|
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$17,221.27
|
|
|
Service Code
|
MSDRG 514
|
| Min. Negotiated Rate |
$8,055.60 |
| Max. Negotiated Rate |
$17,221.27 |
| Rate for Payer: Aetna Medicare |
$8,818.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,599.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,599.48
|
| Rate for Payer: BCBS MAPPO |
$8,479.58
|
| Rate for Payer: BCBS Trust/PPO |
$17,221.27
|
| Rate for Payer: BCN Commercial |
$17,221.27
|
| Rate for Payer: BCN Medicare Advantage |
$8,479.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,479.58
|
| Rate for Payer: Mclaren Medicare |
$8,479.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,903.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,751.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,327.54
|
| Rate for Payer: Nomi Health Commercial |
$13,187.67
|
| Rate for Payer: PACE Medicare |
$8,055.60
|
| Rate for Payer: PACE SWMI |
$8,479.58
|
| Rate for Payer: PHP Medicare Advantage |
$8,479.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,481.66
|
| Rate for Payer: Priority Health Medicare |
$8,479.58
|
| Rate for Payer: Priority Health Tiered Network |
$13,185.33
|
| Rate for Payer: Railroad Medicare Medicare |
$8,479.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,663.49
|
| Rate for Payer: UHC Core |
$13,941.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,479.58
|
| Rate for Payer: UHC Exchange |
$11,385.36
|
| Rate for Payer: VA VA |
$8,479.58
|
|
|
HAND PROCEDURES FOR INJURIES
|
Facility
|
IP
|
$37,003.37
|
|
|
Service Code
|
MSDRG 906
|
| Min. Negotiated Rate |
$14,971.57 |
| Max. Negotiated Rate |
$37,003.37 |
| Rate for Payer: Aetna Medicare |
$16,389.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,699.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,699.44
|
| Rate for Payer: BCBS MAPPO |
$15,759.55
|
| Rate for Payer: BCBS Trust/PPO |
$37,003.37
|
| Rate for Payer: BCN Commercial |
$37,003.37
|
| Rate for Payer: BCN Medicare Advantage |
$15,759.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,759.55
|
| Rate for Payer: Mclaren Medicare |
$15,759.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,547.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,123.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,335.51
|
| Rate for Payer: Nomi Health Commercial |
$22,734.96
|
| Rate for Payer: PACE Medicare |
$14,971.57
|
| Rate for Payer: PACE SWMI |
$15,759.55
|
| Rate for Payer: PHP Medicare Advantage |
$15,759.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31,668.72
|
| Rate for Payer: Priority Health Medicare |
$15,759.55
|
| Rate for Payer: Priority Health Tiered Network |
$25,334.97
|
| Rate for Payer: Railroad Medicare Medicare |
$15,759.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,727.12
|
| Rate for Payer: UHC Core |
$24,033.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,759.55
|
| Rate for Payer: UHC Exchange |
$19,627.85
|
| Rate for Payer: VA VA |
$15,759.55
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
OP
|
$66.86
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$60.17 |
| Rate for Payer: Aetna Commercial |
$56.83
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.08
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$31.22
|
| Rate for Payer: BCN Commercial |
$31.22
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Advantage |
$46.80
|
| Rate for Payer: Cofinity Commercial |
$57.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$60.17
|
| Rate for Payer: Mclaren Medicaid |
$15.31
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Nomi Health Commercial |
$43.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$56.83
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$42.12
|
| Rate for Payer: Priority Health Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.92
|
| Rate for Payer: UHC Core |
$43.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.28
|
| Rate for Payer: UHC Exchange |
$43.92
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
IP
|
$66.86
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.12 |
| Max. Negotiated Rate |
$60.17 |
| Rate for Payer: Aetna Commercial |
$56.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.46
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Advantage |
$46.80
|
| Rate for Payer: Cofinity Commercial |
$57.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Healthscope Commercial |
$60.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: PHP Commercial |
$56.83
|
| Rate for Payer: Priority Health SBD |
$42.12
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
OP
|
$7.03
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$6.33 |
| Rate for Payer: Aetna Commercial |
$5.98
|
| Rate for Payer: Aetna Medicare |
$3.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.57
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cofinity Advantage |
$4.92
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.62
|
| Rate for Payer: Healthscope Commercial |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.27
|
| Rate for Payer: PHP Commercial |
$5.98
|
| Rate for Payer: Priority Health SBD |
$4.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.57
|
| Rate for Payer: UHC Core |
$3.66
|
| Rate for Payer: UHC Exchange |
$2.76
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
IP
|
$7.03
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$6.33 |
| Rate for Payer: Aetna Commercial |
$5.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.57
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cofinity Advantage |
$4.92
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.62
|
| Rate for Payer: Healthscope Commercial |
$6.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.27
|
| Rate for Payer: PHP Commercial |
$5.98
|
| Rate for Payer: Priority Health SBD |
