|
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 |
$192.14 |
| 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: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cofinity Commercial |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$149.44
|
| 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: 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 Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$134.50
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| 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 |
$28.09 |
| 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: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| 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: 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 Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| 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
|
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 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: 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: 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 Medicare |
$9.47
|
| Rate for Payer: Priority Health SBD |
$78.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.66
|
| 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 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 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: 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: 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 Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$32.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.74
|
| 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 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
|
|
|
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 |
$47.98 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$93.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.90
|
| Rate for Payer: BCBS Complete |
$50.38
|
| Rate for Payer: BCBS MAPPO |
$89.52
|
| Rate for Payer: BCN Medicare Advantage |
$89.52
|
| 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 |
$89.52
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Mclaren Medicaid |
$47.98
|
| Rate for Payer: Mclaren Medicare |
$89.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.00
|
| Rate for Payer: Meridian Medicaid |
$50.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: PACE Medicare |
$85.04
|
| Rate for Payer: PACE SWMI |
$89.52
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$89.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Medicare |
$89.52
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: Railroad Medicare Medicare |
$89.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.52
|
| Rate for Payer: UHC Medicare Advantage |
$89.52
|
| Rate for Payer: UHCCP Medicaid |
$50.40
|
| Rate for Payer: VA VA |
$89.52
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$275.94 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.70
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$306.60
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health SBD |
$275.94
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$306.60
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$275.94
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$324.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$324.12
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Cofinity Commercial |
$306.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$275.94
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.94 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.70
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$306.60
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health SBD |
$275.94
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$20.48
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health SBD |
$70.69
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$16.89
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: Aetna Medicare |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.98
|
| Rate for Payer: BCBS Complete |
$6.76
|
| Rate for Payer: Cash Price |
$13.51
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$14.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.51
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.36
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.98
|
| Rate for Payer: Priority Health SBD |
$10.64
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$16.89
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.98
|
| Rate for Payer: Cash Price |
$13.51
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$14.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.51
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.36
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.98
|
| Rate for Payer: Priority Health SBD |
$10.64
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.48
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$15.69
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$16.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Medicare Advantage |
$29.28
|
| Rate for Payer: UHCCP Medicaid |
$16.48
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health SBD |
$34.08
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.62 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.83
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.64
|
| Rate for Payer: Priority Health SBD |
$63.62
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.48
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Mclaren Medicaid |
$15.69
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$16.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.83
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.64
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$63.62
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Medicare Advantage |
$29.28
|
| Rate for Payer: UHCCP Medicaid |
$16.48
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$435.40
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$274.30 |
| Max. Negotiated Rate |
$391.86 |
| Rate for Payer: Aetna Commercial |
$370.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.01
|
| Rate for Payer: Cash Price |
$348.32
|
| Rate for Payer: Cofinity Commercial |
$304.78
|
| Rate for Payer: Cofinity Commercial |
$374.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$304.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.32
|
| Rate for Payer: Healthscope Commercial |
$391.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.09
|
| Rate for Payer: PHP Commercial |
$370.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.01
|
| Rate for Payer: Priority Health SBD |
$274.30
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$435.40
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$174.16 |
| Max. Negotiated Rate |
$391.86 |
| Rate for Payer: Aetna Commercial |
$370.09
|
| Rate for Payer: Aetna Medicare |
$217.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.01
|
| Rate for Payer: BCBS Complete |
$174.16
|
| Rate for Payer: Cash Price |
$348.32
|
| Rate for Payer: Cofinity Commercial |
$304.78
|
| Rate for Payer: Cofinity Commercial |
$374.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$304.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.32
|
| Rate for Payer: Healthscope Commercial |
$391.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.09
|
| Rate for Payer: PHP Commercial |
$370.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.01
|
| Rate for Payer: Priority Health SBD |
$274.30
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$35.69
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health SBD |
$32.12
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Cofinity Commercial |
$35.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$12.06
|
| Rate for Payer: VA VA |
$21.42
|
|
