|
HC COLL CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$8.57
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$7.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.57
|
| Rate for Payer: Cash Price |
$6.86
|
| Rate for Payer: Cofinity Commercial |
$6.00
|
| Rate for Payer: Cofinity Commercial |
$7.37
|
| Rate for Payer: Healthscope Commercial |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.28
|
| Rate for Payer: PHP Commercial |
$7.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.00
|
| Rate for Payer: Priority Health SBD |
$5.40
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
IP
|
$2,355.43
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,483.92 |
| Max. Negotiated Rate |
$2,119.89 |
| Rate for Payer: Aetna Commercial |
$2,002.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,531.03
|
| Rate for Payer: Cash Price |
$1,884.34
|
| Rate for Payer: Cofinity Commercial |
$1,648.80
|
| Rate for Payer: Cofinity Commercial |
$2,025.67
|
| Rate for Payer: Healthscope Commercial |
$2,119.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,002.12
|
| Rate for Payer: PHP Commercial |
$2,002.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,648.80
|
| Rate for Payer: Priority Health SBD |
$1,483.92
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
OP
|
$2,355.43
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$942.17 |
| Max. Negotiated Rate |
$2,119.89 |
| Rate for Payer: Aetna Commercial |
$2,002.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,531.03
|
| Rate for Payer: BCBS Complete |
$942.17
|
| Rate for Payer: Cash Price |
$1,884.34
|
| Rate for Payer: Cofinity Commercial |
$1,648.80
|
| Rate for Payer: Cofinity Commercial |
$2,025.67
|
| Rate for Payer: Healthscope Commercial |
$2,119.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,002.12
|
| Rate for Payer: PHP Commercial |
$2,002.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,648.80
|
| Rate for Payer: Priority Health SBD |
$1,483.92
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
IP
|
$359.40
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$323.46 |
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.61
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$251.58
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health SBD |
$226.42
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
OP
|
$359.40
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$131.63 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: Aetna Medicare |
$290.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.11
|
| Rate for Payer: BCBS Complete |
$160.42
|
| Rate for Payer: BCBS MAPPO |
$279.29
|
| Rate for Payer: BCBS Trust/PPO |
$210.31
|
| Rate for Payer: BCN Medicare Advantage |
$279.29
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Cofinity Commercial |
$251.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.29
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Mclaren Medicaid |
$152.77
|
| Rate for Payer: Mclaren Medicare |
$279.29
|
| Rate for Payer: Meridian Medicaid |
$160.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$293.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PACE Medicare |
$265.33
|
| Rate for Payer: PACE SWMI |
$279.29
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: PHP Medicare Advantage |
$279.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health Medicare |
$279.29
|
| Rate for Payer: Priority Health SBD |
$226.42
|
| Rate for Payer: Railroad Medicare Medicare |
$279.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.29
|
| Rate for Payer: UHC Exchange |
$131.63
|
| Rate for Payer: UHC Medicare Advantage |
$287.67
|
| Rate for Payer: VA VA |
$279.29
|
|
|
HC COLONOSCOPY
|
Facility
|
OP
|
$2,560.49
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,024.20 |
| Max. Negotiated Rate |
$2,304.44 |
| Rate for Payer: Aetna Commercial |
$2,176.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.32
|
| Rate for Payer: BCBS Complete |
$1,024.20
|
| Rate for Payer: Cash Price |
$2,048.39
|
| Rate for Payer: Cofinity Commercial |
$1,792.34
|
| Rate for Payer: Cofinity Commercial |
$2,202.02
|
| Rate for Payer: Healthscope Commercial |
$2,304.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,176.42
|
| Rate for Payer: PHP Commercial |
$2,176.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.34
|
| Rate for Payer: Priority Health SBD |
$1,613.11
|
|
|
HC COLONOSCOPY
|
Facility
|
IP
|
$2,560.49
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,613.11 |
| Max. Negotiated Rate |
$2,304.44 |
| Rate for Payer: Aetna Commercial |
$2,176.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.32
|
| Rate for Payer: Cash Price |
$2,048.39
|
