|
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$19,278.83
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$8,118.00 |
| Max. Negotiated Rate |
$19,278.83 |
| Rate for Payer: Aetna Medicare |
$8,887.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,681.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,681.58
|
| Rate for Payer: BCBS MAPPO |
$8,545.26
|
| Rate for Payer: BCBS Trust/PPO |
$19,278.83
|
| Rate for Payer: BCN Commercial |
$19,278.83
|
| Rate for Payer: BCN Medicare Advantage |
$8,545.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,545.26
|
| Rate for Payer: Mclaren Medicare |
$8,545.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,972.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,827.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,399.79
|
| Rate for Payer: Nomi Health Commercial |
$13,297.32
|
| Rate for Payer: PACE Medicare |
$8,118.00
|
| Rate for Payer: PACE SWMI |
$8,545.26
|
| Rate for Payer: PHP Medicare Advantage |
$8,545.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,618.70
|
| Rate for Payer: Priority Health Medicare |
$8,545.26
|
| Rate for Payer: Priority Health Tiered Network |
$13,294.96
|
| Rate for Payer: Railroad Medicare Medicare |
$8,545.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,802.04
|
| Rate for Payer: UHC Core |
$14,057.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,545.26
|
| Rate for Payer: UHC Exchange |
$11,480.02
|
| Rate for Payer: VA VA |
$8,545.26
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$67,473.56
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$23,377.21 |
| Max. Negotiated Rate |
$67,473.56 |
| Rate for Payer: Aetna Medicare |
$25,591.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,759.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,759.49
|
| Rate for Payer: BCBS MAPPO |
$24,607.59
|
| Rate for Payer: BCBS Trust/PPO |
$67,473.56
|
| Rate for Payer: BCN Commercial |
$67,473.56
|
| Rate for Payer: BCN Medicare Advantage |
$24,607.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,607.59
|
| Rate for Payer: Mclaren Medicare |
$24,607.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,837.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,298.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$27,068.35
|
| Rate for Payer: Nomi Health Commercial |
$40,108.68
|
| Rate for Payer: PACE Medicare |
$23,377.21
|
| Rate for Payer: PACE SWMI |
$24,607.59
|
| Rate for Payer: PHP Medicare Advantage |
$24,607.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50,126.96
|
| Rate for Payer: Priority Health Medicare |
$24,607.59
|
| Rate for Payer: Priority Health Tiered Network |
$40,101.56
|
| Rate for Payer: Railroad Medicare Medicare |
$24,607.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,679.96
|
| Rate for Payer: UHC Core |
$42,400.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24,607.59
|
| Rate for Payer: UHC Exchange |
$34,627.16
|
| Rate for Payer: VA VA |
$24,607.59
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$90,567.89
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$33,931.07 |
| Max. Negotiated Rate |
$90,567.89 |
| Rate for Payer: Aetna Medicare |
$37,145.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,646.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,646.15
|
| Rate for Payer: BCBS MAPPO |
$35,716.92
|
| Rate for Payer: BCBS Trust/PPO |
$90,567.89
|
| Rate for Payer: BCN Commercial |
$90,567.89
|
| Rate for Payer: BCN Medicare Advantage |
$35,716.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,716.92
|
| Rate for Payer: Mclaren Medicare |
$35,716.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,502.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,074.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$39,288.61
|
| Rate for Payer: Nomi Health Commercial |
$58,652.43
|
| Rate for Payer: PACE Medicare |
$33,931.07
|
| Rate for Payer: PACE SWMI |
$35,716.92
|
| Rate for Payer: PHP Medicare Advantage |
$35,716.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73,302.53
|
| Rate for Payer: Priority Health Medicare |
$35,716.92
|
| Rate for Payer: Priority Health Tiered Network |
$58,642.02
|
| Rate for Payer: Railroad Medicare Medicare |
$35,716.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74,111.21
|
| Rate for Payer: UHC Core |
$62,003.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35,716.92
|
| Rate for Payer: UHC Exchange |
$50,636.60
|
| Rate for Payer: VA VA |
$35,716.92
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$60,991.88
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$19,072.72 |
