|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$537.50
|
| Rate for Payer: BCN Commercial |
$537.50
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Cofinity Commercial |
$645.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$580.99
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$682.44
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$58.66
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$476.50 |
| Max. Negotiated Rate |
$680.72 |
| Rate for Payer: Aetna Commercial |
$642.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.63
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$529.44
|
| Rate for Payer: Cofinity Commercial |
$650.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$529.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Healthscope Commercial |
$680.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: PHP Commercial |
$642.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: Priority Health SBD |
$476.50
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$680.72 |
| Rate for Payer: Aetna Commercial |
$642.90
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$445.96
|
| Rate for Payer: BCN Commercial |
$445.96
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$650.46
|
| Rate for Payer: Cofinity Commercial |
$529.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$529.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$680.72
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$642.90
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$476.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$559.70
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$58.66
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,926.05 |
| Max. Negotiated Rate |
$4,180.08 |
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.94
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,251.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health SBD |
$2,926.05
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$243.38 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$366.70
|
| Rate for Payer: BCN Commercial |
$366.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,251.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,926.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.38
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$123.27 |
| Max. Negotiated Rate |
$176.09 |
| Rate for Payer: Aetna Commercial |
$166.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.18
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$136.96
|
| Rate for Payer: Cofinity Commercial |
$168.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Healthscope Commercial |
$176.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: PHP Commercial |
$166.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: Priority Health SBD |
$123.27
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna Commercial |
$166.31
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$48.40
|
| Rate for Payer: BCN Commercial |
$48.40
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$168.27
|
| Rate for Payer: Cofinity Commercial |
$136.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$176.09
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$166.31
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$123.27
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$144.79
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$48.57
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.74 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$1,049.72
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$388.23
|
| Rate for Payer: BCN Commercial |
$388.23
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,062.07
|
| Rate for Payer: Cofinity Commercial |
$864.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$864.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,111.47
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$1,049.72
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$778.03
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.03 |
| Max. Negotiated Rate |
$1,111.47 |
| Rate for Payer: Aetna Commercial |
$1,049.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.73
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,062.07
|
| Rate for Payer: Cofinity Commercial |
$864.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$864.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Healthscope Commercial |
$1,111.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: PHP Commercial |
$1,049.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: Priority Health SBD |
$778.03
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCN Commercial |
$4.63
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| 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: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| 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 |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$39.80
|
| 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 |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$12.04
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| 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 ANTIBODIES CMPT
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.57 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.38
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.38
|
| Rate for Payer: Priority Health SBD |
$25.57
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.38
|
| 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: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| 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 |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$34.49
|
| 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 |
$26.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$12.04
|
| Rate for Payer: Priority Health SBD |
$25.57
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| 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 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
|
Facility
|
OP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$75.28 |
| Rate for Payer: Aetna Commercial |
$71.09
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.61
|
| Rate for Payer: BCN Commercial |
$10.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Cofinity Commercial |
$58.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$75.28
|
| 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 |
$71.09
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$71.09
|
| 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 |
$54.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.33
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$52.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| 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
|
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 |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.61
|
| Rate for Payer: BCN Commercial |
$10.61
|
| 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: Nomi Health Commercial |
$17.97
|
| 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 HMO/PPO/Tiered Network |
$12.33
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| 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: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| 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: Nomi Health Commercial |
$22.58
|
| 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 HMO/PPO/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$12.04
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| 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
|
OP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.74 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$716.97
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$352.94
|
| Rate for Payer: BCN Commercial |
$352.94
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cash Price |
$674.79
|
| 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: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$759.14
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$716.97
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$531.40
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.74
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
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 ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$909.03 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$300.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$25.35
|
| Rate for Payer: BCN Commercial |
$25.35
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$308.97
|
| 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 |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$607.36
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.03
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$727.22
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.55
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$162.83
|
| Rate for Payer: VA VA |
$289.22
|
|
|
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
|
|