| Rate for Payer: Cofinity Commercial |
$1,792.34
|
| Rate for Payer: Cofinity Commercial |
$2,202.02
|
| Rate for Payer: Healthscope Commercial |
$2,304.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,176.42
|
| Rate for Payer: PHP Commercial |
$2,176.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.34
|
| Rate for Payer: Priority Health SBD |
$1,613.11
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,745.16
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,098.06 |
| Max. Negotiated Rate |
$2,470.64 |
| Rate for Payer: Aetna Commercial |
$2,333.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,784.35
|
| Rate for Payer: BCBS Complete |
$1,098.06
|
| Rate for Payer: Cash Price |
$2,196.13
|
| Rate for Payer: Cofinity Commercial |
$1,921.61
|
| Rate for Payer: Cofinity Commercial |
$2,360.84
|
| Rate for Payer: Healthscope Commercial |
$2,470.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,333.39
|
| Rate for Payer: PHP Commercial |
$2,333.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.61
|
| Rate for Payer: Priority Health SBD |
$1,729.45
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,745.16
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,729.45 |
| Max. Negotiated Rate |
$2,470.64 |
| Rate for Payer: Aetna Commercial |
$2,333.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,784.35
|
| Rate for Payer: Cash Price |
$2,196.13
|
| Rate for Payer: Cofinity Commercial |
$1,921.61
|
| Rate for Payer: Cofinity Commercial |
$2,360.84
|
| Rate for Payer: Healthscope Commercial |
$2,470.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,333.39
|
| Rate for Payer: PHP Commercial |
$2,333.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.61
|
| Rate for Payer: Priority Health SBD |
$1,729.45
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$6,832.88
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,304.71 |
| Max. Negotiated Rate |
$6,149.59 |
| Rate for Payer: Aetna Commercial |
$5,807.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,441.37
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cofinity Commercial |
$4,783.02
|
| Rate for Payer: Cofinity Commercial |
$5,876.28
|
| Rate for Payer: Healthscope Commercial |
$6,149.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,807.95
|
| Rate for Payer: PHP Commercial |
$5,807.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,783.02
|
| Rate for Payer: Priority Health SBD |
$4,304.71
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$6,832.88
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.11 |
| Max. Negotiated Rate |
$6,149.59 |
| Rate for Payer: Aetna Commercial |
$5,807.95
|
| Rate for Payer: Aetna Medicare |
$2,893.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,441.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,477.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,477.26
|
| Rate for Payer: BCBS Complete |
$1,597.87
|
| Rate for Payer: BCBS MAPPO |
$2,781.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.43
|
| Rate for Payer: BCCCP Commercial |
$370.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,781.81
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cofinity Commercial |
$5,876.28
|
| Rate for Payer: Cofinity Commercial |
$4,783.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,781.81
|
| Rate for Payer: Healthscope Commercial |
$6,149.59
|
| Rate for Payer: Mclaren Medicaid |
$1,521.65
|
| Rate for Payer: Mclaren Medicare |
$2,781.81
|
| Rate for Payer: Meridian Medicaid |
$1,597.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,920.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,199.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,807.95
|
| Rate for Payer: PACE Medicare |
$2,642.72
|
| Rate for Payer: PACE SWMI |
$2,781.81
|
| Rate for Payer: PHP Commercial |
$5,807.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,781.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,521.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,783.02
|
| Rate for Payer: Priority Health Medicare |
$2,781.81
|
| Rate for Payer: Priority Health SBD |
$4,304.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,781.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,781.81
|
| Rate for Payer: UHC Exchange |
$179.11
|
| Rate for Payer: UHC Medicare Advantage |
$2,865.26
|
| Rate for Payer: VA VA |
$2,781.81
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$7,950.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,008.50 |
| Max. Negotiated Rate |
$7,155.00 |
| Rate for Payer: Aetna Commercial |
$6,757.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,167.50
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$5,565.00
|
| Rate for Payer: Cofinity Commercial |
$6,837.00
