|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$847.52 |
| Max. Negotiated Rate |
$1,210.75 |
| Rate for Payer: Aetna Commercial |
$1,089.68
|
| Rate for Payer: ASR ASR |
$1,174.43
|
| Rate for Payer: BCBS Trust/PPO |
$938.69
|
| Rate for Payer: BCN Commercial |
$938.69
|
| 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: Healthscope Commercial |
$1,210.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.43
|
| Rate for Payer: Mclaren Commercial |
$1,089.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,065.46
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.77
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$39.78 |
| Rate for Payer: Aetna Commercial |
$35.80
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$38.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$30.84
|
| Rate for Payer: BCN Commercial |
$30.84
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$39.78
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$35.80
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.20
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$28.24
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.85 |
| Max. Negotiated Rate |
$39.78 |
| Rate for Payer: Aetna Commercial |
$35.80
|
| Rate for Payer: ASR ASR |
$38.59
|
| Rate for Payer: BCBS Trust/PPO |
$30.84
|
| Rate for Payer: BCN Commercial |
$30.84
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$39.78
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Mclaren Commercial |
$35.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.01
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$73.80
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$79.54
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$63.57
|
| Rate for Payer: BCN Commercial |
$63.57
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$77.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$82.00
|
| Rate for Payer: Healthscope Whirlpool |
$79.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$73.80
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.62
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$58.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.16
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$82.00 |
| Rate for Payer: Aetna Commercial |
$73.80
|
| Rate for Payer: ASR ASR |
$79.54
|
| Rate for Payer: BCBS Trust/PPO |
$63.57
|
| Rate for Payer: BCN Commercial |
$63.57
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$77.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Healthscope Commercial |
$82.00
|
| Rate for Payer: Healthscope Whirlpool |
$79.54
|
| Rate for Payer: Mclaren Commercial |
$73.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.16
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$89.00 |
| Rate for Payer: Aetna Commercial |
$80.10
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$86.33
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$69.00
|
| Rate for Payer: BCN Commercial |
$69.00
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$89.00
|
| Rate for Payer: Healthscope Whirlpool |
$86.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$80.10
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.99
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$63.19
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.32
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.30 |
| Max. Negotiated Rate |
$89.00 |
| Rate for Payer: Aetna Commercial |
$80.10
|
| Rate for Payer: ASR ASR |
$86.33
|
| Rate for Payer: BCBS Trust/PPO |
$69.00
|
| Rate for Payer: BCN Commercial |
$69.00
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Healthscope Commercial |
$89.00
|
| Rate for Payer: Healthscope Whirlpool |
$86.33
|
| Rate for Payer: Mclaren Commercial |
$80.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.32
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: ASR ASR |
$55.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$44.19
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$53.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$57.00
|
| Rate for Payer: Healthscope Whirlpool |
$55.29
|
| Rate for Payer: Mclaren Commercial |
$51.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.16
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$55.29
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$44.19
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$53.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$57.00
|
| Rate for Payer: Healthscope Whirlpool |
$55.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$51.30
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.87
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.47
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$826.95 |
| Rate for Payer: Aetna Commercial |
$744.26
|
| 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 |
$802.14
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$641.13
|
| Rate for Payer: BCN Commercial |
$641.13
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$777.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$826.95
|
| Rate for Payer: Healthscope Whirlpool |
$802.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$744.26
|
| 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 |
$702.91
|
| 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 |
$578.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.52
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$587.13
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.72
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$578.86 |
| Max. Negotiated Rate |
$826.95 |
| Rate for Payer: Aetna Commercial |
$744.26
|
| Rate for Payer: ASR ASR |
$802.14
|
| Rate for Payer: BCBS Trust/PPO |
$641.13
|
| Rate for Payer: BCN Commercial |
$641.13
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$777.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Healthscope Commercial |
$826.95
|
| Rate for Payer: Healthscope Whirlpool |
$802.14
|
| Rate for Payer: Mclaren Commercial |
$744.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.72
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$265.05 |
| Max. Negotiated Rate |
$378.64 |
| Rate for Payer: Aetna Commercial |
$340.78
|
| Rate for Payer: ASR ASR |
$367.28
|
| Rate for Payer: BCBS Trust/PPO |
$293.56
|
| Rate for Payer: BCN Commercial |
$293.56
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$355.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Healthscope Commercial |
$378.64
|
| Rate for Payer: Healthscope Whirlpool |
$367.28
|
| Rate for Payer: Mclaren Commercial |
