|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$138.37
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$124.53 |
| Rate for Payer: Aetna Commercial |
$117.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.94
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$119.00
|
| Rate for Payer: Cofinity Commercial |
$96.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.70
|
| Rate for Payer: Healthscope Commercial |
$124.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.61
|
| Rate for Payer: PHP Commercial |
$117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.94
|
| Rate for Payer: Priority Health SBD |
$87.17
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$138.37
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$144.09 |
| Rate for Payer: Aetna Commercial |
$117.61
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$96.86
|
| Rate for Payer: Cofinity Commercial |
$119.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$124.53
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.61
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$117.61
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.94
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$87.17
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$28.82
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,360.73
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,487.26 |
| Max. Negotiated Rate |
$2,124.66 |
| Rate for Payer: Aetna Commercial |
$2,006.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,534.47
|
| Rate for Payer: Cash Price |
$1,888.58
|
| Rate for Payer: Cofinity Commercial |
$1,652.51
|
| Rate for Payer: Cofinity Commercial |
$2,030.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,652.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.58
|
| Rate for Payer: Healthscope Commercial |
$2,124.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.62
|
| Rate for Payer: PHP Commercial |
$2,006.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.47
|
| Rate for Payer: Priority Health SBD |
$1,487.26
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,360.73
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$944.29 |
| Max. Negotiated Rate |
$2,124.66 |
| Rate for Payer: Aetna Commercial |
$2,006.62
|
| Rate for Payer: Aetna Medicare |
$1,180.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,534.47
|
| Rate for Payer: BCBS Complete |
$944.29
|
| Rate for Payer: Cash Price |
$1,888.58
|
| Rate for Payer: Cofinity Commercial |
$1,652.51
|
| Rate for Payer: Cofinity Commercial |
$2,030.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,652.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.58
|
| Rate for Payer: Healthscope Commercial |
$2,124.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.62
|
| Rate for Payer: PHP Commercial |
$2,006.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.47
|
| Rate for Payer: Priority Health SBD |
$1,487.26
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$502.41
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$452.17 |
| Rate for Payer: Aetna Commercial |
$427.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.57
|
| Rate for Payer: Cash Price |
$401.93
|
| Rate for Payer: Cofinity Commercial |
$351.69
|
| Rate for Payer: Cofinity Commercial |
$432.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.93
|
| Rate for Payer: Healthscope Commercial |
$452.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.05
|
| Rate for Payer: PHP Commercial |
$427.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.57
|
| Rate for Payer: Priority Health SBD |
$316.52
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$502.41
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.96 |
| Max. Negotiated Rate |
$452.17 |
| Rate for Payer: Aetna Commercial |
$427.05
|
| Rate for Payer: Aetna Medicare |
$251.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.57
|
| Rate for Payer: BCBS Complete |
$200.96
|
| Rate for Payer: Cash Price |
$401.93
|
| Rate for Payer: Cofinity Commercial |
$351.69
|
| Rate for Payer: Cofinity Commercial |
$432.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.93
|
| Rate for Payer: Healthscope Commercial |
$452.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.05
|
| Rate for Payer: PHP Commercial |
$427.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.57
|
| Rate for Payer: Priority Health SBD |
$316.52
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$552.65
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$221.06 |
| Max. Negotiated Rate |
$497.38 |
| Rate for Payer: Aetna Commercial |
$469.75
|
| Rate for Payer: Aetna Medicare |
$276.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.22
|
| Rate for Payer: BCBS Complete |
$221.06
|
| Rate for Payer: Cash Price |
$442.12
|
| Rate for Payer: Cofinity Commercial |
$386.86
|
| Rate for Payer: Cofinity Commercial |
$475.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.12
|
| Rate for Payer: Healthscope Commercial |
$497.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.75
|
| Rate for Payer: PHP Commercial |
$469.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.22
|
| Rate for Payer: Priority Health SBD |
$348.17
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$552.65
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.17 |
| Max. Negotiated Rate |
$497.38 |
| Rate for Payer: Aetna Commercial |
$469.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.22
|
| Rate for Payer: Cash Price |
$442.12
|
| Rate for Payer: Cofinity Commercial |
$386.86
|
| Rate for Payer: Cofinity Commercial |
$475.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.12
|
| Rate for Payer: Healthscope Commercial |
$497.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.75
|
| Rate for Payer: PHP Commercial |
$469.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.22
|
| Rate for Payer: Priority Health SBD |
$348.17
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$3,130.61
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,100.88 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$3,130.61
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,100.88 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$1,011.36
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$404.54 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna Medicare |
$505.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.38
|
| Rate for Payer: BCBS Complete |
$404.54
