|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$29.78 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$83.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: BCBS Complete |
$66.58
|
| Rate for Payer: BCBS Trust/PPO |
$29.78
|
| Rate for Payer: BCN Commercial |
$29.78
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Advantage |
$116.52
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health SBD |
$104.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.20
|
| Rate for Payer: UHC Core |
$86.73
|
| Rate for Payer: UHC Exchange |
$65.42
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$104.87 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Advantage |
$116.52
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health SBD |
$104.87
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.39
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Advantage |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health SBD |
$20.73
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Advantage |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Mclaren Medicaid |
$15.07
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$20.73
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.39
|
| Rate for Payer: UHC Core |
$17.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$12.93
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,770.86
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$662.25 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,505.23
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$662.25
|
| Rate for Payer: BCN Commercial |
$662.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cofinity Advantage |
$1,239.60
|
| Rate for Payer: Cofinity Commercial |
$1,522.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,593.77
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,505.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.14
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,505.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,115.64
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,770.86
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,115.64 |
| Max. Negotiated Rate |
$1,593.77 |
| Rate for Payer: Aetna Commercial |
$1,505.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.06
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cofinity Advantage |
$1,239.60
|
| Rate for Payer: Cofinity Commercial |
$1,522.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.69
|
| Rate for Payer: Healthscope Commercial |
$1,593.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,505.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.14
|
| Rate for Payer: PHP Commercial |
$1,505.23
|
| Rate for Payer: Priority Health SBD |
$1,115.64
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.32
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: Aetna Medicare |
$4.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.41
|
| Rate for Payer: BCBS Complete |
$3.33
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Advantage |
$5.82
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: Priority Health SBD |
$5.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.16
|
| Rate for Payer: UHC Core |
$4.16
|
| Rate for Payer: UHC Exchange |
$4.16
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.32
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.41
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Advantage |
$5.82
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: Priority Health SBD |
$5.24
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,147.65
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,353.02 |
| Max. Negotiated Rate |
$1,932.88 |
| Rate for Payer: Aetna Commercial |
$1,825.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.97
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cofinity Advantage |
$1,503.36
|
| Rate for Payer: Cofinity Commercial |
$1,846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,718.12
|
| Rate for Payer: Healthscope Commercial |
$1,932.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,825.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,610.74
|
| Rate for Payer: PHP Commercial |
$1,825.50
|
| Rate for Payer: Priority Health SBD |
$1,353.02
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,147.65
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$844.03 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,825.50
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,193.17
|
| Rate for Payer: BCN Commercial |
$1,193.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cofinity Advantage |
$1,503.36
|
| Rate for Payer: Cofinity Commercial |
$1,846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,718.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,932.88
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,825.50
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,610.74
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,825.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,353.02
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,395.97
|
| Rate for Payer: UHC Core |
$1,118.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$844.03
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,377.78 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.78
|
| Rate for Payer: BCN Commercial |
$1,377.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.31
|
| Rate for Payer: UHC Core |
$1,923.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.66
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.49 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,199.55
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,015.72 |
| Max. Negotiated Rate |
$2,879.59 |
| Rate for Payer: Aetna Commercial |
$2,719.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.71
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cofinity Advantage |
$2,239.68
|
| Rate for Payer: Cofinity Commercial |
$2,751.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.64
|
| Rate for Payer: Healthscope Commercial |
$2,879.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.66
|
| Rate for Payer: PHP Commercial |
$2,719.62
|
| Rate for Payer: Priority Health SBD |
$2,015.72
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,199.55
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,257.42 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$2,719.62
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,390.46
|
| Rate for Payer: BCN Commercial |
$2,390.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cofinity Advantage |
$2,239.68
|
| Rate for Payer: Cofinity Commercial |
$2,751.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,879.59
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.62
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.66
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$2,719.62
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,015.72
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,079.71
|
| Rate for Payer: UHC Core |
$1,666.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,257.42
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,223.02
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,889.57
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$869.56
|
| Rate for Payer: BCN Commercial |
$869.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cofinity Advantage |
$1,556.11
|
| Rate for Payer: Cofinity Commercial |
$1,911.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,778.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,000.72
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,889.57
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,667.27
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,889.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,400.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,444.96
|
| Rate for Payer: UHC Core |
$1,158.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$873.65
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,223.02
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,400.50 |
| Max. Negotiated Rate |
$2,000.72 |
| Rate for Payer: Aetna Commercial |
$1,889.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.96
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cofinity Advantage |
$1,556.11
|
| Rate for Payer: Cofinity Commercial |
$1,911.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,778.42
|
| Rate for Payer: Healthscope Commercial |
$2,000.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,889.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,667.27