|
| Rate for Payer: Healthscope Commercial |
$7,155.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PHP Commercial |
$6,757.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health SBD |
$5,008.50
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$7,950.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.52 |
| Max. Negotiated Rate |
$7,155.00 |
| Rate for Payer: Aetna Commercial |
$6,757.50
|
| Rate for Payer: Aetna Medicare |
$2,893.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,167.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,477.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,477.26
|
| Rate for Payer: BCBS Complete |
$1,597.87
|
| Rate for Payer: BCBS MAPPO |
$2,781.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.43
|
| Rate for Payer: BCCCP Commercial |
$331.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,781.81
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$6,837.00
|
| Rate for Payer: Cofinity Commercial |
$5,565.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,781.81
|
| Rate for Payer: Healthscope Commercial |
$7,155.00
|
| Rate for Payer: Mclaren Medicaid |
$1,521.65
|
| Rate for Payer: Mclaren Medicare |
$2,781.81
|
| Rate for Payer: Meridian Medicaid |
$1,597.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,920.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,199.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PACE Medicare |
$2,642.72
|
| Rate for Payer: PACE SWMI |
$2,781.81
|
| Rate for Payer: PHP Commercial |
$6,757.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,781.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,521.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health Medicare |
$2,781.81
|
| Rate for Payer: Priority Health SBD |
$5,008.50
|
| Rate for Payer: Railroad Medicare Medicare |
$2,781.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,781.81
|
| Rate for Payer: UHC Exchange |
$156.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,865.26
|
| Rate for Payer: VA VA |
$2,781.81
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
OP
|
$279.48
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.39 |
| Max. Negotiated Rate |
$251.53 |
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna Medicare |
$184.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.64
|
| Rate for Payer: BCBS Complete |
$101.85
|
| Rate for Payer: BCBS MAPPO |
$177.31
|
| Rate for Payer: BCBS Trust/PPO |
$91.31
|
| Rate for Payer: BCCCP Commercial |
$134.56
|
| Rate for Payer: BCN Medicare Advantage |
$177.31
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cofinity Commercial |
$240.35
|
| Rate for Payer: Cofinity Commercial |
$195.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.31
|
| Rate for Payer: Healthscope Commercial |
$251.53
|
| Rate for Payer: Mclaren Medicaid |
$96.99
|
| Rate for Payer: Mclaren Medicare |
$177.31
|
| Rate for Payer: Meridian Medicaid |
$101.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$237.56
|
| Rate for Payer: PACE Medicare |
$168.44
|
| Rate for Payer: PACE SWMI |
$177.31
|
| Rate for Payer: PHP Commercial |
$237.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.64
|
| Rate for Payer: Priority Health Medicare |
$177.31
|
| Rate for Payer: Priority Health SBD |
$176.07
|
| Rate for Payer: Railroad Medicare Medicare |
$177.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.31
|
| Rate for Payer: UHC Exchange |
$89.39
|
| Rate for Payer: UHC Medicare Advantage |
$182.63
|
| Rate for Payer: VA VA |
$177.31
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
IP
|
$279.48
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.07 |
| Max. Negotiated Rate |
$251.53 |
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.66
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cofinity Commercial |
$195.64
|
| Rate for Payer: Cofinity Commercial |
$240.35
|
| Rate for Payer: Healthscope Commercial |
$251.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$237.56
|
| Rate for Payer: PHP Commercial |
$237.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.64
|
| Rate for Payer: Priority Health SBD |
$176.07
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
OP
|
$417.69
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$375.92 |
| Rate for Payer: Aetna Commercial |
$355.04
|
| Rate for Payer: Aetna Medicare |
$296.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.81
|
| Rate for Payer: BCBS Complete |
$163.96
|
| Rate for Payer: BCBS MAPPO |
$285.45
|
| Rate for Payer: BCBS Trust/PPO |
$117.15
|
| Rate for Payer: BCCCP Commercial |
$161.36
|
| Rate for Payer: BCN Medicare Advantage |
$285.45
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$359.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.45
