|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,314.44
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,458.10 |
| 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: 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
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$492.56
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.31 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$418.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.16
|
| Rate for Payer: Cash Price |
$394.05
|
| Rate for Payer: Cofinity Commercial |
$344.79
|
| Rate for Payer: Cofinity Commercial |
$423.60
|
| Rate for Payer: Healthscope Commercial |
$443.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$418.68
|
| Rate for Payer: PHP Commercial |
$418.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.79
|
| Rate for Payer: Priority Health SBD |
$310.31
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$492.56
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.36 |
| Max. Negotiated Rate |
$1,726.63 |
| Rate for Payer: Aetna Commercial |
$418.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.16
|
| Rate for Payer: BCBS Complete |
$197.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,726.63
|
| Rate for Payer: Cash Price |
$394.05
|
| Rate for Payer: Cash Price |
$394.05
|
| Rate for Payer: Cofinity Commercial |
$423.60
|
| Rate for Payer: Cofinity Commercial |
$344.79
|
| Rate for Payer: Healthscope Commercial |
$443.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$418.68
|
| Rate for Payer: PHP Commercial |
$418.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.79
|
| Rate for Payer: Priority Health SBD |
$310.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.90
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$165.36
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$541.81
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.84 |
| Max. Negotiated Rate |
$1,266.80 |
| Rate for Payer: Aetna Commercial |
$460.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.18
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.80
|
| Rate for Payer: Cash Price |
$433.45
|
| Rate for Payer: Cash Price |
$433.45
|
| Rate for Payer: Cofinity Commercial |
$465.96
|
| Rate for Payer: Cofinity Commercial |
$379.27
|
| Rate for Payer: Healthscope Commercial |
$487.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.54
|
| Rate for Payer: PHP Commercial |
$460.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.27
|
| Rate for Payer: Priority Health SBD |
$341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.72
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$138.84
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$541.81
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.34 |
| Max. Negotiated Rate |
$487.63 |
| Rate for Payer: Aetna Commercial |
$460.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.18
|
| Rate for Payer: Cash Price |
$433.45
|
| Rate for Payer: Cofinity Commercial |
$379.27
|
| Rate for Payer: Cofinity Commercial |
$465.96
|
| Rate for Payer: Healthscope Commercial |
$487.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.54
|
| Rate for Payer: PHP Commercial |
$460.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.27
|
| Rate for Payer: Priority Health SBD |
$341.34
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,381.71
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.03 |
| Max. Negotiated Rate |
$7,632.00 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna Medicare |
$5,289.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,148.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,357.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,357.20
|
| Rate for Payer: BCBS Complete |
$2,921.26
|
| Rate for Payer: BCBS MAPPO |
$5,085.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,019.64
|
| Rate for Payer: BCN Medicare Advantage |
$5,085.76
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,085.76
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Mclaren Medicaid |
$2,781.91
|
| Rate for Payer: Mclaren Medicare |
$5,085.76
|
| Rate for Payer: Meridian Medicaid |
$2,921.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,340.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,848.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PACE Medicare |
$4,831.47
|
| Rate for Payer: PACE SWMI |
$5,085.76
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: PHP Medicare Advantage |
$5,085.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,781.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health Medicare |
$5,085.76
|
| Rate for Payer: Priority Health SBD |
$4,020.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5,085.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.23
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,085.76
|
| Rate for Payer: UHC Exchange |
$332.03
|
| Rate for Payer: UHC Medicare Advantage |
$5,238.33
|
| Rate for Payer: VA VA |
$5,085.76
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,381.71
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,020.48 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,148.11
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health SBD |
$4,020.48
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,381.71
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.24 |
| Max. Negotiated Rate |
$7,632.00 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna Medicare |
$5,289.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,148.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,357.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,357.20
|
| Rate for Payer: BCBS Complete |
$2,921.26
|
| Rate for Payer: BCBS MAPPO |
$5,085.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,471.08
|
| Rate for Payer: BCN Medicare Advantage |
$5,085.76
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,085.76
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Mclaren Medicaid |
$2,781.91
|
| Rate for Payer: Mclaren Medicare |
$5,085.76
|
| Rate for Payer: Meridian Medicaid |
$2,921.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,340.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,848.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PACE Medicare |
$4,831.47
|
| Rate for Payer: PACE SWMI |
$5,085.76
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: PHP Medicare Advantage |
$5,085.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,781.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health Medicare |
$5,085.76
|
| Rate for Payer: Priority Health SBD |
$4,020.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5,085.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.56
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,085.76
|
| Rate for Payer: UHC Exchange |
$283.24
|
| Rate for Payer: UHC Medicare Advantage |
$5,238.33
|
| Rate for Payer: VA VA |
$5,085.76
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,381.71
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,020.48 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,148.11
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health SBD |
$4,020.48
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$991.53
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$322.20 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.49
|
| Rate for Payer: BCBS Complete |
$396.61
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Cofinity Commercial |
$694.07
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health SBD |
$624.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.42
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$322.20
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$991.53