$4.43
|
|
|
HC 20CM TL CATHETER
|
Facility
|
IP
|
$283.98
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.91 |
| Max. Negotiated Rate |
$255.58 |
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Advantage |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.99
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health SBD |
$178.91
|
|
|
HC 20CM TL CATHETER
|
Facility
|
OP
|
$283.98
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.60 |
| Max. Negotiated Rate |
$255.58 |
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna Medicare |
$141.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: BCBS Complete |
$113.59
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Advantage |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.99
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health SBD |
$178.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.59
|
| Rate for Payer: UHC Core |
$147.95
|
| Rate for Payer: UHC Exchange |
$111.60
|
|
|
HC 23BPG, U
|
Facility
|
OP
|
$76.41
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.85 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: BCBS Complete |
$22.94
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$44.54
|
| Rate for Payer: BCN Commercial |
$44.54
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Advantage |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Mclaren Medicaid |
$21.85
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: Meridian Medicaid |
$43.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.77
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health SBD |
$48.14
|
| Rate for Payer: Priority Health Tiered Network |
$33.42
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.66
|
| Rate for Payer: UHC Core |
$62.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.77
|
| Rate for Payer: UHC Exchange |
$62.66
|
| Rate for Payer: UHC Medicaid |
$21.85
|
| Rate for Payer: UHCCP Medicaid |
$21.85
|
| Rate for Payer: VA VA |
$41.77
|
|
|
HC 23BPG, U
|
Facility
|
IP
|
$76.41
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.67
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Advantage |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: Priority Health SBD |
$48.14
|
|
|
HC 23BPR URINE
|
Facility
|
OP
|
$88.65
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.85 |
| Max. Negotiated Rate |
$79.78 |
| Rate for Payer: Aetna Commercial |
$75.35
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: BCBS Complete |
$22.94
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$44.54
|
| Rate for Payer: BCN Commercial |
$44.54
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$70.92
|
| Rate for Payer: Cash Price |
$70.92
|
| Rate for Payer: Cofinity Advantage |
$62.05
|
| Rate for Payer: Cofinity Commercial |
$76.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$79.78
|
| Rate for Payer: Mclaren Medicaid |
$21.85
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: Meridian Medicaid |
$43.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.35
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.49
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$75.35
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.77
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health SBD |
$55.85
|
| Rate for Payer: Priority Health Tiered Network |
$33.42
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.66
|
| Rate for Payer: UHC Core |
$62.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.77
|
| Rate for Payer: UHC Exchange |
$62.66
|
| Rate for Payer: UHC Medicaid |
$21.85
|
| Rate for Payer: UHCCP Medicaid |
$21.85
|
| Rate for Payer: VA VA |
$41.77
|
|
|
HC 23BPR URINE
|
Facility
|
IP
|
$88.65
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$79.78 |
| Rate for Payer: Aetna Commercial |
$75.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.62
|
| Rate for Payer: Cash Price |
$70.92
|
| Rate for Payer: Cofinity Advantage |
$62.05
|
| Rate for Payer: Cofinity Commercial |
$76.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.92
|
| Rate for Payer: Healthscope Commercial |
$79.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.49
|
| Rate for Payer: PHP Commercial |
$75.35
|
| Rate for Payer: Priority Health SBD |
$55.85
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
IP
|
$1,583.18
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$997.40 |
| Max. Negotiated Rate |
$1,424.86 |
| Rate for Payer: Aetna Commercial |
$1,345.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.07
|
| Rate for Payer: Cash Price |
$1,266.54
|
| Rate for Payer: Cofinity Advantage |
$1,108.23
|
| Rate for Payer: Cofinity Commercial |
$1,361.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.54
|
| Rate for Payer: Healthscope Commercial |
$1,424.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,187.38
|
| Rate for Payer: PHP Commercial |
$1,345.70
|
| Rate for Payer: Priority Health SBD |
$997.40
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
OP
|
$1,583.18
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,424.86 |
| Rate for Payer: Aetna Commercial |
$1,345.70
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$614.40
|
| Rate for Payer: BCN Commercial |
$614.40
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,266.54
|
| Rate for Payer: Cash Price |
$1,266.54
|
| Rate for Payer: Cofinity Advantage |
$1,108.23
|
| Rate for Payer: Cofinity Commercial |
$1,361.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$1,424.86
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.70
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,187.38
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$1,345.70
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$997.40
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
IP
|
$842.06
