|
HC BIOTINIDASE
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.21 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna Commercial |
$56.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.55
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$57.62
|
| Rate for Payer: Healthscope Commercial |
$60.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PHP Commercial |
$56.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health SBD |
$42.21
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna Commercial |
$56.95
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$13.21
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$57.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$60.30
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$56.95
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health SBD |
$42.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.24
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$16.87
|
| Rate for Payer: UHC Medicare Advantage |
$17.38
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,442.85
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,949.00 |
| Max. Negotiated Rate |
$8,498.56 |
| Rate for Payer: Aetna Commercial |
$8,026.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,137.85
|
| Rate for Payer: Cash Price |
$7,554.28
|
| Rate for Payer: Cofinity Commercial |
$6,610.00
|
| Rate for Payer: Cofinity Commercial |
$8,120.85
|
| Rate for Payer: Healthscope Commercial |
$8,498.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,026.42
|
| Rate for Payer: PHP Commercial |
$8,026.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,610.00
|
| Rate for Payer: Priority Health SBD |
$5,949.00
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,442.85
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,777.14 |
| Max. Negotiated Rate |
$8,498.56 |
| Rate for Payer: Aetna Commercial |
$8,026.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,137.85
|
| Rate for Payer: BCBS Complete |
$3,777.14
|
| Rate for Payer: Cash Price |
$7,554.28
|
| Rate for Payer: Cofinity Commercial |
$6,610.00
|
| Rate for Payer: Cofinity Commercial |
$8,120.85
|
| Rate for Payer: Healthscope Commercial |
$8,498.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,026.42
|
| Rate for Payer: PHP Commercial |
$8,026.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,610.00
|
| Rate for Payer: Priority Health SBD |
$5,949.00
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,722.47
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,085.16 |
| Max. Negotiated Rate |
$1,550.22 |
| Rate for Payer: Aetna Commercial |
$1,464.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.61
|
| Rate for Payer: Cash Price |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,205.73
|
| Rate for Payer: Cofinity Commercial |
$1,481.32
|
| Rate for Payer: Healthscope Commercial |
$1,550.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.10
|
| Rate for Payer: PHP Commercial |
$1,464.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.73
|
| Rate for Payer: Priority Health SBD |
$1,085.16
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,722.47
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$688.99 |
| Max. Negotiated Rate |
$1,550.22 |
| Rate for Payer: Aetna Commercial |
$1,464.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.61
|
| Rate for Payer: BCBS Complete |
$688.99
|
| Rate for Payer: Cash Price |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,205.73
|
| Rate for Payer: Cofinity Commercial |
$1,481.32
|
| Rate for Payer: Healthscope Commercial |
$1,550.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.10
|
| Rate for Payer: PHP Commercial |
$1,464.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.73
|
| Rate for Payer: Priority Health SBD |
$1,085.16
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$857.95
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$36.02 |
| Max. Negotiated Rate |
$772.16 |
| Rate for Payer: Aetna Commercial |
$729.26
|
| Rate for Payer: Aetna Medicare |
$197.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.22
|
| Rate for Payer: BCBS Complete |
$109.01
|
| Rate for Payer: BCBS MAPPO |
$189.78
|
| Rate for Payer: BCBS Trust/PPO |
$162.72
|
| Rate for Payer: BCN Medicare Advantage |
$189.78
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cofinity Commercial |
$737.84
|
| Rate for Payer: Cofinity Commercial |
$600.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.78
|
| Rate for Payer: Healthscope Commercial |
$772.16
|
| Rate for Payer: Mclaren Medicaid |
$103.81
|
| Rate for Payer: Mclaren Medicare |
$189.78
|
| Rate for Payer: Meridian Medicaid |
$109.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.26
|
| Rate for Payer: PACE Medicare |
$180.29
|
| Rate for Payer: PACE SWMI |
$189.78
|
| Rate for Payer: PHP Commercial |
$729.26
|
| Rate for Payer: PHP Medicare Advantage |
$189.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.56
|
| Rate for Payer: Priority Health Medicare |
$189.78
|
| Rate for Payer: Priority Health SBD |
$540.51
|
| Rate for Payer: Railroad Medicare Medicare |
$189.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.78
|
| Rate for Payer: UHC Exchange |
$36.02
|
| Rate for Payer: UHC Medicare Advantage |
$195.47
|
| Rate for Payer: VA VA |
$189.78
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$857.95
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$540.51 |
| Max. Negotiated Rate |
$772.16 |
| Rate for Payer: Aetna Commercial |
$729.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.67
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cofinity Commercial |
$600.56
|
| Rate for Payer: Cofinity Commercial |
$737.84
|
| Rate for Payer: Healthscope Commercial |
$772.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.26
|
| Rate for Payer: PHP Commercial |
$729.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.56
|
| Rate for Payer: Priority Health SBD |
$540.51
|
|
|
HC BIRCH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$1,998.72
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,259.19 |
| Max. Negotiated Rate |
$1,798.85 |
| Rate for Payer: Aetna Commercial |
$1,698.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.17
|
| Rate for Payer: Cash Price |
$1,598.98
|
| Rate for Payer: Cofinity Commercial |
$1,399.10
|
| Rate for Payer: Cofinity Commercial |
$1,718.90
|
| Rate for Payer: Healthscope Commercial |
$1,798.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,698.91
|
| Rate for Payer: PHP Commercial |
$1,698.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.10
|
| Rate for Payer: Priority Health SBD |
$1,259.19
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$1,998.72
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$799.49 |
| Max. Negotiated Rate |
$1,798.85 |
| Rate for Payer: Aetna Commercial |
$1,698.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.17
|
| Rate for Payer: BCBS Complete |
$799.49
|
| Rate for Payer: Cash Price |
$1,598.98
|
| Rate for Payer: Cofinity Commercial |
$1,399.10
|
| Rate for Payer: Cofinity Commercial |
$1,718.90
|
| Rate for Payer: Healthscope Commercial |
$1,798.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,698.91
|
| Rate for Payer: PHP Commercial |
