|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$983.18 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Advantage |
$1,092.42
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health SBD |
$983.18
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$96.83 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$192.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.44
|
| Rate for Payer: BCBS Complete |
$101.68
|
| Rate for Payer: BCBS MAPPO |
$185.15
|
| Rate for Payer: BCBS Trust/PPO |
$625.77
|
| Rate for Payer: BCN Commercial |
$625.77
|
| Rate for Payer: BCN Medicare Advantage |
$185.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Advantage |
$1,092.42
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.15
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Mclaren Medicaid |
$96.83
|
| Rate for Payer: Mclaren Medicare |
$185.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.41
|
| Rate for Payer: Meridian Medicaid |
$194.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$555.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PACE Medicare |
$175.89
|
| Rate for Payer: PACE SWMI |
$185.15
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$185.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$598.75
|
| Rate for Payer: Priority Health Medicare |
$185.15
|
| Rate for Payer: Priority Health SBD |
$983.18
|
| Rate for Payer: Priority Health Tiered Network |
$479.00
|
| Rate for Payer: Railroad Medicare Medicare |
$185.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.39
|
| Rate for Payer: UHC Core |
$813.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.15
|
| Rate for Payer: UHC Exchange |
$613.32
|
| Rate for Payer: UHC Medicaid |
$96.83
|
| Rate for Payer: UHCCP Medicaid |
$96.83
|
| Rate for Payer: VA VA |
$185.15
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$21.56
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$41.87
|
| Rate for Payer: BCN Commercial |
$41.87
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$20.53
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$58.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.26
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: Priority Health Tiered Network |
$31.41
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$58.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.26
|
| Rate for Payer: UHC Exchange |
$58.89
|
| Rate for Payer: UHC Medicaid |
$20.53
|
| Rate for Payer: UHCCP Medicaid |
$20.53
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$99.10 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health SBD |
$99.10
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$815.92 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: Aetna Medicare |
$1,038.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.49
|
| Rate for Payer: BCBS Complete |
$830.46
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Advantage |
$1,453.30
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,660.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: Priority Health SBD |
$1,307.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.49
|
| Rate for Payer: UHC Core |
$1,081.67
|
| Rate for Payer: UHC Exchange |
$815.92
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,307.97 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.49
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Advantage |
$1,453.30
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: Priority Health SBD |
$1,307.97
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Advantage |
$1,547.89
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,393.10
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,393.10 |
| Max. Negotiated Rate |
$1,990.14 |
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.33
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Advantage |
$1,547.89
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: Priority Health SBD |
$1,393.10
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,326.75 |
| Max. Negotiated Rate |
$1,895.36 |
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.87
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Advantage |
$1,474.17
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: Priority Health SBD |
$1,326.75
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Advantage |
$1,474.17
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,326.75
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,606.80 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Advantage |
$1,785.34
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,129.89
|
| Rate for Payer: BCN Commercial |
$2,129.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Advantage |
$1,785.34
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$2,596.12 |
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: Aetna Medicare |
$834.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$118.12
|
| Rate for Payer: BCN Commercial |
$118.12
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Advantage |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Mclaren Medicaid |
$419.85
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$842.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$2,408.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,596.12
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health SBD |
$124.94
|
| Rate for Payer: Priority Health Tiered Network |
$2,076.90
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.35
|
| Rate for Payer: UHC Core |
$1,225.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,225.35
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$124.94 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.91
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Advantage |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: Priority Health SBD |
$124.94
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.39 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna Medicare |
$75.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: BCBS Complete |
$60.45
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.23
|
| Rate for Payer: UHC Core |
$78.74
|
| Rate for Payer: UHC Exchange |
$59.39
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.36 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health SBD |
$31.36
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.56 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna Medicare |
$24.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health SBD |
$31.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.36
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: UHC Exchange |
$19.56
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$16,914.59 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna Medicare |
$13,424.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: BCBS Complete |
$10,739.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,478.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,451.56
|
| Rate for Payer: UHC Core |
$13,988.10
|
| Rate for Payer: UHC Exchange |
$10,551.48
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: Aetna Medicare |
$3,512.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,565.96
|
| Rate for Payer: BCBS Complete |
$2,809.82
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Advantage |
$4,917.19
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,619.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: Priority Health SBD |
$4,425.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,565.96
|
| Rate for Payer: UHC Core |
$3,659.79
|
| Rate for Payer: UHC Exchange |
$2,760.65
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,425.47 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,565.96
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Advantage |
$4,917.19
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: Priority Health SBD |
$4,425.47
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,436.53 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: Aetna Medicare |
$4,372.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,683.83
|
| Rate for Payer: BCBS Complete |
$3,497.74
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Advantage |
$6,121.05
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,995.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: Priority Health SBD |
$5,508.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,683.83
|
| Rate for Payer: UHC Core |
$4,555.81
|
| Rate for Payer: UHC Exchange |
$3,436.53
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,508.95 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,683.83
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Advantage |
$6,121.05
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: Priority Health SBD |
$5,508.95
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,889.50
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.57 |
| Max. Negotiated Rate |
$17,000.55 |
| Rate for Payer: Aetna Commercial |
$16,056.08
|
| Rate for Payer: Aetna Medicare |
$9,444.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,278.17
|
| Rate for Payer: BCBS Complete |
$7,555.80
|
| Rate for Payer: Cash Price |
$15,111.60
|
| Rate for Payer: Cofinity Advantage |
$13,222.65
|
| Rate for Payer: Cofinity Commercial |
$16,244.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,111.60
|
| Rate for Payer: Healthscope Commercial |
$17,000.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,111.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,056.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,167.12
|
| Rate for Payer: PHP Commercial |
$16,056.08
|
| Rate for Payer: Priority Health SBD |
$11,900.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,278.17
|
| Rate for Payer: UHC Core |
$9,841.43
|
| Rate for Payer: UHC Exchange |
$7,423.57
|
|
