|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$141.14
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$127.03 |
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$54.58
|
| Rate for Payer: BCN Commercial |
$54.58
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cofinity Advantage |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Mclaren Medicaid |
$26.77
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.97
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.86
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$119.97
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$88.92
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,407.94
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$963.18 |
| Max. Negotiated Rate |
$2,167.15 |
| Rate for Payer: Aetna Commercial |
$2,046.75
|
| Rate for Payer: Aetna Medicare |
$1,203.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,565.16
|
| Rate for Payer: BCBS Complete |
$963.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,912.39
|
| Rate for Payer: BCN Commercial |
$1,912.39
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cofinity Advantage |
$1,685.56
|
| Rate for Payer: Cofinity Commercial |
$2,070.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,926.35
|
| Rate for Payer: Healthscope Commercial |
$2,167.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,926.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,046.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,805.95
|
| Rate for Payer: PHP Commercial |
$2,046.75
|
| Rate for Payer: Priority Health SBD |
$1,517.00
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,407.94
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,517.00 |
| Max. Negotiated Rate |
$2,167.15 |
| Rate for Payer: Aetna Commercial |
$2,046.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,565.16
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cofinity Advantage |
$1,685.56
|
| Rate for Payer: Cofinity Commercial |
$2,070.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,926.35
|
| Rate for Payer: Healthscope Commercial |
$2,167.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,046.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,805.95
|
| Rate for Payer: PHP Commercial |
$2,046.75
|
| Rate for Payer: Priority Health SBD |
$1,517.00
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$512.46
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.98 |
| Max. Negotiated Rate |
$2,277.40 |
| Rate for Payer: Aetna Commercial |
$435.59
|
| Rate for Payer: Aetna Medicare |
$256.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.10
|
| Rate for Payer: BCBS Complete |
$204.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,277.40
|
| Rate for Payer: BCN Commercial |
$2,277.40
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cofinity Advantage |
$358.72
|
| Rate for Payer: Cofinity Commercial |
$440.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.97
|
| Rate for Payer: Healthscope Commercial |
$461.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$409.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.35
|
| Rate for Payer: PHP Commercial |
$435.59
|
| Rate for Payer: Priority Health SBD |
$322.85
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$512.46
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$322.85 |
| Max. Negotiated Rate |
$461.21 |
| Rate for Payer: Aetna Commercial |
$435.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.10
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cofinity Advantage |
$358.72
|
| Rate for Payer: Cofinity Commercial |
$440.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.97
|
| Rate for Payer: Healthscope Commercial |
$461.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.35
|
| Rate for Payer: PHP Commercial |
$435.59
|
| Rate for Payer: Priority Health SBD |
$322.85
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$580.28
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.11 |
| Max. Negotiated Rate |
$1,670.90 |
| Rate for Payer: Aetna Commercial |
$493.24
|
| Rate for Payer: Aetna Medicare |
$290.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.18
|
| Rate for Payer: BCBS Complete |
$232.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.90
|
| Rate for Payer: BCN Commercial |
$1,670.90
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cofinity Advantage |
$406.20
|
| Rate for Payer: Cofinity Commercial |
$499.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.22
|
| Rate for Payer: Healthscope Commercial |
$522.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.21
|
| Rate for Payer: PHP Commercial |
$493.24
|
| Rate for Payer: Priority Health SBD |
$365.58
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$580.28
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$365.58 |
| Max. Negotiated Rate |
$522.25 |
| Rate for Payer: Aetna Commercial |
$493.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.18
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cofinity Advantage |
$406.20
|
| Rate for Payer: Cofinity Commercial |
$499.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.22
|
| Rate for Payer: Healthscope Commercial |
$522.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.21
|
| Rate for Payer: PHP Commercial |
$493.24
|
| Rate for Payer: Priority Health SBD |
$365.58
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,639.53
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,182.90 |
| Max. Negotiated Rate |
$5,975.58 |
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,639.53
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,982.87
|
| Rate for Payer: BCN Commercial |
$3,982.87
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Mclaren Medicaid |
$2,965.99
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,834.81
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.93 |
| Max. Negotiated Rate |
$6,151.33 |
| Rate for Payer: Aetna Commercial |
$5,809.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,442.63
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cofinity Advantage |
$4,784.37
|
| Rate for Payer: Cofinity Commercial |
$5,877.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,467.85
|
| Rate for Payer: Healthscope Commercial |
$6,151.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,809.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,126.11
|
| Rate for Payer: PHP Commercial |
$5,809.59
|
| Rate for Payer: Priority Health SBD |
$4,305.93
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,834.81
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna Commercial |
$5,809.59
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,442.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$5,897.30
|
| Rate for Payer: BCN Commercial |
$5,897.30
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cofinity Advantage |
$4,784.37
|
| Rate for Payer: Cofinity Commercial |
$5,877.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,467.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$6,151.33
|
| Rate for Payer: Mclaren Medicaid |
$2,965.99
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,809.59
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,126.11
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$5,809.59
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$4,305.93
