|
HC CORDIS CATHETER
|
Facility
|
IP
|
$192.76
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.44 |
| Max. Negotiated Rate |
$173.48 |
| Rate for Payer: Aetna Commercial |
$163.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.29
|
| Rate for Payer: Cash Price |
$154.21
|
| Rate for Payer: Cofinity Commercial |
$134.93
|
| Rate for Payer: Cofinity Commercial |
$165.77
|
| Rate for Payer: Healthscope Commercial |
$173.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.85
|
| Rate for Payer: PHP Commercial |
$163.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.93
|
| Rate for Payer: Priority Health SBD |
$121.44
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
IP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,355.99 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,430.78
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$2,617.76
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health SBD |
$2,355.99
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
OP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,495.86 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,430.78
|
| Rate for Payer: BCBS Complete |
$1,495.86
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$2,617.76
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health SBD |
$2,355.99
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.24
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health SBD |
$58.39
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$95.77 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$48.67
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$58.39
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.25
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$31.50
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health SBD |
$28.35
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.25
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$31.50
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health SBD |
$28.35
|
| Rate for Payer: UHC Core |
$28.22
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN POLLEN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORN POLLEN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORO ANGIOS W RHC
|
Facility
|
OP
|
$8,788.64
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,089.40 |
| Max. Negotiated Rate |
$7,909.78 |
| Rate for Payer: Aetna Commercial |
$7,470.34
|
| Rate for Payer: Aetna Medicare |
$3,015.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,712.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,624.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,624.31
|
| Rate for Payer: BCBS Complete |
$1,665.44
|
| Rate for Payer: BCBS MAPPO |
$2,899.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,791.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,899.45
|
| Rate for Payer: Cash Price |
$7,030.91
|
| Rate for Payer: Cash Price |
$7,030.91
|
| Rate for Payer: Cofinity Commercial |
$7,558.23
|
| Rate for Payer: Cofinity Commercial |
$6,152.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,899.45
|
| Rate for Payer: Healthscope Commercial |
$7,909.78
|
| Rate for Payer: Mclaren Medicaid |
$1,586.00
|
| Rate for Payer: Mclaren Medicare |
$2,899.45
|
| Rate for Payer: Meridian Medicaid |
$1,665.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,044.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,334.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,470.34
|
| Rate for Payer: PACE Medicare |
$2,754.48
|
| Rate for Payer: PACE SWMI |
$2,899.45
|
| Rate for Payer: PHP Commercial |
$7,470.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,899.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,586.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,152.05
|
| Rate for Payer: Priority Health Medicare |
$2,899.45
|
| Rate for Payer: Priority Health SBD |
$5,536.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,899.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.34
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,899.45
|
| Rate for Payer: UHC Exchange |
$1,089.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,986.43
|
| Rate for Payer: VA VA |
$2,899.45
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,788.64
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,536.84 |
| Max. Negotiated Rate |
$7,909.78 |
| Rate for Payer: Aetna Commercial |
$7,470.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,712.62
|
| Rate for Payer: Cash Price |
$7,030.91
|
| Rate for Payer: Cofinity Commercial |
$6,152.05
|
| Rate for Payer: Cofinity Commercial |
$7,558.23
|
| Rate for Payer: Healthscope Commercial |
$7,909.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,470.34
|
| Rate for Payer: PHP Commercial |
$7,470.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,152.05
|
| Rate for Payer: Priority Health SBD |
$5,536.84
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$6,972.49
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,392.67 |
| Max. Negotiated Rate |
$6,275.24 |
