|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,235.18 |
| Max. Negotiated Rate |
$3,193.12 |
| Rate for Payer: Aetna Commercial |
$3,015.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,306.14
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$2,483.54
|
| Rate for Payer: Cofinity Commercial |
$3,051.20
|
| Rate for Payer: Healthscope Commercial |
$3,193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PHP Commercial |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health SBD |
$2,235.18
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,937.44 |
| Max. Negotiated Rate |
$2,767.77 |
| Rate for Payer: Aetna Commercial |
$2,614.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.94
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,644.76
|
| Rate for Payer: Cofinity Commercial |
$2,152.71
|
| Rate for Payer: Healthscope Commercial |
$2,767.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: PHP Commercial |
$2,614.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: Priority Health SBD |
$1,937.44
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.87 |
| Max. Negotiated Rate |
$7,745.99 |
| Rate for Payer: Aetna Commercial |
$2,614.00
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,812.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,644.76
|
| Rate for Payer: Cofinity Commercial |
$2,152.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$2,767.77
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$2,614.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,745.99
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health Narrow Network |
$6,196.79
|
| Rate for Payer: Priority Health SBD |
$1,937.44
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$136.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$4,496.47 |
| Rate for Payer: Aetna Commercial |
$1,711.03
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,308.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$659.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,731.16
|
| Rate for Payer: Cofinity Commercial |
$1,409.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,811.68
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,711.03
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,711.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,496.47
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.18
|
| Rate for Payer: Priority Health SBD |
$1,268.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$84.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,268.18 |
| Max. Negotiated Rate |
$1,811.68 |
| Rate for Payer: Aetna Commercial |
$1,711.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,308.44
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,409.09
|
| Rate for Payer: Cofinity Commercial |
$1,731.16
|
| Rate for Payer: Healthscope Commercial |
$1,811.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,711.03
|
| Rate for Payer: PHP Commercial |
$1,711.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.09
|
| Rate for Payer: Priority Health SBD |
$1,268.18
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$894.14 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$743.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$894.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$894.14
|
| Rate for Payer: BCBS Complete |
$410.87
|
| Rate for Payer: BCBS MAPPO |
$715.31
|
| Rate for Payer: BCBS Trust/PPO |
$439.74
|
| Rate for Payer: BCN Medicare Advantage |
$715.31
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.31
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Mclaren Medicaid |
$391.27
|
| Rate for Payer: Mclaren Medicare |
$715.31
|
| Rate for Payer: Meridian Medicaid |
$410.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$751.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$822.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PACE Medicare |
$679.54
|
| Rate for Payer: PACE SWMI |
$715.31
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$715.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$715.31
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: Railroad Medicare Medicare |
$715.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.31
|
| Rate for Payer: UHC Exchange |
$74.00
|
| Rate for Payer: UHC Medicare Advantage |
$736.77
|
| Rate for Payer: VA VA |
$715.31
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$417.69
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,480.31 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,559.05
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,755.90
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health SBD |
$2,480.31
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.87 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: Aetna Medicare |
$1,411.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,559.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,696.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,696.21
|
| Rate for Payer: BCBS Complete |
$779.44
|
| Rate for Payer: BCBS MAPPO |
$1,356.97
|
| Rate for Payer: BCBS Trust/PPO |
$79.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,356.97
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Cofinity Commercial |
$2,755.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,356.97
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Mclaren Medicaid |
$742.26
|
| Rate for Payer: Mclaren Medicare |
$1,356.97
|
| Rate for Payer: Meridian Medicaid |
$779.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,424.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,560.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PACE Medicare |
$1,289.12
|
| Rate for Payer: PACE SWMI |
$1,356.97
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,356.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health Medicare |
$1,356.97
|
| Rate for Payer: Priority Health SBD |
$2,480.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,356.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,356.97
|
| Rate for Payer: UHC Exchange |
$62.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,397.68
|
| Rate for Payer: VA VA |
$1,356.97
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.31 |
| Max. Negotiated Rate |
$344.73 |
| Rate for Payer: Aetna Commercial |
$325.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.97
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$268.12
|
| Rate for Payer: Cofinity Commercial |
$329.41
|
| Rate for Payer: Healthscope Commercial |
$344.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: PHP Commercial |
$325.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: Priority Health SBD |
$241.31
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
