|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,648.14 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,700.46
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Advantage |
$1,831.27
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health SBD |
$1,648.14
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,046.44 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna Medicare |
$1,308.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,700.46
|
| Rate for Payer: BCBS Complete |
$1,046.44
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Advantage |
$1,831.27
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health SBD |
$1,648.14
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,296.63 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: Aetna Medicare |
$1,620.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.03
|
| Rate for Payer: BCBS Complete |
$1,296.63
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Advantage |
$2,269.11
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,593.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: Priority Health SBD |
$2,042.20
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,042.20 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.03
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Advantage |
$2,269.11
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: Priority Health SBD |
$2,042.20
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$161.36 |
| Max. Negotiated Rate |
$1,202.41 |
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$161.36
|
| Rate for Payer: BCN Commercial |
$161.36
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Advantage |
$506.00
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$455.40
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.85
|
| Rate for Payer: UHC Core |
$376.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$284.08
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$650.57 |
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.85
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Advantage |
$506.00
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: Priority Health SBD |
$455.40
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.19 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health SBD |
$47.19
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$9.52
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$4.67
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$9.52
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$4.67
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.19 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health SBD |
$47.19
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$9.52
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Advantage |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$4.67
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Advantage |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health SBD |
$34.08
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.46
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: Priority Health SBD |
$18.86
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.46
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: Priority Health SBD |
$18.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.46
|
| Rate for Payer: UHC Core |
$15.60
|
| Rate for Payer: UHC Exchange |
$11.77
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,584.14 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,666.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$21,092.64
|
| Rate for Payer: BCN Commercial |
$21,092.64
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Advantage |
$2,871.27
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Mclaren Medicaid |
$4,064.56
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$2,584.14
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,584.14 |
| Max. Negotiated Rate |
$3,691.63 |
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,666.18
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Advantage |
$2,871.27
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: Priority Health SBD |
$2,584.14
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.54
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna Commercial |
$1.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.00
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cofinity Advantage |
$1.08
|
| Rate for Payer: Cofinity Commercial |
$1.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.23
|
| Rate for Payer: Healthscope Commercial |
$1.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.16
|
| Rate for Payer: PHP Commercial |
$1.31
|
| Rate for Payer: Priority Health SBD |
$0.97
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.54
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna Commercial |
$1.31
|
| Rate for Payer: Aetna Medicare |
$0.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.00
|
| Rate for Payer: BCBS Complete |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cofinity Advantage |
$1.08
|
| Rate for Payer: Cofinity Commercial |
$1.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.23
|
| Rate for Payer: Healthscope Commercial |
$1.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.16
|
| Rate for Payer: PHP Commercial |
$1.31
|
| Rate for Payer: Priority Health SBD |
$0.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
OP
|
$181.03
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.41 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$153.88
|
| Rate for Payer: Aetna Medicare |
$90.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.67
|
| Rate for Payer: BCBS Complete |
$72.41
|
| Rate for Payer: Cash Price |
$144.82
|
| Rate for Payer: Cofinity Advantage |
$126.72
|
| Rate for Payer: Cofinity Commercial |
$155.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.82
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.77
|
| Rate for Payer: PHP Commercial |
$153.88
|
| Rate for Payer: Priority Health SBD |
$114.05
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
IP
|
$181.03
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.05 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$153.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.67
|
| Rate for Payer: Cash Price |
$144.82
|
| Rate for Payer: Cofinity Advantage |
$126.72
|
| Rate for Payer: Cofinity Commercial |
$155.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.82
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.77
|
| Rate for Payer: PHP Commercial |
$153.88
|
| Rate for Payer: Priority Health SBD |
$114.05
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$13.43
|
| Rate for Payer: BCN Commercial |
$13.43
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
|
|
HC BURN CARE LARGE
|
Facility
|
IP
|
$705.48
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$444.45 |
| Max. Negotiated Rate |
$634.93 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.56
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cofinity Advantage |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.38
|
| Rate for Payer: Healthscope Commercial |
$634.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.11
|
| Rate for Payer: PHP Commercial |
$599.66
|
| Rate for Payer: Priority Health SBD |
$444.45
|
|
|
HC BURN CARE LARGE
|
Facility
|
OP
|
$705.48
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.05 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$181.05
|
| Rate for Payer: BCN Commercial |
$181.05
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cofinity Advantage |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$634.93
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.66
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.11
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$599.66
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$444.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
OP
|
$542.58
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Commercial |
$461.19
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$148.89
|
| Rate for Payer: BCN Commercial |
$148.89
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$434.06
|
| Rate for Payer: Cash Price |
$434.06
|
| Rate for Payer: Cash Price |
$434.06
|
| Rate for Payer: Cofinity Advantage |
$379.81
|
| Rate for Payer: Cofinity Commercial |
$466.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$488.32
|
| Rate for Payer: Mclaren Medicaid |
$104.55
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.19
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.94
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$461.19
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$341.83
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