| Rate for Payer: Aetna Commercial |
$5,926.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,532.12
|
| Rate for Payer: Cash Price |
$5,577.99
|
| Rate for Payer: Cofinity Commercial |
$4,880.74
|
| Rate for Payer: Cofinity Commercial |
$5,996.34
|
| Rate for Payer: Healthscope Commercial |
$6,275.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,926.62
|
| Rate for Payer: PHP Commercial |
$5,926.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,880.74
|
| Rate for Payer: Priority Health SBD |
$4,392.67
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$6,972.49
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,187.30 |
| Max. Negotiated Rate |
$6,837.00 |
| Rate for Payer: Aetna Commercial |
$5,926.62
|
| Rate for Payer: Aetna Medicare |
$3,015.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,532.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,624.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,624.31
|
| Rate for Payer: BCBS Complete |
$1,665.44
|
| Rate for Payer: BCBS MAPPO |
$2,899.45
|
| Rate for Payer: BCBS Trust/PPO |
$4,084.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,899.45
|
| Rate for Payer: Cash Price |
$5,577.99
|
| Rate for Payer: Cash Price |
$5,577.99
|
| Rate for Payer: Cofinity Commercial |
$5,996.34
|
| Rate for Payer: Cofinity Commercial |
$4,880.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,899.45
|
| Rate for Payer: Healthscope Commercial |
$6,275.24
|
| Rate for Payer: Mclaren Medicaid |
$1,586.00
|
| Rate for Payer: Mclaren Medicare |
$2,899.45
|
| Rate for Payer: Meridian Medicaid |
$1,665.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,044.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,334.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,926.62
|
| Rate for Payer: PACE Medicare |
$2,754.48
|
| Rate for Payer: PACE SWMI |
$2,899.45
|
| Rate for Payer: PHP Commercial |
$5,926.62
|
| Rate for Payer: PHP Medicare Advantage |
$2,899.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,586.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,880.74
|
| Rate for Payer: Priority Health Medicare |
$2,899.45
|
| Rate for Payer: Priority Health SBD |
$4,392.67
|
| Rate for Payer: Railroad Medicare Medicare |
$2,899.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,306.03
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,899.45
|
| Rate for Payer: UHC Exchange |
$1,187.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,986.43
|
| Rate for Payer: VA VA |
$2,899.45
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,402.32
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,663.46 |
| Max. Negotiated Rate |
$6,662.09 |
| Rate for Payer: Aetna Commercial |
$6,291.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,811.51
|
| Rate for Payer: Cash Price |
$5,921.86
|
| Rate for Payer: Cofinity Commercial |
$6,366.00
|
| Rate for Payer: Cofinity Commercial |
$5,181.62
|
| Rate for Payer: Healthscope Commercial |
$6,662.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,291.97
|
| Rate for Payer: PHP Commercial |
$6,291.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,181.62
|
| Rate for Payer: Priority Health SBD |
$4,663.46
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,402.32
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$875.58 |
| Max. Negotiated Rate |
$6,837.00 |
| Rate for Payer: Aetna Commercial |
$6,291.97
|
| Rate for Payer: Aetna Medicare |
$3,015.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,811.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,624.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,624.31
|
| Rate for Payer: BCBS Complete |
$1,665.44
|
| Rate for Payer: BCBS MAPPO |
$2,899.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,899.45
|
| Rate for Payer: Cash Price |
$5,921.86
|
| Rate for Payer: Cash Price |
$5,921.86
|
| Rate for Payer: Cofinity Commercial |
$5,181.62
|
| Rate for Payer: Cofinity Commercial |
$6,366.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,899.45
|
| Rate for Payer: Healthscope Commercial |
$6,662.09
|
| Rate for Payer: Mclaren Medicaid |
$1,586.00
|
| Rate for Payer: Mclaren Medicare |
$2,899.45
|
| Rate for Payer: Meridian Medicaid |
$1,665.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,044.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,334.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,291.97
|
| Rate for Payer: PACE Medicare |
$2,754.48
|
| Rate for Payer: PACE SWMI |
$2,899.45
|
| Rate for Payer: PHP Commercial |
$6,291.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,899.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,586.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,181.62
|
| Rate for Payer: Priority Health Medicare |
$2,899.45
|
| Rate for Payer: Priority Health SBD |
$4,663.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,899.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.14
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,899.45
|
| Rate for Payer: UHC Exchange |
$875.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,986.43