OP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.19 |
| Max. Negotiated Rate |
$344.73 |
| Rate for Payer: Aetna Commercial |
$325.58
|
| Rate for Payer: Aetna Medicare |
$226.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.68
|
| Rate for Payer: BCBS Complete |
$124.84
|
| Rate for Payer: BCBS MAPPO |
$217.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.34
|
| Rate for Payer: BCN Medicare Advantage |
$217.34
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$329.41
|
| Rate for Payer: Cofinity Commercial |
$268.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.34
|
| Rate for Payer: Healthscope Commercial |
$344.73
|
| Rate for Payer: Mclaren Medicaid |
$118.88
|
| Rate for Payer: Mclaren Medicare |
$217.34
|
| Rate for Payer: Meridian Medicaid |
$124.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: PACE Medicare |
$206.47
|
| Rate for Payer: PACE SWMI |
$217.34
|
| Rate for Payer: PHP Commercial |
$325.58
|
| Rate for Payer: PHP Medicare Advantage |
$217.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: Priority Health Medicare |
$217.34
|
| Rate for Payer: Priority Health SBD |
$241.31
|
| Rate for Payer: Railroad Medicare Medicare |
$217.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.34
|
| Rate for Payer: UHC Exchange |
$45.19
|
| Rate for Payer: UHC Medicare Advantage |
$223.86
|
| Rate for Payer: VA VA |
$217.34
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
IP
|
$4,100.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,583.00 |
| Max. Negotiated Rate |
$3,690.00 |
| Rate for Payer: Aetna Commercial |
$3,485.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,665.00
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$2,870.00
|
| Rate for Payer: Cofinity Commercial |
$3,526.00
|
| Rate for Payer: Healthscope Commercial |
$3,690.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,485.00
|
| Rate for Payer: PHP Commercial |
$3,485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,870.00
|
| Rate for Payer: Priority Health SBD |
$2,583.00
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
OP
|
$4,100.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$4,496.47 |
| Rate for Payer: Aetna Commercial |
$3,485.00
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,665.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$79.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$2,870.00
|
| Rate for Payer: Cofinity Commercial |
$3,526.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$3,690.00
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,485.00
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$3,485.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,870.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,496.47
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.18
|
| Rate for Payer: Priority Health SBD |
$2,583.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$90.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY INTRANASAL
|
Facility
|
OP
|
$3,950.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
76100448
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.45 |
| Max. Negotiated Rate |
$3,555.00 |
| Rate for Payer: Aetna Commercial |
$3,357.50
|
| Rate for Payer: Aetna Medicare |
$1,411.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,567.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,696.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,696.21
|
| Rate for Payer: BCBS Complete |
$779.44
|
| Rate for Payer: BCBS MAPPO |
$1,356.97
|
| Rate for Payer: BCBS Trust/PPO |
$77.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,356.97
|
| Rate for Payer: Cash Price |
$3,160.00
|
| Rate for Payer: Cash Price |
$3,160.00
|
| Rate for Payer: Cofinity Commercial |
$3,397.00
|
| Rate for Payer: Cofinity Commercial |
$2,765.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,356.97
|
| Rate for Payer: Healthscope Commercial |
$3,555.00
|
| Rate for Payer: Mclaren Medicaid |
$742.26
|
| Rate for Payer: Mclaren Medicare |
$1,356.97
|
| Rate for Payer: Meridian Medicaid |
$779.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,424.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,560.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,357.50
|
| Rate for Payer: PACE Medicare |
$1,289.12
|
| Rate for Payer: PACE SWMI |
$1,356.97
|
| Rate for Payer: PHP Commercial |
$3,357.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,356.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,765.00
|
| Rate for Payer: Priority Health Medicare |
$1,356.97
|
| Rate for Payer: Priority Health SBD |
$2,488.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,356.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,356.97
|
| Rate for Payer: UHC Exchange |
$67.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,397.68
|
| Rate for Payer: VA VA |
$1,356.97
|
|
|
HC BIOPSY INTRANASAL
|
Facility
|
IP
|
$3,950.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
76100448
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,488.50 |
| Max. Negotiated Rate |
$3,555.00 |
| Rate for Payer: Aetna Commercial |
$3,357.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,567.50
|
| Rate for Payer: Cash Price |
$3,160.00
|
| Rate for Payer: Cofinity Commercial |
$2,765.00
|
| Rate for Payer: Cofinity Commercial |
$3,397.00
|
| Rate for Payer: Healthscope Commercial |
$3,555.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,357.50
|
| Rate for Payer: PHP Commercial |
$3,357.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,765.00
|
| Rate for Payer: Priority Health SBD |
$2,488.50
|
|
|
HC BIOPSY LIVER
|
Facility
|
IP
|
$1,619.89
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
36100197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.53 |
| Max. Negotiated Rate |
$1,457.90 |
| Rate for Payer: Aetna Commercial |
$1,376.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.93
|
| Rate for Payer: Cash Price |
$1,295.91
|
| Rate for Payer: Cofinity Commercial |
$1,133.92
|
| Rate for Payer: Cofinity Commercial |
$1,393.11
|
| Rate for Payer: Healthscope Commercial |
$1,457.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,376.91
|
| Rate for Payer: PHP Commercial |
$1,376.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,133.92
|
| Rate for Payer: Priority Health SBD |
$1,020.53
|
|
|
HC BIOPSY LIVER
|
Facility
|
OP
|
$1,619.89
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
36100197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.48 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$1,376.91
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$670.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,295.91
|
| Rate for Payer: Cash Price |
