|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health SBD |
$32.77
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$81.84 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$26.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.91
|
| Rate for Payer: BCBS Complete |
$14.66
|
| Rate for Payer: BCBS MAPPO |
$25.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.29
|
| Rate for Payer: BCN Medicare Advantage |
$25.53
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.53
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.96
|
| Rate for Payer: Mclaren Medicare |
$25.53
|
| Rate for Payer: Meridian Medicaid |
$14.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Medicare |
$24.25
|
| Rate for Payer: PACE SWMI |
$25.53
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$25.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.84
|
| Rate for Payer: Priority Health Medicare |
$25.53
|
| Rate for Payer: Priority Health Narrow Network |
$65.47
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$25.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.53
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Medicare Advantage |
$26.30
|
| Rate for Payer: VA VA |
$25.53
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$80.01 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Aetna Commercial |
$107.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.55
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$109.22
|
| Rate for Payer: Cofinity Commercial |
$88.90
|
| Rate for Payer: Healthscope Commercial |
$114.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: PHP Commercial |
$107.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: Priority Health SBD |
$80.01
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Aetna Commercial |
$107.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.55
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$88.90
|
| Rate for Payer: Cofinity Commercial |
$109.22
|
| Rate for Payer: Healthscope Commercial |
$114.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: PHP Commercial |
$107.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: Priority Health SBD |
$80.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Exchange |
$44.53
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$23.90 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health SBD |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.29
|
| Rate for Payer: UHC Exchange |
$23.90
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health SBD |
$37.80
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.77 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.38
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$56.41
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health SBD |
$50.77
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$94.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna Medicare |
$26.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.91
|
| Rate for Payer: BCBS Complete |
$14.66
|
| Rate for Payer: BCBS MAPPO |
$25.53
|
| Rate for Payer: BCBS Trust/PPO |
$94.52
|
| Rate for Payer: BCN Medicare Advantage |
$25.53
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$56.41
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.53
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$13.96
|
| Rate for Payer: Mclaren Medicare |
$25.53
|
| Rate for Payer: Meridian Medicaid |
$14.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PACE Medicare |
$24.25
|
| Rate for Payer: PACE SWMI |
$25.53
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: PHP Medicare Advantage |
$25.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.84
|
| Rate for Payer: Priority Health Medicare |
$25.53
|
| Rate for Payer: Priority Health Narrow Network |
$65.47
|
| Rate for Payer: Priority Health SBD |
$50.77
|
| Rate for Payer: Railroad Medicare Medicare |
$25.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.53
|
| Rate for Payer: UHC Exchange |
$42.89
|
| Rate for Payer: UHC Medicare Advantage |
$26.30
|
| Rate for Payer: VA VA |
$25.53
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.54 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$40.60
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health SBD |
$36.54
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| 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 |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$40.60
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| 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 |
$49.30
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$49.30
|
| 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 |
$40.60
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health SBD |
$36.54
|
| 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 CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.73 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$108.91
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$84.63 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.04 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna Medicare |
$9.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.52
|
| Rate for Payer: BCBS Complete |
$5.30
|
| Rate for Payer: BCBS MAPPO |
$9.22
|
| Rate for Payer: BCBS Trust/PPO |
$7.23
|
| Rate for Payer: BCN Medicare Advantage |
$9.22
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$103.60
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Mclaren Medicaid |
$5.04
|
| Rate for Payer: Mclaren Medicare |
$9.22
|
| Rate for Payer: Meridian Medicaid |
$5.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PACE Medicare |
$8.76
|
| Rate for Payer: PACE SWMI |
$9.22
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: PHP Medicare Advantage |
$9.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health Medicare |
$9.22
|
| Rate for Payer: Priority Health SBD |
$93.24
|
| Rate for Payer: Railroad Medicare Medicare |
$9.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.06
|
| Rate for Payer: UHC Core |
$15.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.22
|
| Rate for Payer: UHC Exchange |
$9.22
|
| Rate for Payer: UHC Medicare Advantage |
$9.50
|
| Rate for Payer: VA VA |
$9.22
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.24 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.20
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$103.60
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health SBD |
$93.24
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$712.28
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$641.05 |
| Rate for Payer: Aetna Commercial |