|
| Rate for Payer: VA VA |
$2,899.45
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,213.20
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$3,914.32 |
| Max. Negotiated Rate |
$5,591.88 |
| Rate for Payer: Aetna Commercial |
$5,281.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,038.58
|
| Rate for Payer: Cash Price |
$4,970.56
|
| Rate for Payer: Cofinity Commercial |
$4,349.24
|
| Rate for Payer: Cofinity Commercial |
$5,343.35
|
| Rate for Payer: Healthscope Commercial |
$5,591.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,281.22
|
| Rate for Payer: PHP Commercial |
$5,281.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,349.24
|
| Rate for Payer: Priority Health SBD |
$3,914.32
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,530.89
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$964.46 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.08
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,071.62
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,301.26
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.62
|
| Rate for Payer: Priority Health SBD |
$964.46
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,530.89
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.08
|
| Rate for Payer: BCBS Complete |
$612.36
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Cofinity Commercial |
$1,071.62
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,301.26
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.62
|
| Rate for Payer: Priority Health SBD |
$964.46
|
|
|
HC CORONARY STENT
|
Facility
|
IP
|
$4,451.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,804.13 |
| Max. Negotiated Rate |
$4,005.90 |
| Rate for Payer: Aetna Commercial |
$3,783.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,893.15
|
| Rate for Payer: Cash Price |
$3,560.80
|
| Rate for Payer: Cofinity Commercial |
$3,115.70
|
| Rate for Payer: Cofinity Commercial |
$3,827.86
|
| Rate for Payer: Healthscope Commercial |
$4,005.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,783.35
|
| Rate for Payer: PHP Commercial |
$3,783.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.70
|
| Rate for Payer: Priority Health SBD |
$2,804.13
|
|
|
HC CORONARY STENT
|
Facility
|
OP
|
$4,451.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,780.40 |
| Max. Negotiated Rate |
$4,005.90 |
| Rate for Payer: Aetna Commercial |
$3,783.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,893.15
|
| Rate for Payer: BCBS Complete |
$1,780.40
|
| Rate for Payer: Cash Price |
$3,560.80
|
| Rate for Payer: Cofinity Commercial |
$3,115.70
|
| Rate for Payer: Cofinity Commercial |
$3,827.86
|
| Rate for Payer: Healthscope Commercial |
$4,005.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,783.35
|
| Rate for Payer: PHP Commercial |
$3,783.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.70
|
| Rate for Payer: Priority Health SBD |
$2,804.13
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$10,900.35
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,360.14 |
| Max. Negotiated Rate |
$9,810.32 |
| Rate for Payer: Aetna Commercial |
$9,265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,085.23
|
| Rate for Payer: BCBS Complete |
$4,360.14
|
| Rate for Payer: Cash Price |
$8,720.28
|
| Rate for Payer: Cofinity Commercial |
$7,630.24
|
| Rate for Payer: Cofinity Commercial |
$9,374.30
|
| Rate for Payer: Healthscope Commercial |
$9,810.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,265.30
|
| Rate for Payer: PHP Commercial |
$9,265.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,630.24
|
| Rate for Payer: Priority Health SBD |
$6,867.22
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$10,900.35
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,867.22 |
| Max. Negotiated Rate |
$9,810.32 |
| Rate for Payer: Aetna Commercial |
$9,265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,085.23
|
| Rate for Payer: Cash Price |
$8,720.28
|
| Rate for Payer: Cofinity Commercial |
$7,630.24
|
| Rate for Payer: Cofinity Commercial |
$9,374.30
|
| Rate for Payer: Healthscope Commercial |
$9,810.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,265.30
|
| Rate for Payer: PHP Commercial |
$9,265.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,630.24
|
| Rate for Payer: Priority Health SBD |
$6,867.22
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$3,984.27
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,510.09 |
| Max. Negotiated Rate |
$3,585.84 |
| Rate for Payer: Aetna Commercial |
$3,386.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,589.78
|
| Rate for Payer: Cash Price |
$3,187.42
|
| Rate for Payer: Cofinity Commercial |
$2,788.99
|
| Rate for Payer: Cofinity Commercial |
$3,426.47
|
| Rate for Payer: Healthscope Commercial |
$3,585.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,386.63
|
| Rate for Payer: PHP Commercial |
$3,386.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,788.99
|
| Rate for Payer: Priority Health SBD |
$2,510.09
|
|