| Max. Negotiated Rate |
$60,991.88 |
| Rate for Payer: Aetna Medicare |
$20,879.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,095.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,095.69
|
| Rate for Payer: BCBS MAPPO |
$20,076.55
|
| Rate for Payer: BCBS Trust/PPO |
$60,991.88
|
| Rate for Payer: BCN Commercial |
$60,991.88
|
| Rate for Payer: BCN Medicare Advantage |
$20,076.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,076.55
|
| Rate for Payer: Mclaren Medicare |
$20,076.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,080.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,088.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$22,084.21
|
| Rate for Payer: Nomi Health Commercial |
$32,545.41
|
| Rate for Payer: PACE Medicare |
$19,072.72
|
| Rate for Payer: PACE SWMI |
$20,076.55
|
| Rate for Payer: PHP Medicare Advantage |
$20,076.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40,674.55
|
| Rate for Payer: Priority Health Medicare |
$20,076.55
|
| Rate for Payer: Priority Health Tiered Network |
$32,539.63
|
| Rate for Payer: Railroad Medicare Medicare |
$20,076.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41,123.27
|
| Rate for Payer: UHC Core |
$34,404.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20,076.55
|
| Rate for Payer: UHC Exchange |
$28,097.54
|
| Rate for Payer: VA VA |
$20,076.55
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$176,798.28
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$49,968.55 |
| Max. Negotiated Rate |
$176,798.28 |
| Rate for Payer: Aetna Medicare |
$54,702.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65,748.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65,748.09
|
| Rate for Payer: BCBS MAPPO |
$52,598.47
|
| Rate for Payer: BCBS Trust/PPO |
$176,798.28
|
| Rate for Payer: BCN Commercial |
$176,798.28
|
| Rate for Payer: BCN Medicare Advantage |
$52,598.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52,598.47
|
| Rate for Payer: Mclaren Medicare |
$52,598.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55,228.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60,488.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$57,858.32
|
| Rate for Payer: Nomi Health Commercial |
$86,831.19
|
| Rate for Payer: PACE Medicare |
$49,968.55
|
| Rate for Payer: PACE SWMI |
$52,598.47
|
| Rate for Payer: PHP Medicare Advantage |
$52,598.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$108,519.74
|
| Rate for Payer: Priority Health Medicare |
$52,598.47
|
| Rate for Payer: Priority Health Tiered Network |
$86,815.78
|
| Rate for Payer: Railroad Medicare Medicare |
$52,598.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109,716.93
|
| Rate for Payer: UHC Core |
$91,792.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52,598.47
|
| Rate for Payer: UHC Exchange |
$74,964.26
|
| Rate for Payer: VA VA |
$52,598.47
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$19,779.42
|
|
|
Service Code
|
APR-DRG 9102
|
| Min. Negotiated Rate |
$18,837.55 |
| Max. Negotiated Rate |
$19,779.42 |
| Rate for Payer: BCBS Complete |
$19,779.42
|
| Rate for Payer: Mclaren Medicaid |
$18,837.55
|
| Rate for Payer: Meridian Medicaid |
$19,779.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,837.55
|
| Rate for Payer: UHC Medicaid |
$18,837.55
|
| Rate for Payer: UHCCP Medicaid |
$18,837.55
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$33,986.94
|
|
|
Service Code
|
APR-DRG 9104
|
| Min. Negotiated Rate |
$32,368.52 |
| Max. Negotiated Rate |
$33,986.94 |
| Rate for Payer: BCBS Complete |
$33,986.94
|
| Rate for Payer: Mclaren Medicaid |
$32,368.52
|
| Rate for Payer: Meridian Medicaid |
$33,986.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$32,368.52
|
| Rate for Payer: UHC Medicaid |
$32,368.52
|
| Rate for Payer: UHCCP Medicaid |
$32,368.52
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$28,846.16
|
|
|
Service Code
|
APR-DRG 9103
|
| Min. Negotiated Rate |
$27,472.54 |
| Max. Negotiated Rate |
$28,846.16 |
| Rate for Payer: BCBS Complete |
$28,846.16
|
| Rate for Payer: Mclaren Medicaid |
$27,472.54
|
| Rate for Payer: Meridian Medicaid |
$28,846.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,472.54
|
| Rate for Payer: UHC Medicaid |
$27,472.54
|
| Rate for Payer: UHCCP Medicaid |
$27,472.54
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$15,734.22
|
|
|
Service Code
|
APR-DRG 9101
|
| Min. Negotiated Rate |
$14,984.97 |
| Max. Negotiated Rate |
$15,734.22 |
| Rate for Payer: BCBS Complete |
$15,734.22
|
| Rate for Payer: Mclaren Medicaid |
$14,984.97
|
