|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$3,984.27
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$168.63 |
| 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: BCBS Complete |
$1,593.71
|
| Rate for Payer: BCBS Trust/PPO |
$171.93
|
| Rate for Payer: Cash Price |
$3,187.42
|
| Rate for Payer: Cash Price |
$3,187.42
|
| Rate for Payer: Cofinity Commercial |
$3,426.47
|
| Rate for Payer: Cofinity Commercial |
$2,788.99
|
| 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
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.49
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$168.63
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,108.34
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,328.25 |
| Max. Negotiated Rate |
$1,897.51 |
| Rate for Payer: Aetna Commercial |
$1,792.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,370.42
|
| Rate for Payer: Cash Price |
$1,686.67
|
| Rate for Payer: Cofinity Commercial |
$1,475.84
|
| Rate for Payer: Cofinity Commercial |
$1,813.17
|
| Rate for Payer: Healthscope Commercial |
$1,897.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,792.09
|
| Rate for Payer: PHP Commercial |
$1,792.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.84
|
| Rate for Payer: Priority Health SBD |
$1,328.25
|
|
|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,108.34
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$322.53 |
| Max. Negotiated Rate |
$2,864.58 |
| Rate for Payer: Aetna Commercial |
$1,792.09
|
| Rate for Payer: Aetna Medicare |
$967.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,370.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,162.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,162.89
|
| Rate for Payer: BCBS Complete |
$534.37
|
| Rate for Payer: BCBS MAPPO |
$930.31
|
| Rate for Payer: BCBS Trust/PPO |
$709.19
|
| Rate for Payer: BCN Medicare Advantage |
$930.31
|
| Rate for Payer: Cash Price |
$1,686.67
|
| Rate for Payer: Cash Price |
$1,686.67
|
| Rate for Payer: Cofinity Commercial |
$1,475.84
|
| Rate for Payer: Cofinity Commercial |
$1,813.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.31
|
| Rate for Payer: Healthscope Commercial |
$1,897.51
|
| Rate for Payer: Mclaren Medicaid |
$508.88
|
| Rate for Payer: Mclaren Medicare |
$930.31
|
| Rate for Payer: Meridian Medicaid |
$534.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$976.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,069.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,792.09
|
| Rate for Payer: PACE Medicare |
$883.79
|
| Rate for Payer: PACE SWMI |
$930.31
|
| Rate for Payer: PHP Commercial |
$1,792.09
|
| Rate for Payer: PHP Medicare Advantage |
$930.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,864.58
|
| Rate for Payer: Priority Health Medicare |
$930.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,291.66
|
| Rate for Payer: Priority Health SBD |
$1,328.25
|
| Rate for Payer: Railroad Medicare Medicare |
$930.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$930.31
|
| Rate for Payer: UHC Exchange |
$322.53
|
| Rate for Payer: UHC Medicare Advantage |
$958.22
|
| Rate for Payer: VA VA |
$930.31
|
|
|
HC CORTICOL SALIVA
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.36
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$12.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Medicaid |
$9.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$16.30
|
| Rate for Payer: UHC Medicare Advantage |
$16.79
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTICOL SALIVA
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.36
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$12.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Medicaid |
$9.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$16.30
|
| Rate for Payer: UHC Medicare Advantage |
$16.79
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$40.95
|
|
|
HC CORTISOL SERUM
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.36
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$12.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Medicaid |
$9.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$16.30
|
| Rate for Payer: UHC Medicare Advantage |
$16.79
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL SERUM
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC CORTISOL URINE
|
Facility
|
IP
|
$46.92
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.84
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.88
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.84
|
| Rate for Payer: Priority Health SBD |
$29.56
|
|
|
HC CORTISOL URINE
|
Facility
|
OP
|
$46.92
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Cofinity Commercial |
$32.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.88
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.84
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health SBD |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.05
|
| Rate for Payer: UHC Core |
$28.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$16.71
|
| Rate for Payer: UHC Medicare Advantage |
$17.21
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.25 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.72
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$51.39
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.41
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.39
|
| Rate for Payer: Priority Health SBD |
$46.25
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Cofinity Commercial |
