|
HC ARTHROGRAM SACROILIAC
|
Facility
|
IP
|
$956.46
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$602.57 |
| Max. Negotiated Rate |
$860.81 |
| Rate for Payer: Aetna Commercial |
$812.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.70
|
| Rate for Payer: Cash Price |
$765.17
|
| Rate for Payer: Cofinity Advantage |
$669.52
|
| Rate for Payer: Cofinity Commercial |
$822.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.17
|
| Rate for Payer: Healthscope Commercial |
$860.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$812.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.35
|
| Rate for Payer: PHP Commercial |
$812.99
|
| Rate for Payer: Priority Health SBD |
$602.57
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,090.19
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$686.82 |
| Max. Negotiated Rate |
$981.17 |
| Rate for Payer: Aetna Commercial |
$926.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.62
|
| Rate for Payer: Cash Price |
$872.15
|
| Rate for Payer: Cofinity Advantage |
$763.13
|
| Rate for Payer: Cofinity Commercial |
$937.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.15
|
| Rate for Payer: Healthscope Commercial |
$981.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.64
|
| Rate for Payer: PHP Commercial |
$926.66
|
| Rate for Payer: Priority Health SBD |
$686.82
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,090.19
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$258.82 |
| Max. Negotiated Rate |
$981.17 |
| Rate for Payer: Aetna Commercial |
$926.66
|
| Rate for Payer: Aetna Medicare |
$545.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.62
|
| Rate for Payer: BCBS Complete |
$436.08
|
| Rate for Payer: BCBS Trust/PPO |
$565.76
|
| Rate for Payer: BCN Commercial |
$565.76
|
| Rate for Payer: Cash Price |
$872.15
|
| Rate for Payer: Cash Price |
$872.15
|
| Rate for Payer: Cash Price |
$872.15
|
| Rate for Payer: Cofinity Advantage |
$763.13
|
| Rate for Payer: Cofinity Commercial |
$937.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.15
|
| Rate for Payer: Healthscope Commercial |
$981.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$872.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.64
|
| Rate for Payer: PHP Commercial |
$926.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$323.52
|
| Rate for Payer: Priority Health SBD |
$686.82
|
| Rate for Payer: Priority Health Tiered Network |
$258.82
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
OP
|
$1,853.20
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$728.31 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Commercial |
$1,575.22
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,204.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,395.52
|
| Rate for Payer: BCN Commercial |
$1,395.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$1,482.56
|
| Rate for Payer: Cash Price |
$1,482.56
|
| Rate for Payer: Cash Price |
$1,482.56
|
| Rate for Payer: Cofinity Advantage |
$1,297.24
|
| Rate for Payer: Cofinity Commercial |
$1,593.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$1,667.88
|
| Rate for Payer: Mclaren Medicaid |
$1,705.10
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.22
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,389.90
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$1,575.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$1,167.52
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.58
|
| Rate for Payer: UHC Core |
$965.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$728.31
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,853.20
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,167.52 |
| Max. Negotiated Rate |
$1,667.88 |
| Rate for Payer: Aetna Commercial |
$1,575.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,204.58
|
| Rate for Payer: Cash Price |
$1,482.56
|
| Rate for Payer: Cofinity Advantage |
$1,297.24
|
| Rate for Payer: Cofinity Commercial |
$1,593.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.56
|
| Rate for Payer: Healthscope Commercial |
$1,667.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,389.90
|
| Rate for Payer: PHP Commercial |
$1,575.22
|
| Rate for Payer: Priority Health SBD |
$1,167.52
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,178.93
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Commercial |
$3,552.09
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,716.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$929.01
|
| Rate for Payer: BCN Commercial |
$929.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,343.14
|
| Rate for Payer: Cash Price |
$3,343.14
|
| Rate for Payer: Cash Price |
$3,343.14
|
| Rate for Payer: Cofinity Advantage |
$2,925.25
|
| Rate for Payer: Cofinity Commercial |
$3,593.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$3,761.04
|
| Rate for Payer: Mclaren Medicaid |
$837.96
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.09
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.20
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$3,552.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health SBD |
$2,632.73
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,716.30
|
| Rate for Payer: UHC Core |
$2,177.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$1,642.32
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
IP
|
$4,178.93
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,632.73 |
| Max. Negotiated Rate |
$3,761.04 |
| Rate for Payer: Aetna Commercial |
$3,552.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,716.30
|
| Rate for Payer: Cash Price |
$3,343.14
|
| Rate for Payer: Cofinity Advantage |
$2,925.25
|
| Rate for Payer: Cofinity Commercial |
$3,593.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.14
|
| Rate for Payer: Healthscope Commercial |
$3,761.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.20
|
| Rate for Payer: PHP Commercial |
$3,552.09
|
| Rate for Payer: Priority Health SBD |
$2,632.73
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$940.65
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$592.61 |
| Max. Negotiated Rate |
$846.59 |
| Rate for Payer: Healthscope Commercial |
$846.59
|
| Rate for Payer: Aetna Commercial |
$799.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.42
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cofinity Advantage |
$658.46
|
| Rate for Payer: Cofinity Commercial |
$808.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.49
|
| Rate for Payer: PHP Commercial |
$799.55
|
| Rate for Payer: Priority Health SBD |
$592.61
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$940.65
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$846.59 |
| Rate for Payer: Aetna Commercial |
$799.55
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.42
|
| 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 |
$530.01
|
| Rate for Payer: BCN Commercial |
$530.01
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cofinity Advantage |
$658.46
|
| Rate for Payer: Cofinity Commercial |
$808.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$846.59
|
| 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 |
$799.55
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.49
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$799.55
|
| 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 |
$592.61
|
| 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) |
$611.42
|
| Rate for Payer: UHC Core |
$490.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$369.68