|
| Rate for Payer: PHP Commercial |
$1,889.57
|
| Rate for Payer: Priority Health SBD |
$1,400.50
|
|
|
HC BIOPSY BREAST OPEN INCISIONAL
|
Facility
|
OP
|
$4,660.75
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
76100558
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$311.32 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Commercial |
$3,961.64
|
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,029.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.44
|
| Rate for Payer: BCCCP Commercial |
$311.32
|
| Rate for Payer: BCN Commercial |
$1,392.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cofinity Advantage |
$3,262.53
|
| Rate for Payer: Cofinity Commercial |
$4,008.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,728.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$4,194.68
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,961.64
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,495.56
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$3,961.64
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health SBD |
$2,936.27
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,029.49
|
| Rate for Payer: UHC Core |
$2,428.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Exchange |
$1,831.67
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
HC BIOPSY BREAST OPEN INCISIONAL
|
Facility
|
IP
|
$4,660.75
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
76100558
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,936.27 |
| Max. Negotiated Rate |
$4,194.68 |
| Rate for Payer: Aetna Commercial |
$3,961.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,029.49
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cofinity Advantage |
$3,262.53
|
| Rate for Payer: Cofinity Commercial |
$4,008.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,728.60
|
| Rate for Payer: Healthscope Commercial |
$4,194.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,961.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,495.56
|
| Rate for Payer: PHP Commercial |
$3,961.64
|
| Rate for Payer: Priority Health SBD |
$2,936.27
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$689.79
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$434.57 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.36
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Advantage |
$482.85
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: Priority Health SBD |
$434.57
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$689.79
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.09 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Advantage |
$482.85
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$434.57
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.36
|
| Rate for Payer: UHC Core |
$359.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$271.09
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC BIOPSY/EXCISION LYMPH NODE, OPEN SUPERFICIAL
|
Facility
|
IP
|
$7,660.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
76100535
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,825.80 |
| Max. Negotiated Rate |
$6,894.00 |
| Rate for Payer: Aetna Commercial |
$6,511.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,979.00
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cofinity Advantage |
$5,362.00
|
| Rate for Payer: Cofinity Commercial |
$6,587.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,128.00
|
| Rate for Payer: Healthscope Commercial |
$6,894.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,511.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,745.00
|
| Rate for Payer: PHP Commercial |
$6,511.00
|
| Rate for Payer: Priority Health SBD |
$4,825.80
|
|
|
HC BIOPSY/EXCISION LYMPH NODE, OPEN SUPERFICIAL
|
Facility
|
OP
|
$7,660.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
76100535
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Commercial |
$6,511.00
|
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,979.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,377.78
|
| Rate for Payer: BCN Commercial |
$2,377.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cofinity Advantage |
$5,362.00
|
| Rate for Payer: Cofinity Commercial |
$6,587.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$6,894.00
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,511.00
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,745.00
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$6,511.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health SBD |
$4,825.80
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,979.00
|
| Rate for Payer: UHC Core |
$3,990.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Exchange |
$3,010.38
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$4,096.05
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.51 |
| Max. Negotiated Rate |
$3,686.45 |
| Rate for Payer: Aetna Commercial |
$3,481.64
|
| Rate for Payer: Aetna Commercial |
$5,222.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,662.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,993.65
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cofinity Advantage |
$2,867.24
|
| Rate for Payer: Cofinity Advantage |
$4,300.86
|
| Rate for Payer: Cofinity Commercial |
$3,522.60
|
| Rate for Payer: Cofinity Commercial |
$5,283.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,915.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Healthscope Commercial |
$5,529.67
|
| Rate for Payer: Healthscope Commercial |
$3,686.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,222.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,608.06
|
| Rate for Payer: PHP Commercial |
$3,481.64
|
| Rate for Payer: PHP Commercial |
$5,222.47
|
| Rate for Payer: Priority Health SBD |
$2,580.51
|
| Rate for Payer: Priority Health SBD |
$3,870.77
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$4,096.05
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.73 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna Commercial |
$3,481.64
|
| Rate for Payer: Aetna Commercial |
$5,222.47
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,993.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,662.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$104.73
|
| Rate for Payer: BCBS Trust/PPO |
$104.73
|
| Rate for Payer: BCN Commercial |
$104.73
|
| Rate for Payer: BCN Commercial |
$104.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cofinity Advantage |
$4,300.86
|
| Rate for Payer: Cofinity Advantage |
$2,867.24
|
| Rate for Payer: Cofinity Commercial |
$3,522.60
|
| Rate for Payer: Cofinity Commercial |
$5,283.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,915.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,686.45
|
| Rate for Payer: Healthscope Commercial |
$5,529.67
|
| Rate for Payer: Mclaren Medicaid |
$808.56
|
| Rate for Payer: Mclaren Medicaid |
$808.56
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,222.47
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,608.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$3,481.64
|
| Rate for Payer: PHP Commercial |
$5,222.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health SBD |
$3,870.77
|
| Rate for Payer: Priority Health SBD |
$2,580.51
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,662.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,993.65
|
| Rate for Payer: UHC Core |
$3,201.07
|
| Rate for Payer: UHC Core |
$2,134.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,414.62
|
| Rate for Payer: UHC Exchange |
$1,609.75
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
OP
|
$398.50
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.72 |
| Max. Negotiated Rate |
$763.21 |
| Rate for Payer: Aetna Commercial |
$338.73
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$67.72
|
| Rate for Payer: BCN Commercial |
$67.72
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cofinity Advantage |
$278.95
|
| Rate for Payer: Cofinity Commercial |
$342.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$358.65
|
| Rate for Payer: Mclaren Medicaid |
$123.43
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.73
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.88
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$338.73
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$251.06
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.02
|
| Rate for Payer: UHC Core |
$207.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$156.61
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