$51.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.41
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.39
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health SBD |
$46.25
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.05
|
| Rate for Payer: UHC Core |
$28.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$16.71
|
| Rate for Payer: UHC Medicare Advantage |
$17.21
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
OP
|
$26.93
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$30.68 |
| Rate for Payer: Aetna Commercial |
$22.89
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.84
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$18.87
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$18.85
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$24.24
|
| Rate for Payer: Mclaren Medicaid |
$13.18
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$13.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.89
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$16.97
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$30.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$24.09
|
| Rate for Payer: UHC Medicare Advantage |
$24.81
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
IP
|
$26.93
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.97 |
| Max. Negotiated Rate |
$24.24 |
| Rate for Payer: Aetna Commercial |
$22.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.50
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$18.85
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Healthscope Commercial |
$24.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.89
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health SBD |
$16.97
|
|
|
HC COTTONWOOD IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
|
|
HC COTTONWOOD IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
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 COUNSELING LUNG CA SCREENING
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$135.45 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.50
|
| Rate for Payer: Priority Health SBD |
$135.45
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$232.97 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$82.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.14
|
| Rate for Payer: BCBS Complete |
$45.56
|
| Rate for Payer: BCBS MAPPO |
$79.31
|
| Rate for Payer: BCBS Trust/PPO |
$42.98
|
| Rate for Payer: BCN Medicare Advantage |
$79.31
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.31
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Mclaren Medicaid |
$43.38
|
| Rate for Payer: Mclaren Medicare |
$79.31
|
| Rate for Payer: Meridian Medicaid |
$45.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.75
|
| Rate for Payer: PACE Medicare |
$75.34
|
| Rate for Payer: PACE SWMI |
$79.31
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$79.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.97
|
| Rate for Payer: Priority Health Medicare |
$79.31
|
| Rate for Payer: Priority Health Narrow Network |
$186.38
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: Railroad Medicare Medicare |
$79.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.31
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UHC Medicare Advantage |
$81.69
|
| Rate for Payer: VA VA |
$79.31
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.22 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health SBD |
$47.25
|
| Rate for Payer: UHC Core |
$28.22
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health SBD |
$47.25
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,558.80 |
| Max. Negotiated Rate |
$5,757.30 |
| Rate for Payer: Aetna Commercial |
$5,437.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,158.05
|
| Rate for Payer: BCBS Complete |
$2,558.80
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cofinity Commercial |
$4,477.90
|
| Rate for Payer: Cofinity Commercial |
$5,501.42
|
| Rate for Payer: Healthscope Commercial |
$5,757.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,437.45
|
| Rate for Payer: PHP Commercial |
$5,437.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,477.90
|
| Rate for Payer: Priority Health SBD |
$4,030.11
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,030.11 |
| Max. Negotiated Rate |
$5,757.30 |
| Rate for Payer: Aetna Commercial |
$5,437.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,158.05
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cofinity Commercial |
$4,477.90
|
| Rate for Payer: Cofinity Commercial |
$5,501.42
|
| Rate for Payer: Healthscope Commercial |
$5,757.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,437.45
|
| Rate for Payer: PHP Commercial |
$5,437.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,477.90
|
| Rate for Payer: Priority Health SBD |
$4,030.11
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.05 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: BCBS Complete |
$24.20
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$23.05
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Medicaid |
$24.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.56
|
| Rate for Payer: UHC Core |
$50.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.13
|
| Rate for Payer: UHC Exchange |
$42.13
|
| Rate for Payer: UHC Medicare Advantage |
$43.39
|
| Rate for Payer: VA VA |
$42.13
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.70 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$43.70
|
|
