|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
IP
|
$209.30
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$131.86 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna Commercial |
$177.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.04
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$146.51
|
| Rate for Payer: Cofinity Commercial |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$188.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.90
|
| Rate for Payer: PHP Commercial |
$177.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.51
|
| Rate for Payer: Priority Health SBD |
$131.86
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
OP
|
$209.30
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna Commercial |
$177.90
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$146.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$188.37
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.90
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$177.90
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.51
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$131.86
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$11.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$6.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.67
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$11.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$6.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.67
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$122.10
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$109.89 |
| Rate for Payer: Aetna Commercial |
$103.78
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$5.44
|
| Rate for Payer: BCBS MAPPO |
$9.47
|
| Rate for Payer: BCBS Trust/PPO |
$7.41
|
| Rate for Payer: BCN Medicare Advantage |
$9.47
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cofinity Commercial |
$105.01
|
| Rate for Payer: Cofinity Commercial |
$85.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.47
|
| Rate for Payer: Healthscope Commercial |
$109.89
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.78
|
| Rate for Payer: PACE Medicare |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.47
|
| Rate for Payer: PHP Commercial |
$103.78
|
| Rate for Payer: PHP Medicare Advantage |
$9.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.47
|
| Rate for Payer: Priority Health Medicare |
$9.47
|
| Rate for Payer: Priority Health SBD |
$76.92
|
| Rate for Payer: Railroad Medicare Medicare |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.36
|
| Rate for Payer: UHC Core |
$16.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.47
|
| Rate for Payer: UHC Exchange |
$9.47
|
| Rate for Payer: UHC Medicare Advantage |
$9.75
|
| Rate for Payer: VA VA |
$9.47
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$122.10
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.92 |
| Max. Negotiated Rate |
$109.89 |
| Rate for Payer: Aetna Commercial |
$103.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.36
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cofinity Commercial |
$105.01
|
| Rate for Payer: Cofinity Commercial |
$85.47
|
| Rate for Payer: Healthscope Commercial |
$109.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.78
|
| Rate for Payer: PHP Commercial |
$103.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.47
|
| Rate for Payer: Priority Health SBD |
$76.92
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health SBD |
$32.33
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$6.33
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.70
|
| Rate for Payer: UHC Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.08
|
| Rate for Payer: UHC Exchange |
$8.08
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.11 |
| Max. Negotiated Rate |
$312.58 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$89.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.66
|
| Rate for Payer: BCBS Complete |
$49.47
|
| Rate for Payer: BCBS MAPPO |
$86.13
|
| Rate for Payer: BCBS Trust/PPO |
$73.69
|
| Rate for Payer: BCN Medicare Advantage |
$86.13
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$210.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.13
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Mclaren Medicaid |
$47.11
|
| Rate for Payer: Mclaren Medicare |
$86.13
|
| Rate for Payer: Meridian Medicaid |
$49.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PACE Medicare |
$81.82
|
| Rate for Payer: PACE SWMI |
$86.13
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$86.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.58
|
| Rate for Payer: Priority Health Medicare |
$86.13
|
| Rate for Payer: Priority Health Narrow Network |
$250.06
|
| Rate for Payer: Priority Health SBD |
$189.00
|
| Rate for Payer: Railroad Medicare Medicare |
$86.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.13
|
| Rate for Payer: UHC Exchange |
$47.81
|
| Rate for Payer: UHC Medicare Advantage |
$88.71
|
| Rate for Payer: VA VA |
$86.13
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$210.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health SBD |
$189.00
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health SBD |
$69.30
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$115.95 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$34.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.94
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$33.55
|
| Rate for Payer: BCBS Trust/PPO |
$58.35
|
| Rate for Payer: BCN Medicare Advantage |
$33.55
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.55
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$33.55
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PACE Medicare |
$31.87
|
| Rate for Payer: PACE SWMI |
$33.55
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$33.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.95
|
| Rate for Payer: Priority Health Medicare |
$33.55
|
| Rate for Payer: Priority Health Narrow Network |
$92.76
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$33.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.55
|
| Rate for Payer: UHC Exchange |
$37.66
|
| Rate for Payer: UHC Medicare Advantage |
$34.56
|
| Rate for Payer: VA VA |
$33.55
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$16.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.08
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.59
|
| Rate for Payer: Priority Health SBD |
$10.43
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$16.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.08
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.59
|
| Rate for Payer: Priority Health SBD |
$10.43
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$49.75 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.82
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Mclaren Medicaid |
$16.02
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Medicaid |
$16.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.14
|
| Rate for Payer: UHC Core |
$49.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Exchange |
$29.28
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$33.42
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.35
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health SBD |
$62.37
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.82
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Mclaren Medicaid |
$16.02
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Medicaid |
$16.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$62.37
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.14
|
| Rate for Payer: UHC Core |
$49.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Exchange |
$29.28
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$426.86
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$384.17 |
| Rate for Payer: Aetna Commercial |
$362.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.46
|
| Rate for Payer: BCBS Complete |
$170.74
|
| Rate for Payer: Cash Price |
$341.49
|
| Rate for Payer: Cofinity Commercial |
$298.80
|
| Rate for Payer: Cofinity Commercial |
$367.10
|
| Rate for Payer: Healthscope Commercial |
$384.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.83
|
| Rate for Payer: PHP Commercial |
$362.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.80
|
| Rate for Payer: Priority Health SBD |
$268.92
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$426.86
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$268.92 |
| Max. Negotiated Rate |
$384.17 |
| Rate for Payer: Aetna Commercial |
$362.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.46
|
| Rate for Payer: Cash Price |
$341.49
|
| Rate for Payer: Cofinity Commercial |
$298.80
|
| Rate for Payer: Cofinity Commercial |
$367.10
|
| Rate for Payer: Healthscope Commercial |
$384.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.83
|
| Rate for Payer: PHP Commercial |
$362.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.80
|
| Rate for Payer: Priority Health SBD |
$268.92
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health SBD |
$31.49
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$16.78
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$36.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$135.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$29.40
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$40.08
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$94.96
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Mclaren Medicaid |
$28.00
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Medicaid |
$29.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.31
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.96
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$85.47
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.43
|
| Rate for Payer: UHC Core |
$68.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$51.19
|
| Rate for Payer: UHC Medicare Advantage |
$52.73
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$135.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.47 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.18
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Cofinity Commercial |
$94.96
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.31
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.96
|
| Rate for Payer: Priority Health SBD |
$85.47
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,314.44
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$139.16 |
| Max. Negotiated Rate |
$2,083.00 |
| Rate for Payer: Aetna Commercial |
$1,967.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,504.39
|
| Rate for Payer: BCBS Complete |
$925.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.89
|
| Rate for Payer: Cash Price |
$1,851.55
|
| Rate for Payer: Cash Price |
$1,851.55
|
| Rate for Payer: Cofinity Commercial |
$1,990.42
|
| Rate for Payer: Cofinity Commercial |
$1,620.11
|
| Rate for Payer: Healthscope Commercial |
$2,083.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,967.27
|
| Rate for Payer: PHP Commercial |
$1,967.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.11
|
| Rate for Payer: Priority Health SBD |
$1,458.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.08
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$139.16
|
|