$1,698.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.10
|
| Rate for Payer: Priority Health SBD |
$1,259.19
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,955.46 |
| Max. Negotiated Rate |
$24,649.78 |
| Rate for Payer: Aetna Commercial |
$23,280.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,802.62
|
| Rate for Payer: BCBS Complete |
$10,955.46
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$19,172.06
|
| Rate for Payer: Cofinity Commercial |
$23,554.24
|
| Rate for Payer: Healthscope Commercial |
$24,649.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: PHP Commercial |
$23,280.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: Priority Health SBD |
$17,254.85
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$17,254.85 |
| Max. Negotiated Rate |
$24,649.78 |
| Rate for Payer: Aetna Commercial |
$23,280.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,802.62
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$19,172.06
|
| Rate for Payer: Cofinity Commercial |
$23,554.24
|
| Rate for Payer: Healthscope Commercial |
$24,649.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: PHP Commercial |
$23,280.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: Priority Health SBD |
$17,254.85
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.04 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: Priority Health SBD |
$70.04
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$33.55
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Medicaid |
$24.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$70.04
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Core |
$72.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$109.74 |
| Max. Negotiated Rate |
$246.92 |
| Rate for Payer: Aetna Commercial |
$233.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.33
|
| Rate for Payer: BCBS Complete |
$109.74
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$192.05
|
| Rate for Payer: Cofinity Commercial |
$235.95
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: PHP Commercial |
$233.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: Priority Health SBD |
$172.85
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.85 |
| Max. Negotiated Rate |
$246.92 |
| Rate for Payer: Aetna Commercial |
$233.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.33
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$192.05
|
| Rate for Payer: Cofinity Commercial |
$235.95
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: PHP Commercial |
$233.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: Priority Health SBD |
$172.85
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.59 |
| Max. Negotiated Rate |
$135.13 |
| Rate for Payer: Aetna Commercial |
$127.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.59
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$105.10
|
| Rate for Payer: Cofinity Commercial |
$129.12
|
| Rate for Payer: Healthscope Commercial |
$135.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: PHP Commercial |
$127.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health SBD |
$94.59
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$173.33 |
| Rate for Payer: Aetna Commercial |
$127.62
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.04
|
| Rate for Payer: BCBS Complete |
$31.26
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS Trust/PPO |
$69.54
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$129.12
|
| Rate for Payer: Cofinity Commercial |
$105.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$135.13
|
| Rate for Payer: Mclaren Medicaid |
$29.77
|
| Rate for Payer: Mclaren Medicare |
$54.43
|
| Rate for Payer: Meridian Medicaid |
$31.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: PACE Medicare |
$51.71
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Commercial |
$127.62
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.33
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$138.66
|
| Rate for Payer: Priority Health SBD |
$94.59
|
| Rate for Payer: Railroad Medicare Medicare |
$54.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Exchange |
$11.13
|
| Rate for Payer: UHC Medicare Advantage |
$56.06
|
| Rate for Payer: VA VA |
$54.43
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health SBD |
$47.25
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.41
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$7.06
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$7.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$47.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.48
|
| Rate for Payer: UHC Core |
$21.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.90
|
| Rate for Payer: UHC Exchange |
$12.90
|
| Rate for Payer: UHC Medicare Advantage |
$13.29
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.91 |
| Max. Negotiated Rate |
$109.87 |
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.35
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Cofinity Commercial |
$85.46
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PHP Commercial |
$103.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health SBD |
$76.91
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.47 |
| Max. Negotiated Rate |
$351.10 |
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: Aetna Medicare |
$118.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.08
|
| Rate for Payer: BCBS Complete |
$65.29
|
| Rate for Payer: BCBS MAPPO |
$113.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$113.66
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Cofinity Commercial |
$85.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.66
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Mclaren Medicaid |
$62.17
|
| Rate for Payer: Mclaren Medicare |
$113.66
|
| Rate for Payer: Meridian Medicaid |
$65.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PACE Medicare |
$107.98
|
| Rate for Payer: PACE SWMI |
$113.66
|
| Rate for Payer: PHP Commercial |
$103.77
|
| Rate for Payer: PHP Medicare Advantage |
$113.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$351.10
|
| Rate for Payer: Priority Health Medicare |
$113.66
|
| Rate for Payer: Priority Health Narrow Network |
$280.88
|
| Rate for Payer: Priority Health SBD |
$76.91
|
| Rate for Payer: Railroad Medicare Medicare |
$113.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.66
|
| Rate for Payer: UHC Exchange |
$29.47
|
| Rate for Payer: UHC Medicare Advantage |
$117.07
|
| Rate for Payer: VA VA |
$113.66
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$5.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: BCBS Complete |
$2.77
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$3.78
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$52.78
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Mclaren Medicaid |
$2.64
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Medicaid |
$2.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health SBD |
$47.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.78
|
| Rate for Payer: UHC Core |
$7.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Exchange |
$4.82
|
| Rate for Payer: UHC Medicare Advantage |
$4.96
|
| Rate for Payer: VA VA |
$4.82
|
|