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$771.48
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$694.33 |
| Rate for Payer: Aetna Commercial |
$655.76
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.46
|
| 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 |
$441.17
|
| Rate for Payer: BCN Commercial |
$441.17
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$617.18
|
| Rate for Payer: Cash Price |
$617.18
|
| Rate for Payer: Cofinity Advantage |
$540.04
|
| Rate for Payer: Cofinity Commercial |
$663.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$694.33
|
| 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 |
$655.76
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.61
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$655.76
|
| 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 |
$486.03
|
| 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) |
$501.46
|
| Rate for Payer: UHC Core |
$401.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$303.19
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$771.48
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$486.03 |
| Max. Negotiated Rate |
$694.33 |
| Rate for Payer: Aetna Commercial |
$655.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.46
|
| Rate for Payer: Cash Price |
$617.18
|
| Rate for Payer: Cofinity Advantage |
$540.04
|
| Rate for Payer: Cofinity Commercial |
$663.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.18
|
| Rate for Payer: Healthscope Commercial |
$694.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.61
|
| Rate for Payer: PHP Commercial |
$655.76
|
| Rate for Payer: Priority Health SBD |
$486.03
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,737.42
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$469.70 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$469.70
|
| Rate for Payer: BCN Commercial |
$469.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,737.42
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.57 |
| Max. Negotiated Rate |
$4,263.68 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
|
|
HC ASCLERA 1%
|
Facility
|
IP
|
$33.90
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600285
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.36 |
| Max. Negotiated Rate |
$30.51 |
| Rate for Payer: Aetna Commercial |
$28.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.04
|
| Rate for Payer: Cash Price |
$27.12
|
| Rate for Payer: Cofinity Advantage |
$23.73
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.12
|
| Rate for Payer: Healthscope Commercial |
$30.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.43
|
| Rate for Payer: PHP Commercial |
$28.82
|
| Rate for Payer: Priority Health SBD |
$21.36
|
|
|
HC ASCLERA 1%
|
Facility
|
OP
|
$33.90
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600285
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.56 |
| Max. Negotiated Rate |
$30.51 |
| Rate for Payer: Aetna Commercial |
$28.82
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.04
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: Cash Price |
$27.12
|
| Rate for Payer: Cofinity Advantage |
$23.73
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.12
|
| Rate for Payer: Healthscope Commercial |
$30.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.43
|
| Rate for Payer: PHP Commercial |
$28.82
|
| Rate for Payer: Priority Health SBD |
$21.36
|
|
|
HC ASCLERA O.5%
|
Facility
|
IP
|
$29.55
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.62 |
| Max. Negotiated Rate |
$26.59 |
| Rate for Payer: Aetna Commercial |
$25.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.21
|
| Rate for Payer: Cash Price |
$23.64
|
| Rate for Payer: Cofinity Advantage |
$20.68
|
| Rate for Payer: Cofinity Commercial |
$25.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$26.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.16
|
| Rate for Payer: PHP Commercial |
$25.12
|
| Rate for Payer: Priority Health SBD |
$18.62
|
|
|
HC ASCLERA O.5%
|
Facility
|
OP
|
$29.55
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$26.59 |
| Rate for Payer: Aetna Commercial |
$25.12
|
| Rate for Payer: Aetna Medicare |
$14.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.21
|
| Rate for Payer: BCBS Complete |
$11.82
|
| Rate for Payer: Cash Price |
$23.64
|
| Rate for Payer: Cofinity Advantage |
$20.68
|
| Rate for Payer: Cofinity Commercial |
$25.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$26.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.16
|
| Rate for Payer: PHP Commercial |
$25.12
|
| Rate for Payer: Priority Health SBD |
$18.62
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$199.57
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$59.82
|
| Rate for Payer: BCN Commercial |
$59.82
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cofinity Advantage |
$139.70
|
| Rate for Payer: Cofinity Commercial |
$171.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.63
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.68
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$169.63
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$125.73
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.72
|
| Rate for Payer: UHC Core |
$103.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$78.43
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$199.57
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$179.61 |
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.72
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cofinity Advantage |
$139.70
|
| Rate for Payer: Cofinity Commercial |
$171.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.66
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.68
|
| Rate for Payer: PHP Commercial |
$169.63
|
| Rate for Payer: Priority Health SBD |
$125.73
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,296.72
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$816.93 |
| Max. Negotiated Rate |
$1,167.05 |
| Rate for Payer: Aetna Commercial |
$1,102.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.87
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cofinity Advantage |
$907.70
|
| Rate for Payer: Cofinity Commercial |
$1,115.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.38
|
| Rate for Payer: Healthscope Commercial |
$1,167.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.54
|
| Rate for Payer: PHP Commercial |
$1,102.21
|
| Rate for Payer: Priority Health SBD |
$816.93
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,296.72
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$1,102.21
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$497.27
|
| Rate for Payer: BCN Commercial |
$497.27
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cofinity Advantage |
$907.70
|
| Rate for Payer: Cofinity Commercial |
$1,115.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,167.05
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.21
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.54
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,102.21
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$816.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.05
|
| Rate for Payer: BCN Commercial |
$16.05
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$12.04
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Core |
$22.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.05
|
| Rate for Payer: UHC Exchange |
$22.58
|
| Rate for Payer: UHC Medicaid |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
|
