|
HC APTT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC APTT MIXING STUDY
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC APTT MIXING STUDY
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$62.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$58.99 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health SBD |
$58.99
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.46 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$46.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: BCBS Complete |
$37.46
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UHC Core |
$69.29
|
| Rate for Payer: UHC Exchange |
$69.29
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$37.13 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.43
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$37.13 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.43
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$37.13 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.43
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$37.13 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.43
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$37.13 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.43
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,580.84
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,032.34 |
| Max. Negotiated Rate |
$2,322.76 |
| Rate for Payer: Aetna Commercial |
$2,193.71
|
| Rate for Payer: Aetna Medicare |
$1,290.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,677.55
|
| Rate for Payer: BCBS Complete |
$1,032.34
|
| Rate for Payer: Cash Price |
$2,064.67
|
| Rate for Payer: Cofinity Commercial |
$1,806.59
|
| Rate for Payer: Cofinity Commercial |
$2,219.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,806.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Commercial |
$2,322.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.71
|
| Rate for Payer: PHP Commercial |
$2,193.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.55
|
| Rate for Payer: Priority Health SBD |
$1,625.93
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,580.84
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,625.93 |
| Max. Negotiated Rate |
$2,322.76 |
| Rate for Payer: Aetna Commercial |
$2,193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,677.55
|
| Rate for Payer: Cash Price |
$2,064.67
|
| Rate for Payer: Cofinity Commercial |
$1,806.59
|
| Rate for Payer: Cofinity Commercial |
$2,219.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,806.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Commercial |
$2,322.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.71
|
| Rate for Payer: PHP Commercial |
$2,193.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.55
|
| Rate for Payer: Priority Health SBD |
$1,625.93
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$447.35 |
| Max. Negotiated Rate |
$1,006.53 |
| Rate for Payer: Aetna Commercial |
$950.61
|
| Rate for Payer: Aetna Medicare |
$559.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.94
|
| Rate for Payer: BCBS Complete |
$447.35
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$782.86
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$782.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Healthscope Commercial |
$1,006.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: PHP Commercial |
$950.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: Priority Health SBD |
$704.57
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$704.57 |
| Max. Negotiated Rate |
$1,006.53 |
| Rate for Payer: Aetna Commercial |
$950.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.94
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$782.86
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$782.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Healthscope Commercial |
$1,006.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: PHP Commercial |
$950.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: Priority Health SBD |
$704.57
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$744.04 |
| Max. Negotiated Rate |
$1,674.08 |
| Rate for Payer: Aetna Commercial |
$1,581.08
|
| Rate for Payer: Aetna Medicare |
$930.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.06
|
| Rate for Payer: BCBS Complete |
$744.04
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,302.06
|
| Rate for Payer: Cofinity Commercial |
$1,599.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Healthscope Commercial |
$1,674.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: PHP Commercial |
$1,581.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: Priority Health SBD |
$1,171.86
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,171.86 |
| Max. Negotiated Rate |
$1,674.08 |
| Rate for Payer: Aetna Commercial |
$1,581.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.06
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,302.06
|
| Rate for Payer: Cofinity Commercial |
$1,599.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Healthscope Commercial |
$1,674.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: PHP Commercial |
$1,581.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: Priority Health SBD |
$1,171.86
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$719.25 |
| Max. Negotiated Rate |
$1,027.50 |
| Rate for Payer: Aetna Commercial |
$970.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.09
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$799.17
|
| Rate for Payer: Cofinity Commercial |
$981.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$799.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Healthscope Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: PHP Commercial |
$970.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: Priority Health SBD |
$719.25
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$456.67 |
| Max. Negotiated Rate |
$1,027.50 |
| Rate for Payer: Aetna Commercial |
$970.42
|
| Rate for Payer: Aetna Medicare |
$570.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.09
|
| Rate for Payer: BCBS Complete |
$456.67
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$799.17
|
| Rate for Payer: Cofinity Commercial |
$981.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$799.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Healthscope Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: PHP Commercial |
$970.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: Priority Health SBD |
$719.25
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,006.12 |
| Max. Negotiated Rate |
$1,437.31 |
| Rate for Payer: Aetna Commercial |
$1,357.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,038.06
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,117.91
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Healthscope Commercial |
$1,437.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: PHP Commercial |
$1,357.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: Priority Health SBD |
$1,006.12
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$482.40 |
| Max. Negotiated Rate |
$2,533.41 |
| Rate for Payer: Aetna Commercial |
$1,357.46
|
| Rate for Payer: Aetna Medicare |
$936.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,038.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,125.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,125.00
|
| Rate for Payer: BCBS Complete |
$506.52
|
| Rate for Payer: BCBS MAPPO |
$900.00
|
| Rate for Payer: BCN Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Cofinity Commercial |
$1,117.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,437.31
|
| Rate for Payer: Mclaren Medicaid |
$482.40
|
| Rate for Payer: Mclaren Medicare |
$900.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$945.00
|
| Rate for Payer: Meridian Medicaid |
$506.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: PACE Medicare |
$855.00
|
| Rate for Payer: PACE SWMI |
$900.00
|
| Rate for Payer: PHP Commercial |
$1,357.46
|
| Rate for Payer: PHP Medicare Advantage |
$900.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: Priority Health Medicare |
$900.00
|
| Rate for Payer: Priority Health SBD |
$1,006.12
|
| Rate for Payer: Railroad Medicare Medicare |
$900.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,533.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.00
|
| Rate for Payer: UHC Medicare Advantage |
$900.00
|
| Rate for Payer: UHCCP Medicaid |
$506.70
|
| Rate for Payer: VA VA |
$900.00
|
|
