|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$7.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCBS Trust/PPO |
$7.79
|
| Rate for Payer: BCN Commercial |
$7.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.67
|
| Rate for Payer: Meridian Medicaid |
$7.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$10.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$6.93
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.30
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health Tiered Network |
$5.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.95
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.30
|
| Rate for Payer: UHC Exchange |
$10.95
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: VA VA |
$7.30
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$32.09 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health SBD |
$32.09
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.81
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$12.64
|
| Rate for Payer: BCN Commercial |
$12.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.85
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.85
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Mclaren Medicaid |
$6.20
|
| Rate for Payer: Mclaren Medicare |
$11.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$12.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$17.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Medicare |
$11.26
|
| Rate for Payer: PACE SWMI |
$11.85
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.85
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health SBD |
$32.09
|
| Rate for Payer: Priority Health Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.78
|
| Rate for Payer: UHC Core |
$17.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.85
|
| Rate for Payer: UHC Exchange |
$17.78
|
| Rate for Payer: UHC Medicaid |
$6.20
|
| Rate for Payer: UHCCP Medicaid |
$6.20
|
| Rate for Payer: VA VA |
$11.85
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$11.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.51
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.35
|
| Rate for Payer: Meridian Medicaid |
$11.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Medicare |
$10.27
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.81
|
| Rate for Payer: Priority Health Medicare |
$10.81
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Priority Health Tiered Network |
$8.65
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$16.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.81
|
| Rate for Payer: UHC Exchange |
$16.22
|
| Rate for Payer: UHC Medicaid |
$5.65
|
| Rate for Payer: UHCCP Medicaid |
$5.65
|
| Rate for Payer: VA VA |
$10.81
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.32 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$130.95 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$45.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.56
|
| Rate for Payer: BCBS Complete |
$23.97
|
| Rate for Payer: BCBS MAPPO |
$43.65
|
| Rate for Payer: BCBS Trust/PPO |
$46.54
|
| Rate for Payer: BCN Commercial |
$46.54
|
| Rate for Payer: BCN Medicare Advantage |
$43.65
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.65
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$22.83
|
| Rate for Payer: Mclaren Medicare |
$43.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.83
|
| Rate for Payer: Meridian Medicaid |
$45.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$130.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$41.47
|
| Rate for Payer: PACE SWMI |
$43.65
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$43.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.65
|
| Rate for Payer: Priority Health Medicare |
$43.65
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$34.92
|
| Rate for Payer: Railroad Medicare Medicare |
$43.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.48
|
| Rate for Payer: UHC Core |
$65.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.65
|
| Rate for Payer: UHC Exchange |
$65.48
|
| Rate for Payer: UHC Medicaid |
$22.83
|
| Rate for Payer: UHCCP Medicaid |
$22.83
|
| Rate for Payer: VA VA |
$43.65
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$537.65 |
| Max. Negotiated Rate |
$768.08 |
| Rate for Payer: Aetna Commercial |
$725.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.72
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Advantage |
$597.39
|
| Rate for Payer: Cofinity Commercial |
$733.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Healthscope Commercial |
$768.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: PHP Commercial |
$725.41
|
| Rate for Payer: Priority Health SBD |
$537.65
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$294.81 |
| Max. Negotiated Rate |
$768.08 |
| Rate for Payer: Aetna Commercial |
$725.41
|
| Rate for Payer: Aetna Medicare |
$426.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.72
|
| Rate for Payer: BCBS Complete |
$341.37
|
| Rate for Payer: BCBS Trust/PPO |
$294.81
|
| Rate for Payer: BCN Commercial |
$294.81
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Advantage |
$597.39
|
| Rate for Payer: Cofinity Commercial |
$733.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Healthscope Commercial |
$768.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$682.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: PHP Commercial |
$725.41
|
| Rate for Payer: Priority Health SBD |
$537.65
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,212.52 |
| Rate for Payer: Aetna Commercial |
$1,145.15
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.71
|
| 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 |
$627.71
|
| Rate for Payer: BCN Commercial |
$627.71
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Advantage |
$943.07
|
| Rate for Payer: Cofinity Commercial |
$1,158.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,212.52
|
| 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 |
$1,145.15
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,145.15
|
| 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 |
$848.76
|
| 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) |
$875.71
|
| Rate for Payer: UHC Core |
$701.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$529.47
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$848.76 |
| Max. Negotiated Rate |
$1,212.52 |
| Rate for Payer: Aetna Commercial |
$1,145.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.71
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Advantage |
$943.07
|
| Rate for Payer: Cofinity Commercial |
$1,158.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Healthscope Commercial |
$1,212.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,145.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: PHP Commercial |
$1,145.15
|
| Rate for Payer: Priority Health SBD |
$848.76
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$414.54
|
| Rate for Payer: BCN Commercial |
$414.54
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,606.60
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$2,345.94 |
| Rate for Payer: Aetna Commercial |
$2,215.61
|
| Rate for Payer: Aetna Medicare |
$1,303.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.29
|
| Rate for Payer: BCBS Complete |
$1,042.64
|
| Rate for Payer: Cash Price |
$2,085.28
|
| Rate for Payer: Cofinity Advantage |
