|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.69 |
| Max. Negotiated Rate |
$75.28 |
| Rate for Payer: Aetna Commercial |
$71.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.37
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$58.55
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Healthscope Commercial |
$75.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.09
|
| Rate for Payer: PHP Commercial |
$71.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.37
|
| Rate for Payer: Priority Health SBD |
$52.69
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.74
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.19 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health SBD |
$57.19
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.47
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.63 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.79
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health SBD |
$36.63
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.40 |
| Max. Negotiated Rate |
$759.14 |
| Rate for Payer: Aetna Commercial |
$716.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.27
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$590.44
|
| Rate for Payer: Cofinity Commercial |
$725.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$590.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Healthscope Commercial |
$759.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: PHP Commercial |
$716.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health SBD |
$531.40
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$716.97
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$725.40
|
| Rate for Payer: Cofinity Commercial |
$590.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$590.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$759.14
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$716.97
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$531.40
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$810.38 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$299.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$162.08
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.31 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health SBD |
$243.31
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,189.76
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,189.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,970.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,124.80
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,970.78 |
| Max. Negotiated Rate |
$2,815.41 |
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.35
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,189.76
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,189.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health SBD |
$1,970.78
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,817.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Cofinity Commercial |
$3,034.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,034.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$2,730.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,745.82
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,730.66 |
| Max. Negotiated Rate |
$3,900.94 |
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,817.35
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,034.07
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,034.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health SBD |
$2,730.66
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,602.91 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$1,781.01
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$1,602.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,745.82
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,602.91 |
| Max. Negotiated Rate |
$2,289.87 |
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.80
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$1,781.01
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health SBD |
$1,602.91
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$5,360.98 |
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: Aetna Medicare |
$1,980.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Cofinity Commercial |
$3,229.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,229.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health SBD |
$2,906.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,360.98
|
| Rate for Payer: UHC Core |
$3,414.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$3,414.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,072.23
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,906.95 |
| Max. Negotiated Rate |
$4,152.79 |
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.24
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,229.95
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,229.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health SBD |
$2,906.95
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$261.15 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.81 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna Medicare |
$207.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
OP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$311.13 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Cofinity Commercial |
$345.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$311.13
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
IP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$311.13 |
| Max. Negotiated Rate |
$444.46 |
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.00
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$345.69
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health SBD |
$311.13
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$253.93 |
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna Medicare |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Cofinity Commercial |
$163.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health SBD |
$147.22
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$50.79
|
| Rate for Payer: VA VA |
$90.21
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$147.22 |
| Max. Negotiated Rate |
$210.31 |
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.89
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$163.58
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health SBD |
$147.22
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$1,011.37 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,043.48
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,123.74
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,123.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health SBD |
$1,011.37
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$642.14 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: Aetna Medicare |
$802.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,043.48
|
| Rate for Payer: BCBS Complete |
$642.14
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,123.74
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,123.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health SBD |
$1,011.37
|
|
