|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,440.95
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$907.80 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna Commercial |
$1,224.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.62
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cofinity Advantage |
$1,008.66
|
| Rate for Payer: Cofinity Commercial |
$1,239.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.76
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.71
|
| Rate for Payer: PHP Commercial |
$1,224.81
|
| Rate for Payer: Priority Health SBD |
$907.80
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$179.96 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$20.23
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Advantage |
$139.97
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$179.96
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.97
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$125.97
|
| Rate for Payer: Priority Health Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$125.97 |
| Max. Negotiated Rate |
$179.96 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.97
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Advantage |
$139.97
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Healthscope Commercial |
$179.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: Priority Health SBD |
$125.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$104.87 |
| Rate for Payer: Aetna Commercial |
$99.04
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$20.23
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Advantage |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$104.87
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$99.04
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.97
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$73.41
|
| Rate for Payer: Priority Health Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.41 |
| Max. Negotiated Rate |
$104.87 |
| Rate for Payer: Aetna Commercial |
$99.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.74
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Advantage |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Healthscope Commercial |
$104.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: PHP Commercial |
$99.04
|
| Rate for Payer: Priority Health SBD |
$73.41
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$20.23
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.97
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Priority Health Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.95 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health SBD |
$41.95
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.91 |
| Max. Negotiated Rate |
$415.58 |
| Rate for Payer: Aetna Commercial |
$392.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.14
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Advantage |
$323.23
|
| Rate for Payer: Cofinity Commercial |
$397.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Healthscope Commercial |
$415.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: PHP Commercial |
$392.50
|
| Rate for Payer: Priority Health SBD |
$290.91
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.70 |
| Max. Negotiated Rate |
$415.58 |
| Rate for Payer: Aetna Commercial |
$392.50
|
| Rate for Payer: Aetna Medicare |
$230.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.14
|
| Rate for Payer: BCBS Complete |
$184.70
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Advantage |
$323.23
|
| Rate for Payer: Cofinity Commercial |
$397.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Healthscope Commercial |
$415.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: PHP Commercial |
$392.50
|
| Rate for Payer: Priority Health SBD |
$290.91
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,020.52 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,376.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.92
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Advantage |
$1,133.91
|
| Rate for Payer: Cofinity Commercial |
$1,393.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: PHP Commercial |
$1,376.89
|
| Rate for Payer: Priority Health SBD |
$1,020.52
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,376.89
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.92
|
| 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 |
$885.31
|
| Rate for Payer: BCN Commercial |
$885.31
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Advantage |
$1,133.91
|
| Rate for Payer: Cofinity Commercial |
$1,393.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| 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 |
$1,376.89
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,376.89
|
| 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 |
$1,020.52
|
| 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) |
$1,052.92
|
| Rate for Payer: UHC Core |
$843.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$636.61
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$841.09 |
| Max. Negotiated Rate |
$1,201.56 |
| Rate for Payer: Aetna Commercial |
$1,134.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.80
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Advantage |
$934.55
|
| Rate for Payer: Cofinity Commercial |
$1,148.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Healthscope Commercial |
$1,201.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: PHP Commercial |
$1,134.81
|
| Rate for Payer: Priority Health SBD |
$841.09
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,201.56 |
| Rate for Payer: Aetna Commercial |
$1,134.81
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.80
|
| 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 |
$707.66
|
| Rate for Payer: BCN Commercial |
$707.66
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Advantage |
$934.55
|
| Rate for Payer: Cofinity Commercial |
$1,148.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,201.56
|
| 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 |
$1,134.81
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,134.81
|
| 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 |
$841.09
|
| 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) |
$867.80
|
| Rate for Payer: UHC Core |
$695.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$524.68
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$117.82
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$95.73
|
| Rate for Payer: BCN Commercial |
$95.73
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Advantage |
$97.03
|
| Rate for Payer: Cofinity Commercial |
$119.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$124.75
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$117.82
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$87.32
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.32 |
| Max. Negotiated Rate |
$124.75 |
| Rate for Payer: Aetna Commercial |
$117.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.10
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Advantage |
$97.03
|
| Rate for Payer: Cofinity Commercial |
$119.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Healthscope Commercial |
$124.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: PHP Commercial |
$117.82
|
| Rate for Payer: Priority Health SBD |
$87.32
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,283.04 |
| Max. Negotiated Rate |
$4,690.05 |
| Rate for Payer: Aetna Commercial |
$4,429.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,387.26
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Advantage |
$3,647.82
|
| Rate for Payer: Cofinity Commercial |
$4,481.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Healthscope Commercial |
$4,690.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: PHP Commercial |
$4,429.49
|
| Rate for Payer: Priority Health SBD |
$3,283.04
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,427.99 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna Commercial |
$4,429.49
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,387.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,427.99
|
| Rate for Payer: BCN Commercial |
$2,427.99
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Advantage |
$3,647.82
|
| Rate for Payer: Cofinity Commercial |
$4,481.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$4,690.05
|
| Rate for Payer: Mclaren Medicaid |
$2,899.76
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$4,429.49
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$3,283.04
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$555.18 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.81
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Advantage |
$616.87
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: Priority Health SBD |
$555.18
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$482.64
|
| Rate for Payer: BCN Commercial |
$482.64
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Advantage |
$616.87
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$555.18
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.81
|
| Rate for Payer: UHC Core |
$459.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$346.33
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$465.63 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.41
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Advantage |
$517.36
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: Priority Health SBD |
$465.63
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$310.91
|
| Rate for Payer: BCN Commercial |
$310.91
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Advantage |
$517.36
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$465.63
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.41
|
| Rate for Payer: UHC Core |
$385.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$290.46
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$605.65 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.88
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Advantage |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: Priority Health SBD |
$605.65
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$482.64
|
| Rate for Payer: BCN Commercial |
$482.64
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Advantage |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$605.65
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.88
|
| Rate for Payer: UHC Core |
$500.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$377.81
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$725.65 |
| Rate for Payer: Aetna Commercial |
$685.34
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$310.91
|
| Rate for Payer: BCN Commercial |
$310.91
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Advantage |
$564.40
|
| Rate for Payer: Cofinity Commercial |
$693.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$725.65
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$685.34
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$507.96
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.08
|
| Rate for Payer: UHC Core |
$420.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$316.87
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$507.96 |
| Max. Negotiated Rate |
$725.65 |
| Rate for Payer: Aetna Commercial |
$685.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.08
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Advantage |
$564.40
|
| Rate for Payer: Cofinity Commercial |
$693.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Healthscope Commercial |
$725.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PHP Commercial |
$685.34
|
| Rate for Payer: Priority Health SBD |
$507.96
|
|
