|
HC BIOPSY FLOOR MOUTH
|
Facility
|
OP
|
$4,182.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.03 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$3,554.70
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,718.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$82.03
|
| Rate for Payer: BCN Commercial |
$82.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$3,596.52
|
| Rate for Payer: Cofinity Commercial |
$2,927.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,927.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,763.80
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,554.70
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$3,554.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,718.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$2,634.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.50
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
IP
|
$4,182.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,634.66 |
| Max. Negotiated Rate |
$3,763.80 |
| Rate for Payer: Aetna Commercial |
$3,554.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,718.30
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$2,927.40
|
| Rate for Payer: Cofinity Commercial |
$3,596.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,927.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Healthscope Commercial |
$3,763.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,554.70
|
| Rate for Payer: PHP Commercial |
$3,554.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,718.30
|
| Rate for Payer: Priority Health SBD |
$2,634.66
|
|
|
HC BIOPSY INTRANASAL
|
Facility
|
IP
|
$4,029.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
76100448
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,538.27 |
| Max. Negotiated Rate |
$3,626.10 |
| Rate for Payer: Aetna Commercial |
$3,424.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,618.85
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cofinity Commercial |
$2,820.30
|
| Rate for Payer: Cofinity Commercial |
$3,464.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,820.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,223.20
|
| Rate for Payer: Healthscope Commercial |
$3,626.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,424.65
|
| Rate for Payer: PHP Commercial |
$3,424.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.85
|
| Rate for Payer: Priority Health SBD |
$2,538.27
|
|
|
HC BIOPSY INTRANASAL
|
Facility
|
OP
|
$4,029.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
76100448
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.83 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna Commercial |
$3,424.65
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,618.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$79.32
|
| Rate for Payer: BCN Commercial |
$79.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cofinity Commercial |
$3,464.94
|
| Rate for Payer: Cofinity Commercial |
$2,820.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,820.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,223.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,626.10
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,424.65
|
| Rate for Payer: Nomi Health Commercial |
$3,047.79
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$3,424.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,561.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,649.22
|
| Rate for Payer: Priority Health SBD |
$2,538.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.83
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$817.10
|
| Rate for Payer: VA VA |
$1,451.33
|
|
|
HC BIOPSY LIVER
|
Facility
|
IP
|
$1,652.29
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
36100197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,040.94 |
| Max. Negotiated Rate |
$1,487.06 |
| Rate for Payer: Aetna Commercial |
$1,404.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.99
|
| Rate for Payer: Cash Price |
$1,321.83
|
| Rate for Payer: Cofinity Commercial |
$1,156.60
|
| Rate for Payer: Cofinity Commercial |
$1,420.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,156.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,321.83
|
| Rate for Payer: Healthscope Commercial |
$1,487.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,404.45
|
| Rate for Payer: PHP Commercial |
$1,404.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.99
|
| Rate for Payer: Priority Health SBD |
$1,040.94
|
|
|
HC BIOPSY LIVER
|
Facility
|
OP
|
$1,652.29
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
36100197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.55 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,404.45
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$690.61
|
| Rate for Payer: BCN Commercial |
$690.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,321.83
|
| Rate for Payer: Cash Price |
$1,321.83
|
| Rate for Payer: Cash Price |
$1,321.83
|
| Rate for Payer: Cofinity Commercial |
$1,156.60
|
| Rate for Payer: Cofinity Commercial |
$1,420.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,156.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,321.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,487.06
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,404.45
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,404.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,040.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.55
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY LYMPH NODE
|
Facility
|
IP
|
$1,882.13
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
36100186
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,185.74 |
| Max. Negotiated Rate |
$1,693.92 |
| Rate for Payer: Aetna Commercial |
$1,599.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.38
|
| Rate for Payer: Cash Price |
$1,505.70
|
| Rate for Payer: Cofinity Commercial |
$1,317.49
|
| Rate for Payer: Cofinity Commercial |
$1,618.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.70
|
| Rate for Payer: Healthscope Commercial |
$1,693.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.81
|
| Rate for Payer: PHP Commercial |
$1,599.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.38
|
| Rate for Payer: Priority Health SBD |
$1,185.74
|
|
|
HC BIOPSY LYMPH NODE
|
Facility
|
OP
|
$1,882.13
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
36100186
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$89.63 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,599.81
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$503.77
|
| Rate for Payer: BCCCP Commercial |
$162.67
|
| Rate for Payer: BCN Commercial |
$503.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,505.70
|
| Rate for Payer: Cash Price |
$1,505.70
|
| Rate for Payer: Cash Price |
$1,505.70
|
| Rate for Payer: Cofinity Commercial |
$1,317.49
|
| Rate for Payer: Cofinity Commercial |
$1,618.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,693.92
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.81
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,599.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,185.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.63
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY MUSCLE
|
Facility
|
IP
|
$1,925.21
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
36100017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,212.88 |
