|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$7.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.67
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: PACE Medicare |
$6.93
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.30
|
| Rate for Payer: UHC Medicare Advantage |
$7.30
|
| Rate for Payer: UHCCP Medicaid |
$4.11
|
| Rate for Payer: VA VA |
$7.30
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.70 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health SBD |
$43.70
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$31.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health SBD |
$31.46
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.81
|
| Rate for Payer: BCBS Complete |
$6.67
|
| Rate for Payer: BCBS MAPPO |
$11.85
|
| Rate for Payer: BCN Medicare Advantage |
$11.85
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.85
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$11.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PACE Medicare |
$11.26
|
| Rate for Payer: PACE SWMI |
$11.85
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.85
|
| Rate for Payer: UHC Medicare Advantage |
$11.85
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: VA VA |
$11.85
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$11.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.51
|
| Rate for Payer: BCBS Complete |
$6.08
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$5.79
|
| Rate for Payer: Mclaren Medicare |
$10.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.35
|
| Rate for Payer: Meridian Medicaid |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PACE Medicare |
$10.27
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health Medicare |
$10.81
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.81
|
| Rate for Payer: UHC Medicare Advantage |
$10.81
|
| Rate for Payer: UHCCP Medicaid |
$6.09
|
| Rate for Payer: VA VA |
$10.81
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$122.87 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$45.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.56
|
| Rate for Payer: BCBS Complete |
$24.57
|
| Rate for Payer: BCBS MAPPO |
$43.65
|
| Rate for Payer: BCN Medicare Advantage |
$43.65
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.65
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$23.40
|
| Rate for Payer: Mclaren Medicare |
$43.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.83
|
| Rate for Payer: Meridian Medicaid |
$24.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PACE Medicare |
$41.47
|
| Rate for Payer: PACE SWMI |
$43.65
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$43.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health Medicare |
$43.65
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$43.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.65
|
| Rate for Payer: UHC Medicare Advantage |
$43.65
|
| Rate for Payer: UHCCP Medicaid |
$24.57
|
| Rate for Payer: VA VA |
$43.65
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.32 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$779.84
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$311.94 |
| Max. Negotiated Rate |
$701.86 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna Medicare |
$389.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.90
|
| Rate for Payer: BCBS Complete |
$311.94
|
| Rate for Payer: Cash Price |
$623.87
|
| Rate for Payer: Cofinity Commercial |
$545.89
|
| Rate for Payer: Cofinity Commercial |
$670.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$545.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$623.87
|
| Rate for Payer: Healthscope Commercial |
$701.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$662.86
|
| Rate for Payer: PHP Commercial |
$662.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.90
|
| Rate for Payer: Priority Health SBD |
$491.30
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$779.84
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$491.30 |
| Max. Negotiated Rate |
$701.86 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.90
|
| Rate for Payer: Cash Price |
$623.87
|
| Rate for Payer: Cofinity Commercial |
$545.89
|
| Rate for Payer: Cofinity Commercial |
$670.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$545.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$623.87
|
| Rate for Payer: Healthscope Commercial |
$701.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$662.86
|
| Rate for Payer: PHP Commercial |
$662.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.90
|
| Rate for Payer: Priority Health SBD |
$491.30
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,320.82
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$832.12 |
| Max. Negotiated Rate |
$1,188.74 |
| Rate for Payer: Aetna Commercial |
$1,122.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.53
|
| Rate for Payer: Cash Price |
$1,056.66
|
| Rate for Payer: Cofinity Commercial |
$1,135.91
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.66
|
| Rate for Payer: Healthscope Commercial |
$1,188.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.70
|
| Rate for Payer: PHP Commercial |
$1,122.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.53
|
| Rate for Payer: Priority Health SBD |
$832.12
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,320.82
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,188.74 |
| Rate for Payer: Aetna Commercial |
$1,122.70
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.53
|
| 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 |
$1,056.66
|
| Rate for Payer: Cash Price |
$1,056.66
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Cofinity Commercial |
$1,135.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,188.74
|
| 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 |
$1,122.70
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,122.70
|