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.66 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.49
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$694.07
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health SBD |
$624.66
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$991.53
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.66 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.49
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$694.07
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health SBD |
$624.66
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$991.53
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.10 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.49
|
| Rate for Payer: BCBS Complete |
$396.61
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Cofinity Commercial |
$694.07
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health SBD |
$624.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.21
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$161.10
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,829.05
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$1,646.14 |
| Rate for Payer: Aetna Commercial |
$1,554.69
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCBS Trust/PPO |
$46.34
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cofinity Commercial |
$1,572.98
|
| Rate for Payer: Cofinity Commercial |
$1,280.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,646.14
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,554.69
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,554.69
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.43
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health Narrow Network |
$573.14
|
| Rate for Payer: Priority Health SBD |
$1,152.30
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$41.91
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,829.05
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,152.30 |
| Max. Negotiated Rate |
$1,646.14 |
| Rate for Payer: Aetna Commercial |
$1,554.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.88
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cofinity Commercial |
$1,280.34
|
| Rate for Payer: Cofinity Commercial |
$1,572.98
|
| Rate for Payer: Healthscope Commercial |
$1,646.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,554.69
|
| Rate for Payer: PHP Commercial |
$1,554.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.34
|
| Rate for Payer: Priority Health SBD |
$1,152.30
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.78 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.90
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$74.20
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health SBD |
$66.78
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.99 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.43
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$74.20
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Mclaren Medicaid |
$7.99
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Medicaid |
$8.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$66.78
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.52
|
| Rate for Payer: UHC Core |
$24.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Exchange |
$14.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health SBD |
$22.49
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.99 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.43
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$7.99
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Medicaid |
$8.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.52
|
| Rate for Payer: UHC Core |
$24.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Exchange |
$14.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN II
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna Medicare |
$21.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.65
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$20.52
|
| Rate for Payer: BCBS Trust/PPO |
$16.07
|
| Rate for Payer: BCN Medicare Advantage |
$20.52
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Cofinity Commercial |
$227.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.52
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Mclaren Medicaid |
$11.22
|
| Rate for Payer: Mclaren Medicare |
$20.52
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.25
|
| Rate for Payer: PACE Medicare |
$19.49
|
| Rate for Payer: PACE SWMI |
$20.52
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: PHP Medicare Advantage |
$20.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health Medicare |
$20.52
|
| Rate for Payer: Priority Health SBD |
$204.75
|
| Rate for Payer: Railroad Medicare Medicare |
$20.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.62
|
| Rate for Payer: UHC Core |
$34.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.52
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$21.14
|
| Rate for Payer: VA VA |
$20.52
|
|
|
HC ANGIOTENSIN II
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.25
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Cofinity Commercial |
$227.50
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.25
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health SBD |
$204.75
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$65.48
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.56
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cofinity Commercial |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Healthscope Commercial |
$58.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.66
|
| Rate for Payer: PHP Commercial |
$55.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health SBD |
$41.25
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
OP
|
$65.48
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$156.59 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: Aetna Medicare |
$37.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.60
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS MAPPO |
$35.68
|
| Rate for Payer: BCBS Trust/PPO |
$156.59
|
| Rate for Payer: BCN Medicare Advantage |
$35.68
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cofinity Commercial |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.68
|
| Rate for Payer: Healthscope Commercial |
$58.93
|
| Rate for Payer: Mclaren Medicaid |
$19.52
|
| Rate for Payer: Mclaren Medicare |
$35.68
|
| Rate for Payer: Meridian Medicaid |
$20.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.66
|
| Rate for Payer: PACE Medicare |
$33.90
|
| Rate for Payer: PACE SWMI |
$35.68
|
| Rate for Payer: PHP Commercial |
$55.66
|
| Rate for Payer: PHP Medicare Advantage |
$35.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health Medicare |
$35.68
|
| Rate for Payer: Priority Health SBD |
$41.25
|
| Rate for Payer: Railroad Medicare Medicare |
$35.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.68
|
| Rate for Payer: UHC Exchange |
$22.59
|
| Rate for Payer: UHC Medicare Advantage |
$36.75
|
| Rate for Payer: VA VA |
$35.68
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
IP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.63 |
| Max. Negotiated Rate |
$29.48 |
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.29
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health SBD |
$20.63
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
OP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$66.02 |
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.29
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$66.02
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health SBD |
$20.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.65
|
| Rate for Payer: UHC Exchange |
$7.86
|
|