$1,295.91
|
| Rate for Payer: Cofinity Commercial |
$1,133.92
|
| Rate for Payer: Cofinity Commercial |
$1,393.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,457.90
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,376.91
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,376.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,133.92
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health SBD |
$1,020.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.93
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$84.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY LYMPH NODE
|
Facility
|
IP
|
$1,845.23
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
36100186
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,162.49 |
| Max. Negotiated Rate |
$1,660.71 |
| Rate for Payer: Aetna Commercial |
$1,568.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.40
|
| Rate for Payer: Cash Price |
$1,476.18
|
| Rate for Payer: Cofinity Commercial |
$1,291.66
|
| Rate for Payer: Cofinity Commercial |
$1,586.90
|
| Rate for Payer: Healthscope Commercial |
$1,660.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,568.45
|
| Rate for Payer: PHP Commercial |
$1,568.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,291.66
|
| Rate for Payer: Priority Health SBD |
$1,162.49
|
|
|
HC BIOPSY LYMPH NODE
|
Facility
|
OP
|
$1,845.23
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
36100186
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,568.45
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$489.22
|
| Rate for Payer: BCCCP Commercial |
$182.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,476.18
|
| Rate for Payer: Cash Price |
$1,476.18
|
| Rate for Payer: Cofinity Commercial |
$1,291.66
|
| Rate for Payer: Cofinity Commercial |
$1,586.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,660.71
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,568.45
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,568.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,291.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,162.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.12
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$82.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY MUSCLE
|
Facility
|
OP
|
$1,887.46
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
36100017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$4,496.47 |
| Rate for Payer: Aetna Commercial |
$1,604.34
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$554.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,509.97
|
| Rate for Payer: Cash Price |
$1,509.97
|
| Rate for Payer: Cofinity Commercial |
$1,321.22
|
| Rate for Payer: Cofinity Commercial |
$1,623.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,698.71
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,604.34
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,604.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,496.47
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.18
|
| Rate for Payer: Priority Health SBD |
$1,189.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY MUSCLE
|
Facility
|
IP
|
$1,887.46
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
36100017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,189.10 |
| Max. Negotiated Rate |
$1,698.71 |
| Rate for Payer: Aetna Commercial |
$1,604.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.85
|
| Rate for Payer: Cash Price |
$1,509.97
|
| Rate for Payer: Cofinity Commercial |
$1,321.22
|
| Rate for Payer: Cofinity Commercial |
$1,623.22
|
| Rate for Payer: Healthscope Commercial |
$1,698.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,604.34
|
| Rate for Payer: PHP Commercial |
$1,604.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.22
|
| Rate for Payer: Priority Health SBD |
$1,189.10
|
|
|
HC BIOPSY MUSCLE TISSUE SUPERFICIAL
|
Facility
|
OP
|
$2,158.09
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
36100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.65 |
| Max. Negotiated Rate |
$4,496.47 |
| Rate for Payer: Aetna Commercial |
$1,834.38
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$617.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$1,510.66
|
| Rate for Payer: Cofinity Commercial |
$1,855.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,942.28
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,834.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,496.47
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.18
|
| Rate for Payer: Priority Health SBD |
$1,359.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$93.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC BIOPSY MUSCLE TISSUE SUPERFICIAL
|
Facility
|
IP
|
$2,158.09
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
36100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,359.60 |
| Max. Negotiated Rate |
$1,942.28 |
| Rate for Payer: Aetna Commercial |
$1,834.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.76
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$1,510.66
|
| Rate for Payer: Cofinity Commercial |
$1,855.96
|
| Rate for Payer: Healthscope Commercial |
$1,942.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: PHP Commercial |
$1,834.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: Priority Health SBD |
$1,359.60
|
|
|
HC BIOPSY OF LIP
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
76100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.45 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$226.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.68
|
| Rate for Payer: BCBS Complete |
$124.84
|
| Rate for Payer: BCBS MAPPO |
$217.34
|
| Rate for Payer: BCBS Trust/PPO |
$174.32
|
| Rate for Payer: BCN Medicare Advantage |
$217.34
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.34
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Mclaren Medicaid |
$118.88
|
| Rate for Payer: Mclaren Medicare |
$217.34
|
| Rate for Payer: Meridian Medicaid |
$124.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Medicare |
$206.47
|
| Rate for Payer: PACE SWMI |
$217.34
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health Medicare |
$217.34
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: Railroad Medicare Medicare |
$217.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.34
|
| Rate for Payer: UHC Exchange |
$67.45
|
| Rate for Payer: UHC Medicare Advantage |
$223.86
|
| Rate for Payer: VA VA |
$217.34
|
|
|
HC BIOPSY OF LIP
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
76100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$409.50 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health SBD |
$409.50
|
|