| 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 |
$858.53
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$832.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$977.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$977.41
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$514.42 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$604.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$604.24
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,555.49
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,022.20 |
| Max. Negotiated Rate |
$2,299.94 |
| Rate for Payer: Aetna Commercial |
$2,172.17
|
| Rate for Payer: Aetna Medicare |
$1,277.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,661.07
|
| Rate for Payer: BCBS Complete |
$1,022.20
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$1,788.84
|
| Rate for Payer: Cofinity Commercial |
$2,197.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,788.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Healthscope Commercial |
$2,299.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: PHP Commercial |
$2,172.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: Priority Health SBD |
$1,609.96
|
|
|
HC APHERESIS
|
Facility
|
IP
|
$2,555.49
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,609.96 |
| Max. Negotiated Rate |
$2,299.94 |
| Rate for Payer: Aetna Commercial |
$2,172.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,661.07
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$1,788.84
|
| Rate for Payer: Cofinity Commercial |
$2,197.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,788.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Healthscope Commercial |
$2,299.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: PHP Commercial |
$2,172.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: Priority Health SBD |
$1,609.96
|
|
|
HC APIXABAN
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$10.49
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC APIXABAN
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$96.39 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health SBD |
$96.39
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
OP
|
$131.72
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.69 |
| Max. Negotiated Rate |
$118.55 |
| Rate for Payer: Aetna Commercial |
$111.96
|
| Rate for Payer: Aetna Medicare |
$65.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.62
|
| Rate for Payer: BCBS Complete |
$52.69
|
| Rate for Payer: Cash Price |
$105.38
|
| Rate for Payer: Cofinity Commercial |
$113.28
|
| Rate for Payer: Cofinity Commercial |
$92.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.38
|
| Rate for Payer: Healthscope Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.96
|
| Rate for Payer: PHP Commercial |
$111.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.62
|
| Rate for Payer: Priority Health SBD |
$82.98
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
IP
|
$131.72
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.98 |
| Max. Negotiated Rate |
$118.55 |
| Rate for Payer: Aetna Commercial |
$111.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.62
|
| Rate for Payer: Cash Price |
$105.38
|
| Rate for Payer: Cofinity Commercial |
$113.28
|
| Rate for Payer: Cofinity Commercial |
$92.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.38
|
| Rate for Payer: Healthscope Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.96
|
| Rate for Payer: PHP Commercial |
$111.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.62
|
| Rate for Payer: Priority Health SBD |
$82.98
|
|
|
HC APNEALINK PLUS
|
Facility
|
OP
|
$747.76
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$672.98 |
| Rate for Payer: Aetna Commercial |
$635.60
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.04
|
| 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 |
$598.21
|
| Rate for Payer: Cash Price |
$598.21
|
| Rate for Payer: Cofinity Commercial |
$643.07
|
| Rate for Payer: Cofinity Commercial |
$523.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$523.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$672.98
|
| 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 |
$635.60
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$635.60
|
| 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 |
$486.04
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$471.09
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$553.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$553.34
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC APNEALINK PLUS
|
Facility
|
IP
|
$747.76
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$471.09 |
| Max. Negotiated Rate |
$672.98 |
| Rate for Payer: Aetna Commercial |
$635.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.04
|
| Rate for Payer: Cash Price |
$598.21
|
| Rate for Payer: Cofinity Commercial |
$523.43
|
| Rate for Payer: Cofinity Commercial |
$643.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$523.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.21
|
| Rate for Payer: Healthscope Commercial |
$672.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$635.60
|
| Rate for Payer: PHP Commercial |
$635.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.04
|
| Rate for Payer: Priority Health SBD |
$471.09
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.34 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health SBD |
$44.34
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$21.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health SBD |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$11.87
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$59.37 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$21.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| 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 |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$11.87
|
| Rate for Payer: VA VA |
$21.09
|
|