|
| Rate for Payer: Healthscope Commercial |
$375.92
|
| Rate for Payer: Mclaren Medicaid |
$156.14
|
| Rate for Payer: Mclaren Medicare |
$285.45
|
| Rate for Payer: Meridian Medicaid |
$163.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PACE Medicare |
$271.18
|
| Rate for Payer: PACE SWMI |
$285.45
|
| Rate for Payer: PHP Commercial |
$355.04
|
| Rate for Payer: PHP Medicare Advantage |
$285.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health Medicare |
$285.45
|
| Rate for Payer: Priority Health SBD |
$263.14
|
| Rate for Payer: Railroad Medicare Medicare |
$285.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.45
|
| Rate for Payer: UHC Exchange |
$99.21
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: VA VA |
$285.45
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
IP
|
$417.69
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$263.14 |
| Max. Negotiated Rate |
$375.92 |
| Rate for Payer: Aetna Commercial |
$355.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.50
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$359.21
|
| Rate for Payer: Healthscope Commercial |
$375.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PHP Commercial |
$355.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health SBD |
$263.14
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
OP
|
$417.69
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.42 |
| Max. Negotiated Rate |
$375.92 |
| Rate for Payer: Aetna Commercial |
$355.04
|
| Rate for Payer: Aetna Medicare |
$296.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.81
|
| Rate for Payer: BCBS Complete |
$163.96
|
| Rate for Payer: BCBS MAPPO |
$285.45
|
| Rate for Payer: BCBS Trust/PPO |
$124.07
|
| Rate for Payer: BCCCP Commercial |
$170.70
|
| Rate for Payer: BCN Medicare Advantage |
$285.45
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$359.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.45
|
| Rate for Payer: Healthscope Commercial |
$375.92
|
| Rate for Payer: Mclaren Medicaid |
$156.14
|
| Rate for Payer: Mclaren Medicare |
$285.45
|
| Rate for Payer: Meridian Medicaid |
$163.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PACE Medicare |
$271.18
|
| Rate for Payer: PACE SWMI |
$285.45
|
| Rate for Payer: PHP Commercial |
$355.04
|
| Rate for Payer: PHP Medicare Advantage |
$285.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health Medicare |
$285.45
|
| Rate for Payer: Priority Health SBD |
$263.14
|
| Rate for Payer: Railroad Medicare Medicare |
$285.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.45
|
| Rate for Payer: UHC Exchange |
$106.42
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: VA VA |
$285.45
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
IP
|
$417.69
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$263.14 |
| Max. Negotiated Rate |
$375.92 |
| Rate for Payer: Aetna Commercial |
$355.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.50
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$359.21
|
| Rate for Payer: Healthscope Commercial |
$375.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PHP Commercial |
$355.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health SBD |
$263.14
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
IP
|
$361.08
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.48 |
| Max. Negotiated Rate |
$324.97 |
| Rate for Payer: Aetna Commercial |
$306.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.70
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cofinity Commercial |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$310.53
|
| Rate for Payer: Healthscope Commercial |
$324.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.92
|
| Rate for Payer: PHP Commercial |
$306.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.76
|
| Rate for Payer: Priority Health SBD |
$227.48
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
OP
|
$361.08
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.11 |
| Max. Negotiated Rate |
$356.81 |
| Rate for Payer: Aetna Commercial |
$306.92
|
| Rate for Payer: Aetna Medicare |
$296.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.81
|
| Rate for Payer: BCBS Complete |
$163.96
|
| Rate for Payer: BCBS MAPPO |
$285.45
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: BCCCP Commercial |
$179.90
|
| Rate for Payer: BCN Medicare Advantage |
$285.45
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cofinity Commercial |
$310.53
|
| Rate for Payer: Cofinity Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.45
|
| Rate for Payer: Healthscope Commercial |
$324.97
|
| Rate for Payer: Mclaren Medicaid |
$156.14
|
| Rate for Payer: Mclaren Medicare |