$605.44
|
| Rate for Payer: Aetna Medicare |
$101.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.28
|
| Rate for Payer: BCBS Complete |
$56.19
|
| Rate for Payer: BCBS MAPPO |
$97.82
|
| Rate for Payer: BCBS Trust/PPO |
$462.06
|
| Rate for Payer: BCN Medicare Advantage |
$97.82
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cofinity Commercial |
$612.56
|
| Rate for Payer: Cofinity Commercial |
$498.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.82
|
| Rate for Payer: Healthscope Commercial |
$641.05
|
| Rate for Payer: Mclaren Medicaid |
$53.51
|
| Rate for Payer: Mclaren Medicare |
$97.82
|
| Rate for Payer: Meridian Medicaid |
$56.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.44
|
| Rate for Payer: PACE Medicare |
$92.93
|
| Rate for Payer: PACE SWMI |
$97.82
|
| Rate for Payer: PHP Commercial |
$605.44
|
| Rate for Payer: PHP Medicare Advantage |
$97.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.60
|
| Rate for Payer: Priority Health Medicare |
$97.82
|
| Rate for Payer: Priority Health SBD |
$448.74
|
| Rate for Payer: Railroad Medicare Medicare |
$97.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.82
|
| Rate for Payer: UHC Exchange |
$122.46
|
| Rate for Payer: UHC Medicare Advantage |
$100.75
|
| Rate for Payer: VA VA |
$97.82
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$712.28
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$448.74 |
| Max. Negotiated Rate |
$641.05 |
| Rate for Payer: Aetna Commercial |
$605.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.98
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cofinity Commercial |
$498.60
|
| Rate for Payer: Cofinity Commercial |
$612.56
|
| Rate for Payer: Healthscope Commercial |
$641.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.44
|
| Rate for Payer: PHP Commercial |
$605.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.60
|
| Rate for Payer: Priority Health SBD |
$448.74
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,354.99
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$853.64 |
| Max. Negotiated Rate |
$1,219.49 |
| Rate for Payer: Aetna Commercial |
$1,151.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.74
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cofinity Commercial |
$1,165.29
|
| Rate for Payer: Cofinity Commercial |
$948.49
|
| Rate for Payer: Healthscope Commercial |
$1,219.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,151.74
|
| Rate for Payer: PHP Commercial |
$1,151.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$948.49
|
| Rate for Payer: Priority Health SBD |
$853.64
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,354.99
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$1,219.49 |
| Rate for Payer: Aetna Commercial |
$1,151.74
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.74
|
| 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 |
$706.14
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cofinity Commercial |
$948.49
|
| Rate for Payer: Cofinity Commercial |
$1,165.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,219.49
|
| 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 |
$1,151.74
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,151.74
|
| 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 |
$948.49
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health SBD |
$853.64
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$186.64
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
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 |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| 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 CASHEW IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 CASSETTES QUEST
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.00 |
| 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: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| 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 CASSETTES QUEST
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| 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 |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| 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 CAST CLUB FOOT
|
Facility
|
IP
|
$414.24
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$260.97 |
| Max. Negotiated Rate |
$372.82 |
| Rate for Payer: Aetna Commercial |
$352.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.26
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cofinity Commercial |
$289.97
|
| Rate for Payer: Cofinity Commercial |
$356.25
|
| Rate for Payer: Healthscope Commercial |
$372.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.10
|
| Rate for Payer: PHP Commercial |
$352.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.97
|
| Rate for Payer: Priority Health SBD |
$260.97
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$414.24
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.69 |
| Max. Negotiated Rate |
$372.82 |
| Rate for Payer: Aetna Commercial |
$352.10
|
| Rate for Payer: Aetna Medicare |
$145.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.25
|
| Rate for Payer: BCBS Complete |
$80.53
|
| Rate for Payer: BCBS MAPPO |
$140.20
|
| Rate for Payer: BCBS Trust/PPO |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$140.20
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cofinity Commercial |
$356.25
|
| Rate for Payer: Cofinity Commercial |
$289.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.20
|
| Rate for Payer: Healthscope Commercial |
$372.82
|
| Rate for Payer: Mclaren Medicaid |
$76.69
|
| Rate for Payer: Mclaren Medicare |
$140.20
|
| Rate for Payer: Meridian Medicaid |
$80.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.10
|
| Rate for Payer: PACE Medicare |
$133.19
|
| Rate for Payer: PACE SWMI |
$140.20
|
| Rate for Payer: PHP Commercial |
$352.10
|
| Rate for Payer: PHP Medicare Advantage |
$140.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.97
|
| Rate for Payer: Priority Health Medicare |
$140.20
|
| Rate for Payer: Priority Health SBD |
$260.97
|
| Rate for Payer: Railroad Medicare Medicare |
$140.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.20
|
| Rate for Payer: UHC Exchange |
$110.35
|
| Rate for Payer: UHC Medicare Advantage |
$144.41
|
| Rate for Payer: VA VA |
$140.20
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$60.34
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.22
|
| Rate for Payer: BCBS Complete |
$24.14
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.29
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.24
|
| Rate for Payer: Priority Health SBD |
$38.01
|
|
