|
HC AMP FINGER/THUMB W FLAP
|
Facility
|
OP
|
$4,658.14
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
45000091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$714.89 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$3,959.42
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,027.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.51
|
| Rate for Payer: BCN Commercial |
$1,089.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$3,726.51
|
| Rate for Payer: Cash Price |
$3,726.51
|
| Rate for Payer: Cash Price |
$3,726.51
|
| Rate for Payer: Cofinity Commercial |
$4,006.00
|
| Rate for Payer: Cofinity Commercial |
$3,260.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,260.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,726.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$4,192.33
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,959.42
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,959.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,027.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$2,934.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.89
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
HC AMPHETAMINES 3 OR 4
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.78 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.53
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$26.42
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health SBD |
$23.78
|
|
|
HC AMPHETAMINES 3 OR 4
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.53
|
| Rate for Payer: BCBS Complete |
$15.10
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$26.42
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health SBD |
$23.78
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.05 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health SBD |
$64.05
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$34.98
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$15.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health SBD |
$19.92
|
| Rate for Payer: UHC Core |
$22.13
|
| Rate for Payer: UHC Exchange |
$22.13
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.92 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health SBD |
$19.92
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.10
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: BCBS Complete |
$16.44
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$19.39
|
| Rate for Payer: BCN Commercial |
$19.39
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Cofinity Commercial |
$203.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Mclaren Medicaid |
$15.66
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$16.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.10
|
| Rate for Payer: Nomi Health Commercial |
$43.82
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$247.10
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Narrow Network |
$23.37
|
| Rate for Payer: Priority Health SBD |
$183.14
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.21
|
| Rate for Payer: UHC Medicare Advantage |
$29.21
|
| Rate for Payer: UHCCP Medicaid |
$16.45
|
| Rate for Payer: VA VA |
$29.21
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
IP
|
$290.70
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$183.14 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.96
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$203.49
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.10
|
| Rate for Payer: PHP Commercial |
$247.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health SBD |
$183.14
|
|
|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
IP
|
$9,241.20
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,821.96 |
| Max. Negotiated Rate |
$8,317.08 |
| Rate for Payer: Aetna Commercial |
$7,855.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,006.78
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cofinity Commercial |
$6,468.84
|
| Rate for Payer: Cofinity Commercial |
$7,947.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,468.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,392.96
|
| Rate for Payer: Healthscope Commercial |
$8,317.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,855.02
|
| Rate for Payer: PHP Commercial |
$7,855.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,006.78
|
| Rate for Payer: Priority Health SBD |
$5,821.96
|
|
|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
OP
|
$9,241.20
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.35 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$7,855.02
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,006.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.05
|
| Rate for Payer: BCN Commercial |
$1,461.05
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cofinity Commercial |
$7,947.43
|
| Rate for Payer: Cofinity Commercial |
$6,468.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,468.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,392.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$8,317.08
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,855.02
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$7,855.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,006.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$5,821.96
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.35
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UHC Core |
$107.36
|
| Rate for Payer: UHC Exchange |
$107.36
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
|
|
HC AMYLASE FLUID
|
Facility
|
IP
|
$61.61
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.81 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.05
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$43.13
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health SBD |
$38.81
|
|
|
HC AMYLASE FLUID
|
Facility
|
OP
|
$61.61
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$1,076.24 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.74
|
| Rate for Payer: BCN Commercial |
$5.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$43.13
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.67
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$38.81
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$1,076.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$1,076.24
|
| Rate for Payer: UHC Medicare Advantage |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
IP
|
$213.49
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$134.50 |
| Max. Negotiated Rate |
$192.14 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.77
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cofinity Commercial |
$149.44
|
| Rate for Payer: Cofinity Commercial |
$183.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.79
|
| Rate for Payer: Healthscope Commercial |
$192.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.77
|
| Rate for Payer: Priority Health SBD |
$134.50
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
OP
|
$213.49
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$1,076.24 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.74
|
| Rate for Payer: BCN Commercial |
$5.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cofinity Commercial |
$149.44
|
| Rate for Payer: Cofinity Commercial |
$183.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$192.14
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.67
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$134.50
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$1,076.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$1,076.24
|
| Rate for Payer: UHC Medicare Advantage |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health SBD |
$19.66
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$1,076.24 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.74
|
| Rate for Payer: BCN Commercial |
$5.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.67
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$1,076.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$1,076.24
|
| Rate for Payer: UHC Medicare Advantage |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$9.47
|
| Rate for Payer: BCBS Trust/PPO |
$8.38
|
| Rate for Payer: BCN Commercial |
$8.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.47
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$87.18
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.47
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Mclaren Medicaid |
$5.08
|
| Rate for Payer: Mclaren Medicare |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.94
|
| Rate for Payer: Meridian Medicaid |
$5.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.86
|
| Rate for Payer: Nomi Health Commercial |
$14.20
|
| Rate for Payer: PACE Medicare |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.47
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.74
|
| Rate for Payer: Priority Health Medicare |
$9.47
|
| Rate for Payer: Priority Health Narrow Network |
$7.79
|
| Rate for Payer: Priority Health SBD |
$78.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.47
|
| Rate for Payer: UHC Medicare Advantage |
$9.47
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: VA VA |
$9.47
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.46 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.95
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$87.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.86
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.95
|
| Rate for Payer: Priority Health SBD |
$78.46
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: BCBS Complete |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$7.15
|
| Rate for Payer: BCN Commercial |
$7.15
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Cofinity Commercial |
$36.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Mclaren Medicaid |
$4.33
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.31
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health Narrow Network |
$6.65
|
| Rate for Payer: Priority Health SBD |
$32.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.08
|
| Rate for Payer: UHC Medicare Advantage |
$8.08
|
| Rate for Payer: UHCCP Medicaid |
$4.55
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.97 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.02
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$36.64
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: Priority Health SBD |
$32.97
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$282.66 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$93.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.41
|
| Rate for Payer: BCBS Complete |
$50.61
|
| Rate for Payer: BCBS MAPPO |
$89.93
|
| Rate for Payer: BCBS Trust/PPO |
$72.36
|
| Rate for Payer: BCN Commercial |
$72.36
|
| Rate for Payer: BCN Medicare Advantage |
$89.93
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.93
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Mclaren Medicaid |
$48.20
|
| Rate for Payer: Mclaren Medicare |
$89.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.43
|
| Rate for Payer: Meridian Medicaid |
$50.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$269.79
|
| Rate for Payer: PACE Medicare |
$85.43
|
| Rate for Payer: PACE SWMI |
$89.93
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$89.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.66
|
| Rate for Payer: Priority Health Medicare |
$89.93
|
| Rate for Payer: Priority Health Narrow Network |
$226.13
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: Railroad Medicare Medicare |
$89.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.93
|
| Rate for Payer: UHC Medicare Advantage |
$89.93
|
| Rate for Payer: UHCCP Medicaid |
$50.63
|
| Rate for Payer: VA VA |
$89.93
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.78 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health SBD |
$192.78
|
|