$285.45
|
| Rate for Payer: Meridian Medicaid |
$163.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.92
|
| Rate for Payer: PACE Medicare |
$271.18
|
| Rate for Payer: PACE SWMI |
$285.45
|
| Rate for Payer: PHP Commercial |
$306.92
|
| Rate for Payer: PHP Medicare Advantage |
$285.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.76
|
| Rate for Payer: Priority Health Medicare |
$285.45
|
| Rate for Payer: Priority Health SBD |
$227.48
|
| Rate for Payer: Railroad Medicare Medicare |
$285.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.45
|
| Rate for Payer: UHC Exchange |
$131.30
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: VA VA |
$285.45
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
IP
|
$853.74
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$537.86 |
| Max. Negotiated Rate |
$768.37 |
| Rate for Payer: Aetna Commercial |
$725.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.93
|
| Rate for Payer: Cash Price |
$682.99
|
| Rate for Payer: Cofinity Commercial |
$597.62
|
| Rate for Payer: Cofinity Commercial |
$734.22
|
| Rate for Payer: Healthscope Commercial |
$768.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.68
|
| Rate for Payer: PHP Commercial |
$725.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.62
|
| Rate for Payer: Priority Health SBD |
$537.86
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
OP
|
$853.74
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.52 |
| Max. Negotiated Rate |
$894.14 |
| Rate for Payer: Aetna Commercial |
$725.68
|
| Rate for Payer: Aetna Medicare |
$743.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.93
|
| 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 |
$682.99
|
| Rate for Payer: Cash Price |
$682.99
|
| Rate for Payer: Cofinity Commercial |
$597.62
|
| Rate for Payer: Cofinity Commercial |
$734.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.31
|
| Rate for Payer: Healthscope Commercial |
$768.37
|
| 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 |
$725.68
|
| Rate for Payer: PACE Medicare |
$679.54
|
| Rate for Payer: PACE SWMI |
$715.31
|
| Rate for Payer: PHP Commercial |
$725.68
|
| 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 |
$597.62
|
| Rate for Payer: Priority Health Medicare |
$715.31
|
| Rate for Payer: Priority Health SBD |
$537.86
|
| Rate for Payer: Railroad Medicare Medicare |
$715.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.31
|
| Rate for Payer: UHC Exchange |
$119.52
|
| Rate for Payer: UHC Medicare Advantage |
$736.77
|
| Rate for Payer: VA VA |
$715.31
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
IP
|
$414.20
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.95 |
| Max. Negotiated Rate |
$372.78 |
| Rate for Payer: Aetna Commercial |
$352.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.23
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cofinity Commercial |
$289.94
|
| Rate for Payer: Cofinity Commercial |
$356.21
|
| Rate for Payer: Healthscope Commercial |
$372.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.07
|
| Rate for Payer: PHP Commercial |
$352.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.94
|
| Rate for Payer: Priority Health SBD |
$260.95
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
OP
|
$414.20
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.96 |
| Max. Negotiated Rate |
$372.78 |
| Rate for Payer: Aetna Commercial |
$352.07
|
| Rate for Payer: Aetna Medicare |
$296.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.81
|
| Rate for Payer: BCBS Complete |
$163.96
|
| Rate for Payer: BCBS MAPPO |
$285.45
|
| Rate for Payer: BCBS Trust/PPO |
$39.96
|
| Rate for Payer: BCN Medicare Advantage |
$285.45
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cofinity Commercial |
$356.21
|
| Rate for Payer: Cofinity Commercial |
$289.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.45
|
| Rate for Payer: Healthscope Commercial |
$372.78
|
| Rate for Payer: Mclaren Medicaid |
$156.14
|
| Rate for Payer: Mclaren Medicare |
$285.45
|
| Rate for Payer: Meridian Medicaid |
$163.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.07
|
| Rate for Payer: PACE Medicare |
$271.18
|
| Rate for Payer: PACE SWMI |
$285.45
|
| Rate for Payer: PHP Commercial |
$352.07
|
| Rate for Payer: PHP Medicare Advantage |
$285.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.94
|
| Rate for Payer: Priority Health Medicare |
$285.45
|
| Rate for Payer: Priority Health SBD |
$260.95
|
| Rate for Payer: Railroad Medicare Medicare |
$285.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.45
|
| Rate for Payer: UHC Exchange |
$88.08
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: VA VA |
$285.45
|
|