$1,824.62
|
| Rate for Payer: Cofinity Commercial |
$2,241.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,085.28
|
| Rate for Payer: Healthscope Commercial |
$2,345.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,085.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.95
|
| Rate for Payer: PHP Commercial |
$2,215.61
|
| Rate for Payer: Priority Health SBD |
$1,642.16
|
|
|
HC APHERESIS
|
Facility
|
IP
|
$2,606.60
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,642.16 |
| Max. Negotiated Rate |
$2,345.94 |
| Rate for Payer: Aetna Commercial |
$2,215.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.29
|
| Rate for Payer: Cash Price |
$2,085.28
|
| Rate for Payer: Cofinity Advantage |
$1,824.62
|
| Rate for Payer: Cofinity Commercial |
$2,241.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,085.28
|
| Rate for Payer: Healthscope Commercial |
$2,345.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.95
|
| Rate for Payer: PHP Commercial |
$2,215.61
|
| Rate for Payer: Priority Health SBD |
$1,642.16
|
|
|
HC APIXABAN
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$98.32 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
|
|
HC APIXABAN
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$19.87
|
| Rate for Payer: BCN Commercial |
$19.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$9.75
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.96
|
| Rate for Payer: UHC Core |
$27.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
IP
|
$134.35
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.64 |
| Max. Negotiated Rate |
$120.92 |
| Rate for Payer: Aetna Commercial |
$114.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.33
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cofinity Advantage |
$94.05
|
| Rate for Payer: Cofinity Commercial |
$115.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.48
|
| Rate for Payer: Healthscope Commercial |
$120.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.76
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: Priority Health SBD |
$84.64
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
OP
|
$134.35
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$4,833.67 |
| Rate for Payer: Aetna Commercial |
$114.20
|
| Rate for Payer: Aetna Medicare |
$128.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,618.49
|
| Rate for Payer: BCN Commercial |
$4,833.67
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cofinity Advantage |
$94.05
|
| Rate for Payer: Cofinity Commercial |
$115.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$120.92
|
| Rate for Payer: Mclaren Medicaid |
$64.85
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$130.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.20
|
| Rate for Payer: Nomi Health Commercial |
$372.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.76
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$401.00
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health SBD |
$84.64
|
| Rate for Payer: Priority Health Tiered Network |
$320.80
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.78
|
| Rate for Payer: UHC Core |
$209.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$209.78
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC APOLIPO E GENE, WB
|
Facility
|
OP
|
$344.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
31000089
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$71.65 |
| Max. Negotiated Rate |
$411.00 |
| Rate for Payer: PACE Medicare |
$130.15
|
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: Aetna Medicare |
$142.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.25
|
| Rate for Payer: BCBS Complete |
$75.24
|
| Rate for Payer: BCBS MAPPO |
$137.00
|
| Rate for Payer: BCBS Trust/PPO |
$146.07
|
| Rate for Payer: BCN Commercial |
$146.07
|
| Rate for Payer: BCN Medicare Advantage |
$137.00
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Advantage |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.00
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Mclaren Medicaid |
$71.65
|
| Rate for Payer: Mclaren Medicare |
$137.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.85
|
| Rate for Payer: Meridian Medicaid |
$143.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.40
|
| Rate for Payer: Nomi Health Commercial |
$411.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PACE SWMI |
$137.00
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: PHP Medicare Advantage |
$137.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$137.00
|
| Rate for Payer: Priority Health Medicare |
$137.00
|
| Rate for Payer: Priority Health SBD |
$216.72
|
| Rate for Payer: Priority Health Tiered Network |
$109.60
|
| Rate for Payer: Railroad Medicare Medicare |
$137.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.50
|
| Rate for Payer: UHC Core |
$205.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.00
|
| Rate for Payer: UHC Exchange |
$205.50
|
| Rate for Payer: UHC Medicaid |
$71.65
|
| Rate for Payer: UHCCP Medicaid |
$71.65
|
| Rate for Payer: VA VA |
$137.00
|
|
|
HC APOLIPO E GENE, WB
|
Facility
|
IP
|
$344.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
31000089
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$216.72 |
| Max. Negotiated Rate |
$309.60 |
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.60
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Advantage |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: Priority Health SBD |
$216.72
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Advantage |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health SBD |
$32.13
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$21.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: BCBS Complete |
$11.58
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$22.49
|
| Rate for Payer: BCN Commercial |
$22.49
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Advantage |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$11.03
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$31.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.09
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Priority Health Tiered Network |
$16.87
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.64
|
| Rate for Payer: UHC Core |
$31.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.09
|
| Rate for Payer: UHC Exchange |
$31.64
|
| Rate for Payer: UHC Medicaid |
$11.03
|
| Rate for Payer: UHCCP Medicaid |
$11.03
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health SBD |
$32.76
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$21.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: BCBS Complete |
$11.58
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$22.49
|
| Rate for Payer: BCN Commercial |
$22.49
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Mclaren Medicaid |
$11.03
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$31.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.09
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Priority Health Tiered Network |
$16.87
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.64
|
| Rate for Payer: UHC Core |
$31.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.09
|
| Rate for Payer: UHC Exchange |
$31.64
|
| Rate for Payer: UHC Medicaid |
$11.03
|
| Rate for Payer: UHCCP Medicaid |
$11.03
|
| Rate for Payer: VA VA |
$21.09
|
|