$340.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.20
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$378.64 |
| Rate for Payer: Aetna Commercial |
$340.78
|
| 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 |
$367.28
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$293.56
|
| Rate for Payer: BCN Commercial |
$293.56
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$355.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$378.64
|
| Rate for Payer: Healthscope Whirlpool |
$367.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$340.78
|
| 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 |
$321.84
|
| 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 |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.56
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$268.83
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.20
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,146.82 |
| Max. Negotiated Rate |
$3,066.89 |
| Rate for Payer: Aetna Commercial |
$2,760.20
|
| Rate for Payer: ASR ASR |
$2,974.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,377.76
|
| Rate for Payer: BCN Commercial |
$2,377.76
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,882.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Healthscope Commercial |
$3,066.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,974.88
|
| Rate for Payer: Mclaren Commercial |
$2,760.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,698.86
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$3,066.89 |
| Rate for Payer: Aetna Commercial |
$2,760.20
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$2,974.88
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,377.76
|
| Rate for Payer: BCN Commercial |
$2,377.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,882.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$3,066.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,974.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,760.20
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,790.87
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,177.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,698.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,520.09 |
| Max. Negotiated Rate |
$4,249.39 |
| Rate for Payer: Aetna Commercial |
$3,824.45
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$4,121.91
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,294.55
|
| Rate for Payer: BCN Commercial |
$3,294.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$3,994.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$4,249.39
|
| Rate for Payer: Healthscope Whirlpool |
$4,121.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$3,824.45
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,866.94
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$3,017.07
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,739.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,974.57 |
| Max. Negotiated Rate |
$4,249.39 |
| Rate for Payer: Aetna Commercial |
$3,824.45
|
| Rate for Payer: ASR ASR |
$4,121.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,294.55
|
| Rate for Payer: BCN Commercial |
$3,294.55
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$3,994.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Healthscope Commercial |
$4,249.39
|
| Rate for Payer: Healthscope Whirlpool |
$4,121.91
|
| Rate for Payer: Mclaren Commercial |
$3,824.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,739.46
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,746.09 |
| Max. Negotiated Rate |
$2,494.41 |
| Rate for Payer: Aetna Commercial |
$2,244.97
|
| Rate for Payer: ASR ASR |
$2,419.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,933.92
|
| Rate for Payer: BCN Commercial |
$1,933.92
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$2,344.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Healthscope Commercial |
$2,494.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,419.58
|
| Rate for Payer: Mclaren Commercial |
$2,244.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.08
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,520.09 |
| Max. Negotiated Rate |
$3,473.69 |
| Rate for Payer: Aetna Commercial |
$2,244.97
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$2,419.58
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,933.92
|
| Rate for Payer: BCN Commercial |
$1,933.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$2,344.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$2,494.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,419.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$2,244.97
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,269.91
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,523.74
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$4,523.74 |
| Rate for Payer: Aetna Commercial |
$4,071.37
|
| 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 |
$4,388.03
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,507.26
|
| Rate for Payer: BCN Commercial |
$3,507.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cofinity Commercial |
$4,252.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,618.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$4,523.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,388.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$4,071.37
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,845.18
|
| 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 |
$3,166.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,116.60
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,211.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,980.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,523.74
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,166.62 |
| Max. Negotiated Rate |
$4,523.74 |
| Rate for Payer: Aetna Commercial |
$4,071.37
|
| Rate for Payer: ASR ASR |
$4,388.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,507.26
|
| Rate for Payer: BCN Commercial |
$3,507.26
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cofinity Commercial |
$4,252.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,618.99
|
| Rate for Payer: Healthscope Commercial |
$4,523.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,388.03
|
| Rate for Payer: Mclaren Commercial |
$4,071.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,845.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,166.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,980.89
|
|