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$707.95
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$707.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health SBD |
$637.16
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$1,011.36
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.16 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.38
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$707.95
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$707.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health SBD |
$637.16
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$1,011.36
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$404.54 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna Medicare |
$505.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.38
|
| Rate for Payer: BCBS Complete |
$404.54
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$707.95
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$707.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health SBD |
$637.16
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$1,011.36
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.16 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.38
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$707.95
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$707.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health SBD |
$637.16
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,865.63
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,175.35 |
| Max. Negotiated Rate |
$1,679.07 |
| Rate for Payer: Aetna Commercial |
$1,585.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.66
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cofinity Commercial |
$1,305.94
|
| Rate for Payer: Cofinity Commercial |
$1,604.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,305.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,492.50
|
| Rate for Payer: Healthscope Commercial |
$1,679.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,585.79
|
| Rate for Payer: PHP Commercial |
$1,585.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.66
|
| Rate for Payer: Priority Health SBD |
$1,175.35
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,865.63
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,679.07 |
| Rate for Payer: Aetna Commercial |
$1,585.79
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cofinity Commercial |
$1,604.44
|
| Rate for Payer: Cofinity Commercial |
$1,305.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,305.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,492.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,679.07
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,585.79
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,585.79
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.66
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,175.35
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,380.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,380.57
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.12 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health SBD |
$68.12
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.83 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Mclaren Medicaid |
$7.83
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$8.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Medicare Advantage |
$14.60
|
| Rate for Payer: UHCCP Medicaid |
$8.22
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.83 |
| Max. Negotiated Rate |
$41.10 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.83
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$8.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Medicare Advantage |
$14.60
|
| Rate for Payer: UHCCP Medicaid |
$8.22
|
| Rate for Payer: VA VA |
$14.60
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.94 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
|
|
HC ANGIOTENSIN II
|
Facility
|
OP
|
$331.50
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Aetna Commercial |
$281.77
|
| Rate for Payer: Aetna Medicare |
$21.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.65
|
| Rate for Payer: BCBS Complete |
$11.55
|
| Rate for Payer: BCBS MAPPO |
$20.52
|
| Rate for Payer: BCN Medicare Advantage |
$20.52
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cofinity Commercial |
$285.09
|
| Rate for Payer: Cofinity Commercial |
$232.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$232.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.52
|
| Rate for Payer: Healthscope Commercial |
$298.35
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Mclaren Medicare |
$20.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.55
|
| Rate for Payer: Meridian Medicaid |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.77
|
| Rate for Payer: PACE Medicare |
$19.49
|
| Rate for Payer: PACE SWMI |
$20.52
|
| Rate for Payer: PHP Commercial |
$281.77
|
| Rate for Payer: PHP Medicare Advantage |
$20.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.47
|
| Rate for Payer: Priority Health Medicare |
$20.52
|
| Rate for Payer: Priority Health SBD |
$208.84
|
| Rate for Payer: Railroad Medicare Medicare |
$20.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$20.52
|
| Rate for Payer: UHCCP Medicaid |
$11.55
|
| Rate for Payer: VA VA |
$20.52
|
|
|
HC ANGIOTENSIN II
|
Facility
|
IP
|
$331.50
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$208.84 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Aetna Commercial |
$281.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.47
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cofinity Commercial |
$232.05
|
| Rate for Payer: Cofinity Commercial |
$285.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$232.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.20
|
| Rate for Payer: Healthscope Commercial |
$298.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.77
|
| Rate for Payer: PHP Commercial |
$281.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.47
|
| Rate for Payer: Priority Health SBD |
$208.84
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$66.79
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$56.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.43
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.77
|
| Rate for Payer: PHP Commercial |
$56.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health SBD |
$42.08
|
|