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$1,031.59
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$412.64 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna Medicare |
$515.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$1,031.59
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$649.90 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$1,031.59
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$649.90 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$1,031.59
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$412.64 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna Medicare |
$515.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,902.94
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.60 |
| Max. Negotiated Rate |
$1,712.65 |
| Rate for Payer: Aetna Commercial |
$1,617.50
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.91
|
| 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 |
$63.60
|
| Rate for Payer: BCN Commercial |
$63.60
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cofinity Advantage |
$1,332.06
|
| Rate for Payer: Cofinity Commercial |
$1,636.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,712.65
|
| 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 |
$1,617.50
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.20
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,617.50
|
| 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 |
$1,198.85
|
| 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) |
$1,236.91
|
| Rate for Payer: UHC Core |
$991.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$747.86
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,902.94
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,198.85 |
| Max. Negotiated Rate |
$1,712.65 |
| Rate for Payer: Aetna Commercial |
$1,617.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.91
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cofinity Advantage |
$1,332.06
|
| Rate for Payer: Cofinity Commercial |
$1,636.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.35
|
| Rate for Payer: Healthscope Commercial |
$1,712.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.20
|
| Rate for Payer: PHP Commercial |
$1,617.50
|
| Rate for Payer: Priority Health SBD |
$1,198.85
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.48 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Advantage |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.71
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health SBD |
$69.48
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.02
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$15.57
|
| Rate for Payer: BCN Commercial |
$15.57
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Advantage |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Mclaren Medicaid |
$7.64
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$15.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$21.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.71
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.60
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$69.48
|
| Rate for Payer: Priority Health Tiered Network |
$11.68
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$21.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.60
|
| Rate for Payer: UHC Exchange |
$21.90
|
| Rate for Payer: UHC Medicaid |
$7.64
|
| Rate for Payer: UHCCP Medicaid |
$7.64
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health SBD |
$23.40
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.02
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$15.57
|
| Rate for Payer: BCN Commercial |
$15.57
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$7.64
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$15.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$21.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.60
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: Priority Health Tiered Network |
$11.68
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$21.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.60
|
| Rate for Payer: UHC Exchange |
$21.90
|
| Rate for Payer: UHC Medicaid |
$7.64
|
| Rate for Payer: UHCCP Medicaid |
$7.64
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN II
|
Facility
|
OP
|
$338.13
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$304.32 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: Aetna Medicare |
$21.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.65
|
| Rate for Payer: BCBS Complete |
$11.27
|
| Rate for Payer: BCBS MAPPO |
$20.52
|
| Rate for Payer: BCBS Trust/PPO |
$21.88
|
| Rate for Payer: BCN Commercial |
$21.88
|
| Rate for Payer: BCN Medicare Advantage |
$20.52
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Advantage |
$236.69
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.52
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: Mclaren Medicaid |
$10.73
|
| Rate for Payer: Mclaren Medicare |
$20.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.55
|
| Rate for Payer: Meridian Medicaid |
$21.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Nomi Health Commercial |
$30.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PACE Medicare |
$19.49
|
| Rate for Payer: PACE SWMI |
$20.52
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: PHP Medicare Advantage |
$20.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.52
|
| Rate for Payer: Priority Health Medicare |
$20.52
|
| Rate for Payer: Priority Health SBD |
$213.02
|
| Rate for Payer: Priority Health Tiered Network |
$16.42
|
| Rate for Payer: Railroad Medicare Medicare |
$20.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.78
|
| Rate for Payer: UHC Core |
$30.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.52
|
| Rate for Payer: UHC Exchange |
$30.78
|
| Rate for Payer: UHC Medicaid |
$10.73
|
| Rate for Payer: UHCCP Medicaid |
$10.73
|
| Rate for Payer: VA VA |
$20.52
|
|
|
HC ANGIOTENSIN II
|
Facility
|
IP
|
$338.13
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$213.02 |
| Max. Negotiated Rate |
$304.32 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.78
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Advantage |
$236.69
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: Priority Health SBD |
$213.02
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$68.13
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.28
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Advantage |
$47.69
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.10
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: Priority Health SBD |
$42.92
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
OP
|
$68.13
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$161.36 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$161.36
|
| Rate for Payer: BCN Commercial |
$161.36
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Advantage |
$47.69
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Mclaren Medicaid |
$19.47
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.10
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$42.92
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.28
|
| Rate for Payer: UHC Core |
$35.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$26.78
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
