007.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.27 |
| Max. Negotiated Rate |
$191.82 |
| Rate for Payer: Aetna Commercial |
$172.64
|
| Rate for Payer: ASR ASR |
$186.07
|
| Rate for Payer: BCBS Trust/PPO |
$148.72
|
| Rate for Payer: BCN Commercial |
$148.72
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$180.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Healthscope Commercial |
$191.82
|
| Rate for Payer: Healthscope Whirlpool |
$186.07
|
| Rate for Payer: Mclaren Commercial |
$172.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.80
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$191.82 |
| Rate for Payer: Aetna Commercial |
$172.64
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$186.07
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$148.72
|
| Rate for Payer: BCN Commercial |
$148.72
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$180.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$191.82
|
| Rate for Payer: Healthscope Whirlpool |
$186.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$172.64
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.56
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$136.19
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.80
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,210.75 |
| Rate for Payer: Aetna Commercial |
$1,089.68
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$1,174.43
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$938.69
|
| Rate for Payer: BCN Commercial |
$938.69
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cofinity Commercial |
$1,138.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,210.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$1,089.68
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.78
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$859.63
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,065.46
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