| Max. Negotiated Rate |
$1,732.69 |
| Rate for Payer: Aetna Commercial |
$1,636.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.39
|
| Rate for Payer: Cash Price |
$1,540.17
|
| Rate for Payer: Cofinity Commercial |
$1,347.65
|
| Rate for Payer: Cofinity Commercial |
$1,655.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,347.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.17
|
| Rate for Payer: Healthscope Commercial |
$1,732.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.43
|
| Rate for Payer: PHP Commercial |
$1,636.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.39
|
| Rate for Payer: Priority Health SBD |
$1,212.88
|
|
|
HC BIOPSY MUSCLE
|
Facility
|
OP
|
$1,925.21
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
36100017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.58 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,636.43
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$571.30
|
| Rate for Payer: BCN Commercial |
$571.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,540.17
|
| Rate for Payer: Cash Price |
$1,540.17
|
| Rate for Payer: Cash Price |
$1,540.17
|
| Rate for Payer: Cofinity Commercial |
$1,655.68
|
| Rate for Payer: Cofinity Commercial |
$1,347.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,347.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,732.69
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.43
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,636.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,212.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.58
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY MUSCLE TISSUE SUPERFICIAL
|
Facility
|
IP
|
$2,201.25
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
36100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,386.79 |
| Max. Negotiated Rate |
$1,981.12 |
| Rate for Payer: Aetna Commercial |
$1,871.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.81
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cofinity Commercial |
$1,540.88
|
| Rate for Payer: Cofinity Commercial |
$1,893.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,540.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.00
|
| Rate for Payer: Healthscope Commercial |
$1,981.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.06
|
| Rate for Payer: PHP Commercial |
$1,871.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.81
|
| Rate for Payer: Priority Health SBD |
$1,386.79
|
|
|
HC BIOPSY MUSCLE TISSUE SUPERFICIAL
|
Facility
|
OP
|
$2,201.25
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
36100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.01 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,871.06
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$635.87
|
| Rate for Payer: BCN Commercial |
$635.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cofinity Commercial |
$1,893.08
|
| Rate for Payer: Cofinity Commercial |
$1,540.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,540.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,981.12
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.06
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,871.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,386.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.01
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY OF LIP
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
76100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health SBD |
$417.69
|
|
|
HC BIOPSY OF LIP
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 40490
|
| Hospital Charge Code |
76100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$179.51
|
| Rate for Payer: BCN Commercial |
$179.51
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$477.79
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.11
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.09
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.73
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$128.09
|
| Rate for Payer: VA VA |
$227.52
|
|
|
HC BIOPSY OF PROSTATE,INCISIONAL
|
Facility
|
IP
|
$9,474.00
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
76100359
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,968.62 |
| Max. Negotiated Rate |
$8,526.60 |
| Rate for Payer: Aetna Commercial |
$8,052.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,158.10
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cofinity Commercial |
$6,631.80
|
| Rate for Payer: Cofinity Commercial |
$8,147.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,631.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,579.20
|
| Rate for Payer: Healthscope Commercial |
$8,526.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,052.90
|
| Rate for Payer: PHP Commercial |
$8,052.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,158.10
|
| Rate for Payer: Priority Health SBD |
$5,968.62
|
|
|
HC BIOPSY OF PROSTATE,INCISIONAL
|
Facility
|
OP
|
$9,474.00
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
76100359
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.94 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna Commercial |
$8,052.90
|
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,158.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$914.83
|
| Rate for Payer: BCN Commercial |
$914.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cofinity Commercial |
$8,147.64
|
| Rate for Payer: Cofinity Commercial |
$6,631.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,631.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,579.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Healthscope Commercial |
$8,526.60
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,052.90
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Commercial |
$8,052.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,158.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Priority Health SBD |
$5,968.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.94
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,902.51
|
| Rate for Payer: VA VA |
$3,379.23
|
|
|
HC BIOPSY OF VAGINA, SIMPLE
|
Facility
|
OP
|
$870.81
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
76100222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$2,681.40 |
| Rate for Payer: Aetna Commercial |
$740.19
|
| Rate for Payer: Aetna Medicare |
$887.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,066.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,066.41
|
| Rate for Payer: BCBS Complete |
$480.14
|
| Rate for Payer: BCBS MAPPO |
$853.13
|
| Rate for Payer: BCBS Trust/PPO |
$452.82
|
| Rate for Payer: BCN Commercial |
$452.82
|
| Rate for Payer: BCN Medicare Advantage |
$853.13
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cofinity Commercial |
$748.90
|
| Rate for Payer: Cofinity Commercial |
$609.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$609.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$783.73
|
| Rate for Payer: Mclaren Medicaid |
$457.28
|
| Rate for Payer: Mclaren Medicare |
$853.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.79
|
| Rate for Payer: Meridian Medicaid |
$480.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$981.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.19
|
| Rate for Payer: Nomi Health Commercial |
$1,791.57
|
| Rate for Payer: PACE Medicare |
$810.47
|