| Rate for Payer: Meridian Medicaid |
$15,734.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,984.97
|
| Rate for Payer: UHC Medicaid |
$14,984.97
|
| Rate for Payer: UHCCP Medicaid |
$14,984.97
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$105,455.38
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$42,620.86 |
| Max. Negotiated Rate |
$105,455.38 |
| Rate for Payer: Aetna Medicare |
$46,658.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56,080.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56,080.07
|
| Rate for Payer: BCBS MAPPO |
$44,864.06
|
| Rate for Payer: BCBS Trust/PPO |
$105,455.38
|
| Rate for Payer: BCN Commercial |
$105,455.38
|
| Rate for Payer: BCN Medicare Advantage |
$44,864.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,864.06
|
| Rate for Payer: Mclaren Medicare |
$44,864.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47,107.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,593.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$49,350.47
|
| Rate for Payer: Nomi Health Commercial |
$73,920.87
|
| Rate for Payer: PACE Medicare |
$42,620.86
|
| Rate for Payer: PACE SWMI |
$44,864.06
|
| Rate for Payer: PHP Medicare Advantage |
$44,864.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92,384.70
|
| Rate for Payer: Priority Health Medicare |
$44,864.06
|
| Rate for Payer: Priority Health Tiered Network |
$73,907.75
|
| Rate for Payer: Railroad Medicare Medicare |
$44,864.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93,403.89
|
| Rate for Payer: UHC Core |
$78,144.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44,864.06
|
| Rate for Payer: UHC Exchange |
$63,818.35
|
| Rate for Payer: VA VA |
$44,864.06
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$81,916.30
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$29,270.51 |
| Max. Negotiated Rate |
$81,916.30 |
| Rate for Payer: Aetna Medicare |
$32,043.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,513.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,513.82
|
| Rate for Payer: BCBS MAPPO |
$30,811.06
|
| Rate for Payer: BCBS Trust/PPO |
$81,916.30
|
| Rate for Payer: BCN Commercial |
$81,916.30
|
| Rate for Payer: BCN Medicare Advantage |
$30,811.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,811.06
|
| Rate for Payer: Mclaren Medicare |
$30,811.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,351.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,432.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,892.17
|
| Rate for Payer: Nomi Health Commercial |
$50,463.51
|
| Rate for Payer: PACE Medicare |
$29,270.51
|
| Rate for Payer: PACE SWMI |
$30,811.06
|
| Rate for Payer: PHP Medicare Advantage |
$30,811.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63,068.20
|
| Rate for Payer: Priority Health Medicare |
$30,811.06
|
| Rate for Payer: Priority Health Tiered Network |
$50,454.55
|
| Rate for Payer: Railroad Medicare Medicare |
$30,811.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,763.97
|
| Rate for Payer: UHC Core |
$53,346.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,811.06
|
| Rate for Payer: UHC Exchange |
$43,566.83
|
| Rate for Payer: VA VA |
$30,811.06
|
|
|
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); AUTOGENOUS GRAFT
|
Facility
|
OP
|
$17,930.33
|
|
|
Service Code
|
CPT 36825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,023.77 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.77
|
| Rate for Payer: BCN Commercial |
$2,023.77
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Mclaren Medicaid |
$2,899.76
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); NONAUTOGENOUS GRAFT (EG, BIOLOGICAL COLLAGEN, THERMOPLASTIC GRAFT)
|
Facility
|
OP
|
$17,930.33
|
|
|
Service Code
|
CPT 36830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,970.15
|
| Rate for Payer: BCN Commercial |
$4,970.15
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Mclaren Medicaid |
$2,899.76
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING)
|
Facility
|
OP
|
$30,503.59
|
|
|
Service Code
|
CPT 55873
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,933.16 |
| Max. Negotiated Rate |
$30,503.59 |
| Rate for Payer: Aetna Medicare |
$9,809.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,790.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,790.52
|
| Rate for Payer: BCBS Complete |
$5,180.29
|
| Rate for Payer: BCBS MAPPO |
$9,432.42
|
| Rate for Payer: BCBS Trust/PPO |
$8,217.04
|
| Rate for Payer: BCN Commercial |
$8,217.04
|
| Rate for Payer: BCN Medicare Advantage |
$9,432.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,432.42