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$530.50 |
| Max. Negotiated Rate |
$757.85 |
| Rate for Payer: Aetna Commercial |
$715.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.34
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cofinity Advantage |
$589.44
|
| Rate for Payer: Cofinity Commercial |
$724.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.65
|
| Rate for Payer: Healthscope Commercial |
$757.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.54
|
| Rate for Payer: PHP Commercial |
$715.75
|
| Rate for Payer: Priority Health SBD |
$530.50
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$842.06
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna Commercial |
$715.75
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$324.22
|
| Rate for Payer: BCN Commercial |
$324.22
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cofinity Advantage |
$589.44
|
| Rate for Payer: Cofinity Commercial |
$724.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$757.85
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.75
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.54
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$715.75
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$530.50
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.34
|
| Rate for Payer: UHC Core |
$438.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$330.93
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.90
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Advantage |
$9.58
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.27
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health SBD |
$8.62
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna Medicare |
$6.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.90
|
| Rate for Payer: BCBS Complete |
$5.48
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Advantage |
$9.58
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.27
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health SBD |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.90
|
| Rate for Payer: UHC Core |
$7.13
|
| Rate for Payer: UHC Exchange |
$5.38
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$614.31 |
| Rate for Payer: Aetna Commercial |
$580.18
|
| Rate for Payer: Aetna Medicare |
$341.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.67
|
| Rate for Payer: BCBS Complete |
$273.03
|
| Rate for Payer: BCBS Trust/PPO |
$37.10
|
| Rate for Payer: BCN Commercial |
$37.10
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Advantage |
$477.80
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$614.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$546.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: PHP Commercial |
$580.18
|
| Rate for Payer: Priority Health SBD |
$430.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.67
|
| Rate for Payer: UHC Core |
$355.62
|
| Rate for Payer: UHC Exchange |
$268.25
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$430.02 |
| Max. Negotiated Rate |
$614.31 |
| Rate for Payer: Aetna Commercial |
$580.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.67
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Advantage |
$477.80
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$614.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: PHP Commercial |
$580.18
|
| Rate for Payer: Priority Health SBD |
$430.02
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$409.90 |
| Max. Negotiated Rate |
$585.57 |
| Rate for Payer: Aetna Commercial |
$553.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.91
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Advantage |
$455.44
|
| Rate for Payer: Cofinity Commercial |
$559.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$585.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: PHP Commercial |
$553.04
|
| Rate for Payer: Priority Health SBD |
$409.90
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.40 |
| Max. Negotiated Rate |
$585.57 |
| Rate for Payer: Aetna Commercial |
$553.04
|
| Rate for Payer: Aetna Medicare |
$325.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.91
|
| Rate for Payer: BCBS Complete |
$260.25
|
| Rate for Payer: BCBS Trust/PPO |
$95.40
|
| Rate for Payer: BCN Commercial |
$95.40
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Advantage |
$455.44
|
| Rate for Payer: Cofinity Commercial |
$559.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$585.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$520.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: PHP Commercial |
$553.04
|
| Rate for Payer: Priority Health SBD |
$409.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.91
|
| Rate for Payer: UHC Core |
$338.98
|
| Rate for Payer: UHC Exchange |
$255.70
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Advantage |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Advantage |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.25
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Exchange |
$9.82
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.60 |
| Max. Negotiated Rate |
$1,034.19 |
| Rate for Payer: Aetna Commercial |
$976.74
|
| Rate for Payer: Aetna Medicare |
$574.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.91
|
| Rate for Payer: BCBS Complete |
$459.64
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Advantage |
$804.37
|
| Rate for Payer: Cofinity Commercial |
$988.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,034.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$919.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: PHP Commercial |
$976.74
|
| Rate for Payer: Priority Health SBD |
$723.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.91
|
| Rate for Payer: UHC Core |
$598.68
|
| Rate for Payer: UHC Exchange |
$451.60
|
|