| Rate for Payer: PACE SWMI |
$853.13
|
| Rate for Payer: PHP Commercial |
$740.19
|
| Rate for Payer: PHP Medicare Advantage |
$853.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,681.40
|
| Rate for Payer: Priority Health Medicare |
$853.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,145.12
|
| Rate for Payer: Priority Health SBD |
$548.61
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.05
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.13
|
| Rate for Payer: UHC Medicare Advantage |
$853.13
|
| Rate for Payer: UHCCP Medicaid |
$480.31
|
| Rate for Payer: VA VA |
$853.13
|
|
|
HC BIOPSY OF VAGINA, SIMPLE
|
Facility
|
IP
|
$870.81
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
76100222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$548.61 |
| Max. Negotiated Rate |
$783.73 |
| Rate for Payer: Aetna Commercial |
$740.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.03
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cofinity Commercial |
$609.57
|
| Rate for Payer: Cofinity Commercial |
$748.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$609.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.65
|
| Rate for Payer: Healthscope Commercial |
$783.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.19
|
| Rate for Payer: PHP Commercial |
$740.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.03
|
| Rate for Payer: Priority Health SBD |
$548.61
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
76100475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.03 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$79.03
|
| Rate for Payer: BCN Commercial |
$79.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Cofinity Commercial |
$2,811.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,811.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,047.79
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,561.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,649.22
|
| Rate for Payer: Priority Health SBD |
$2,529.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.08
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$817.10
|
| Rate for Payer: VA VA |
$1,451.33
|
|
|
HC BIOPSY OROPHARYNX
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
76100475
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,529.92 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.23
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$2,811.02
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,811.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health SBD |
$2,529.92
|
|
|
HC BIOPSY PALATE UVULA
|
Facility
|
OP
|
$4,029.00
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
76100466
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$75.49 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna Commercial |
$3,424.65
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,618.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$75.49
|
| Rate for Payer: BCN Commercial |
$75.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cofinity Commercial |
$3,464.94
|
| Rate for Payer: Cofinity Commercial |
$2,820.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,820.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,223.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,626.10
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,424.65
|
| Rate for Payer: Nomi Health Commercial |
$3,047.79
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$3,424.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,561.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,649.22
|
| Rate for Payer: Priority Health SBD |
$2,538.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.32
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$817.10
|
| Rate for Payer: VA VA |
$1,451.33
|
|
|
HC BIOPSY PALATE UVULA
|
Facility
|
IP
|
$4,029.00
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
76100466
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,538.27 |
| Max. Negotiated Rate |
$3,626.10 |
| Rate for Payer: Aetna Commercial |
$3,424.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,618.85
|
| Rate for Payer: Cash Price |
$3,223.20
|
| Rate for Payer: Cofinity Commercial |
$2,820.30
|
| Rate for Payer: Cofinity Commercial |
$3,464.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,820.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,223.20
|
| Rate for Payer: Healthscope Commercial |
$3,626.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,424.65
|
| Rate for Payer: PHP Commercial |
$3,424.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.85
|
| Rate for Payer: Priority Health SBD |
$2,538.27
|
|
|
HC BIOPSY PANCREAS
|
Facility
|
IP
|
$1,064.75
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
36100211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$670.79 |
| Max. Negotiated Rate |
$958.28 |
| Rate for Payer: Aetna Commercial |
$905.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.09
|
| Rate for Payer: Cash Price |
$851.80
|
| Rate for Payer: Cofinity Commercial |
$745.32
|
| Rate for Payer: Cofinity Commercial |
$915.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.80
|
| Rate for Payer: Healthscope Commercial |
$958.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.04
|
| Rate for Payer: PHP Commercial |
$905.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.09
|
| Rate for Payer: Priority Health SBD |
$670.79
|
|
|
HC BIOPSY PANCREAS
|
Facility
|
OP
|
$1,064.75
|
|
|
Service Code
|
CPT 48102
|
| Hospital Charge Code |
36100211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$246.24 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$905.04
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$543.70
|
| Rate for Payer: BCN Commercial |
$543.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$851.80
|
| Rate for Payer: Cash Price |
$851.80
|
| Rate for Payer: Cash Price |
$851.80
|
| Rate for Payer: Cofinity Commercial |
$745.32
|
| Rate for Payer: Cofinity Commercial |
$915.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$958.28
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.04
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$905.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$670.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.24
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIOPSY PENIS DEEP STRUCTURES
|
Facility
|
OP
|
$7,306.21
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
76100348
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$225.08 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$6,210.28
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,749.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,844.97
|
| Rate for Payer: Cash Price |
$5,844.97
|
| Rate for Payer: Cash Price |
$5,844.97
|
| Rate for Payer: Cofinity Commercial |
$6,283.34
|
| Rate for Payer: Cofinity Commercial |
$5,114.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,114.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,844.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$6,575.59
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,210.28
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$6,210.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,749.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$4,602.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.08
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