|
| Rate for Payer: Mclaren Medicaid |
$4,933.16
|
| Rate for Payer: Mclaren Medicare |
$9,432.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,904.04
|
| Rate for Payer: Meridian Medicaid |
$9,904.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,847.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,375.66
|
| Rate for Payer: Nomi Health Commercial |
$28,297.26
|
| Rate for Payer: PACE Medicare |
$8,960.80
|
| Rate for Payer: PACE SWMI |
$9,432.42
|
| Rate for Payer: PHP Medicare Advantage |
$9,432.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,933.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,503.59
|
| Rate for Payer: Priority Health Medicare |
$9,432.42
|
| Rate for Payer: Priority Health Tiered Network |
$24,402.87
|
| Rate for Payer: Railroad Medicare Medicare |
$9,432.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,432.42
|
| Rate for Payer: UHC Medicaid |
$4,933.16
|
| Rate for Payer: UHCCP Medicaid |
$4,933.16
|
| Rate for Payer: VA VA |
$9,432.42
|
|
|
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$213.86
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
108145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$85.54 |
| Max. Negotiated Rate |
$192.47 |
| Rate for Payer: Aetna Commercial |
$181.78
|
| Rate for Payer: Aetna Medicare |
$106.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.01
|
| Rate for Payer: BCBS Complete |
$85.54
|
| Rate for Payer: Cash Price |
$171.09
|
| Rate for Payer: Cofinity Advantage |
$149.70
|
| Rate for Payer: Cofinity Commercial |
$183.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.09
|
| Rate for Payer: Healthscope Commercial |
$192.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.40
|
| Rate for Payer: PHP Commercial |
$181.78
|
| Rate for Payer: Priority Health SBD |
$134.73
|
|
|
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$213.86
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
108145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$134.73 |
| Max. Negotiated Rate |
$192.47 |
| Rate for Payer: Aetna Commercial |
$181.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.01
|
| Rate for Payer: Cash Price |
$171.09
|
| Rate for Payer: Cofinity Advantage |
$149.70
|
| Rate for Payer: Cofinity Commercial |
$183.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.09
|
| Rate for Payer: Healthscope Commercial |
$192.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.40
|
| Rate for Payer: PHP Commercial |
$181.78
|
| Rate for Payer: Priority Health SBD |
$134.73
|
|
|
CURETTAGE OR CAUTERY OF ANAL FISSURE, INCLUDING DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE); INITIAL
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 46940
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$133.00 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$133.00
|
| Rate for Payer: BCN Commercial |
$133.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
CURETTAGE, POSTPARTUM
|
Facility
|
OP
|
$10,430.93
|
|
|
Service Code
|
CPT 59160
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.30
|
| Rate for Payer: BCN Commercial |
$2,124.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Mclaren Medicaid |
$1,686.93
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$14,192.04
|
|
|
Service Code
|
APR-DRG 0454
|
| Min. Negotiated Rate |
$13,516.23 |
| Max. Negotiated Rate |
$14,192.04 |
| Rate for Payer: BCBS Complete |
$14,192.04
|
| Rate for Payer: Mclaren Medicaid |
$13,516.23
|
| Rate for Payer: Meridian Medicaid |
$14,192.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,516.23
|
| Rate for Payer: UHC Medicaid |
$13,516.23
|
| Rate for Payer: UHCCP Medicaid |
$13,516.23
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$6,449.05
|
|
|
Service Code
|
APR-DRG 0452
|
| Min. Negotiated Rate |
$6,141.95 |
| Max. Negotiated Rate |
$6,449.05 |
| Rate for Payer: BCBS Complete |
$6,449.05
|
| Rate for Payer: Mclaren Medicaid |
$6,141.95
|
| Rate for Payer: Meridian Medicaid |
$6,449.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,141.95
|
| Rate for Payer: UHC Medicaid |
$6,141.95
|
| Rate for Payer: UHCCP Medicaid |
$6,141.95
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$9,693.36
|
|
|
Service Code
|
APR-DRG 0453
|
| Min. Negotiated Rate |
$9,231.77 |
| Max. Negotiated Rate |
$9,693.36 |
| Rate for Payer: BCBS Complete |
$9,693.36
|
| Rate for Payer: Mclaren Medicaid |
$9,231.77
|
| Rate for Payer: Meridian Medicaid |
$9,693.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,231.77
|
| Rate for Payer: UHC Medicaid |
$9,231.77
|
| Rate for Payer: UHCCP Medicaid |
