|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$907.80
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$817.02 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: Aetna Medicare |
$160.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cofinity Commercial |
$780.71
|
| Rate for Payer: Cofinity Commercial |
$635.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$635.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$817.02
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.63
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$771.63
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.07
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health SBD |
$571.91
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$86.64
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,048.29 |
| Max. Negotiated Rate |
$2,926.12 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,113.31
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,275.88
|
| Rate for Payer: Cofinity Commercial |
$2,796.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,275.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health SBD |
$2,048.29
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,113.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,796.07
|
| Rate for Payer: Cofinity Commercial |
$2,275.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,275.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,048.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,950.62 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.55
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,167.36
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health SBD |
$1,950.62
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Cofinity Commercial |
$2,167.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,950.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Cofinity Commercial |
$2,167.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,950.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,950.62 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.55
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,167.36
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health SBD |
$1,950.62
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$48.19 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$17.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.40
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS MAPPO |
$17.12
|
| Rate for Payer: BCN Medicare Advantage |
$17.12
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$9.18
|
| Rate for Payer: Mclaren Medicare |
$17.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$16.26
|
| Rate for Payer: PACE SWMI |
$17.12
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$17.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$17.12
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.12
|
| Rate for Payer: UHC Medicare Advantage |
$17.12
|
| Rate for Payer: UHCCP Medicaid |
$9.64
|
| Rate for Payer: VA VA |
$17.12
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.22
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$1.16
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$1.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
| Rate for Payer: UHCCP Medicaid |
$1.22
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,562.87 |
| Max. Negotiated Rate |
$3,661.24 |
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,644.23
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$2,847.63
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,847.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health SBD |
$2,562.87
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,562.87 |
| Max. Negotiated Rate |
$17,130.07 |
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,644.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Cofinity Commercial |
$2,847.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,847.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$2,562.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,426.14
|
| Rate for Payer: VA VA |
$6,085.50
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$187.64 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: Aetna Medicare |
$234.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.91
|
| Rate for Payer: BCBS Complete |
$187.64
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$328.36
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$328.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health SBD |
$295.53
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$295.53 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.91
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$328.36
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$328.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health SBD |
$295.53
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$742.25 |
| Max. Negotiated Rate |
$1,670.06 |
| Rate for Payer: Aetna Commercial |
$1,577.28
|
| Rate for Payer: Aetna Medicare |
$927.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.15
|
| Rate for Payer: BCBS Complete |
$742.25
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,298.93
|
| Rate for Payer: Cofinity Commercial |
$1,595.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,670.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: PHP Commercial |
$1,577.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health SBD |
$1,169.04
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,169.04 |
| Max. Negotiated Rate |
$1,670.06 |
| Rate for Payer: Aetna Commercial |
$1,577.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.15
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,298.93
|
| Rate for Payer: Cofinity Commercial |
$1,595.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,670.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: PHP Commercial |
$1,577.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health SBD |
$1,169.04
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
IP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,150.30 |
| Max. Negotiated Rate |
$25,929.00 |
| Rate for Payer: Aetna Commercial |
$24,488.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,726.50
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$20,167.00
|
| Rate for Payer: Cofinity Commercial |
$24,776.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,167.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Healthscope Commercial |
$25,929.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: PHP Commercial |
$24,488.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: Priority Health SBD |
$18,150.30
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
OP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,442.46 |
| Max. Negotiated Rate |
$28,582.07 |
| Rate for Payer: Aetna Commercial |
$24,488.50
|
| Rate for Payer: Aetna Medicare |
$10,560.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,726.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,692.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,692.31
|
| Rate for Payer: BCBS Complete |
$5,714.59
|
| Rate for Payer: BCBS MAPPO |
$10,153.85
|
| Rate for Payer: BCN Medicare Advantage |
$10,153.85
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$24,776.60
|
| Rate for Payer: Cofinity Commercial |
$20,167.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,167.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,153.85
|
| Rate for Payer: Healthscope Commercial |
$25,929.00
|
| Rate for Payer: Mclaren Medicaid |
$5,442.46
|
| Rate for Payer: Mclaren Medicare |
$10,153.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,661.54
|
| Rate for Payer: Meridian Medicaid |
$5,714.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,676.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: PACE Medicare |
$9,646.16
|
| Rate for Payer: PACE SWMI |
$10,153.85
|
| Rate for Payer: PHP Commercial |
$24,488.50
|
| Rate for Payer: PHP Medicare Advantage |
$10,153.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,442.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: Priority Health Medicare |
$10,153.85
|
| Rate for Payer: Priority Health SBD |
$18,150.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10,153.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,582.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,153.85
|
| Rate for Payer: UHC Medicare Advantage |
$10,153.85
|
| Rate for Payer: UHCCP Medicaid |
$5,716.62
|
| Rate for Payer: VA VA |
$10,153.85
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
IP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,356.00 |
| Max. Negotiated Rate |
$19,080.00 |
| Rate for Payer: Aetna Commercial |
$18,020.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,780.00
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$14,840.00
|
| Rate for Payer: Cofinity Commercial |
$18,232.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,840.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Healthscope Commercial |
$19,080.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: PHP Commercial |
$18,020.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: Priority Health SBD |
$13,356.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
OP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,261.83 |
| Max. Negotiated Rate |
$19,080.00 |
| Rate for Payer: Aetna Commercial |
$18,020.00
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,780.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$18,232.00
|
| Rate for Payer: Cofinity Commercial |
$14,840.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,840.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$19,080.00
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$18,020.00
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$13,356.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,426.14
|
| Rate for Payer: VA VA |
$6,085.50
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
IP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,111.00 |
| Max. Negotiated Rate |
$8,730.00 |
| Rate for Payer: Aetna Commercial |
$8,245.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,305.00
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,790.00
|
| Rate for Payer: Cofinity Commercial |
$8,342.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,790.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Healthscope Commercial |
$8,730.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: PHP Commercial |
$8,245.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: Priority Health SBD |
$6,111.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
OP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna Commercial |
$8,245.00
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,305.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$8,342.00
|
| Rate for Payer: Cofinity Commercial |
$6,790.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,790.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$8,730.00
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$8,245.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$6,111.00
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,937.74
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.83
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