$9,231.77
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$4,866.17
|
|
|
Service Code
|
APR-DRG 0451
|
| Min. Negotiated Rate |
$4,634.45 |
| Max. Negotiated Rate |
$4,866.17 |
| Rate for Payer: BCBS Complete |
$4,866.17
|
| Rate for Payer: Mclaren Medicaid |
$4,634.45
|
| Rate for Payer: Meridian Medicaid |
$4,866.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,634.45
|
| Rate for Payer: UHC Medicaid |
$4,634.45
|
| Rate for Payer: UHCCP Medicaid |
$4,634.45
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
HCPCS J3420
|
| Hospital Charge Code |
2007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Commercial |
$16.25
|
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna Commercial |
$18.55
|
| Rate for Payer: Aetna Commercial |
$11.01
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Aetna Medicare |
$8.77
|
| Rate for Payer: Aetna Medicare |
$9.56
|
| Rate for Payer: Aetna Medicare |
$13.48
|
| Rate for Payer: Aetna Medicare |
$10.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.42
|
| Rate for Payer: BCBS Complete |
$10.79
|
| Rate for Payer: BCBS Complete |
$7.02
|
| Rate for Payer: BCBS Complete |
$7.65
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Advantage |
$18.88
|
| Rate for Payer: Cofinity Advantage |
$15.27
|
| Rate for Payer: Cofinity Advantage |
$12.28
|
| Rate for Payer: Cofinity Advantage |
$9.06
|
| Rate for Payer: Cofinity Advantage |
$13.38
|
| Rate for Payer: Cofinity Commercial |
$16.44
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Cofinity Commercial |
$11.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$15.79
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Healthscope Commercial |
$19.64
|
| Rate for Payer: Healthscope Commercial |
$17.21
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.36
|
| Rate for Payer: PHP Commercial |
$16.25
|
| Rate for Payer: PHP Commercial |
$14.91
|
| Rate for Payer: PHP Commercial |
$11.01
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Commercial |
$18.55
|
| Rate for Payer: Priority Health SBD |
$12.05
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Priority Health SBD |
$16.99
|
| Rate for Payer: Priority Health SBD |
$11.05
|
| Rate for Payer: Priority Health SBD |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.06
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Core |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
HCPCS J3420
|
| Hospital Charge Code |
2007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna Commercial |
$11.01
|
| Rate for Payer: Aetna Commercial |
$16.25
|
| Rate for Payer: Aetna Commercial |
$18.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.53
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Advantage |
$15.27
|
| Rate for Payer: Cofinity Advantage |
$13.38
|
| Rate for Payer: Cofinity Advantage |
$18.88
|
| Rate for Payer: Cofinity Advantage |
$9.06
|
| Rate for Payer: Cofinity Advantage |
$12.28
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Cofinity Commercial |
$16.44
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$11.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$17.21
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Healthscope Commercial |
$15.79
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Commercial |
$19.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PHP Commercial |
$11.01
|
| Rate for Payer: PHP Commercial |
$18.55
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Commercial |
$14.91
|
| Rate for Payer: PHP Commercial |
$16.25
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Priority Health SBD |
$12.05
|
| Rate for Payer: Priority Health SBD |
$11.05
|
| Rate for Payer: Priority Health SBD |
$8.16
|
| Rate for Payer: Priority Health SBD |
$16.99
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
OP
|
$3.79
|
|
|
Service Code
|
NDC 50268085511
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$3.41 |
| Rate for Payer: Aetna Commercial |
$3.22
|
| Rate for Payer: Aetna Medicare |
$1.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.46
|
| Rate for Payer: BCBS Complete |
$1.52
|
| Rate for Payer: Cash Price |
$3.03
|
| Rate for Payer: Cofinity Advantage |
$2.65
|
| Rate for Payer: Cofinity Commercial |
$3.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.03
|
| Rate for Payer: Healthscope Commercial |
$3.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.84
|
| Rate for Payer: PHP Commercial |
$3.22
|
| Rate for Payer: Priority Health SBD |
$2.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.46
|
| Rate for Payer: UHC Core |
$1.97
|
| Rate for Payer: UHC Exchange |
$1.49
|
|
