|
HC BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
76100463
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,076.54 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
|
|
HC BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
76100463
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.30 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$88.30
|
| Rate for Payer: BCN Commercial |
$88.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.78
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
IP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,057.05 |
| Max. Negotiated Rate |
$1,510.07 |
| Rate for Payer: Aetna Commercial |
$1,426.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.61
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,174.50
|
| Rate for Payer: Cofinity Commercial |
$1,442.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,174.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Healthscope Commercial |
$1,510.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: PHP Commercial |
$1,426.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: Priority Health SBD |
$1,057.05
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
OP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna Commercial |
$1,426.18
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.99
|
| Rate for Payer: BCN Commercial |
$1,579.99
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,174.50
|
| Rate for Payer: Cofinity Commercial |
$1,442.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,174.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$1,510.07
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: Nomi Health Commercial |
$11,122.44
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$1,426.18
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$1,057.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.44
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$8,174.00
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,981.87
|
| Rate for Payer: VA VA |
$5,296.40
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.86 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$518.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$184.64
|
| Rate for Payer: BCN Commercial |
$184.64
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$963.90
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,047.80
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.21
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Priority Health SBD |
$867.51
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.86
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$280.91
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$867.51 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.05
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Cofinity Commercial |
$963.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health SBD |
$867.51
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
IP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$548.65 |
| Max. Negotiated Rate |
$783.79 |
| Rate for Payer: Aetna Commercial |
$740.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.07
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$609.62
|
| Rate for Payer: Cofinity Commercial |
$748.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$609.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Healthscope Commercial |
$783.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.25
|
| Rate for Payer: PHP Commercial |
$740.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.07
|
| Rate for Payer: Priority Health SBD |
$548.65
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
OP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.30 |
| Max. Negotiated Rate |
$2,681.40 |
| Rate for Payer: Aetna Commercial |
$740.25
|
| Rate for Payer: Aetna Medicare |
$887.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.07
|
| 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 |
$696.70
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$748.96
|
| Rate for Payer: Cofinity Commercial |
$609.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$609.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$783.79
|
| 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 |
$740.25
|
| 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 |
$740.25
|
| 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 |
$566.07
|
| 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 |
$548.65
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.30
|
| 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 BIOTINIDASE
|
Facility
|
IP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.05 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health SBD |
$43.05
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$1,784.84 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.93
|
| Rate for Payer: BCN Commercial |
$14.93
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$25.30
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.87
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$13.50
|
| Rate for Payer: Priority Health SBD |
$43.05
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.24
|
| Rate for Payer: UHC Core |
$1,784.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$1,784.84
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.50
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,067.98 |
| Max. Negotiated Rate |
$8,668.54 |
| Rate for Payer: Aetna Commercial |
$8,186.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,260.61
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$6,742.20
|
| Rate for Payer: Cofinity Commercial |
$8,283.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,742.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Healthscope Commercial |
$8,668.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: PHP Commercial |
$8,186.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: Priority Health SBD |
$6,067.98
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,852.68 |
| Max. Negotiated Rate |
$8,668.54 |
| Rate for Payer: Aetna Commercial |
$8,186.95
|
| Rate for Payer: Aetna Medicare |
$4,815.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,260.61
|
| Rate for Payer: BCBS Complete |
$3,852.68
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$6,742.20
|
| Rate for Payer: Cofinity Commercial |
$8,283.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,742.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Healthscope Commercial |
$8,668.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: PHP Commercial |
$8,186.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: Priority Health SBD |
$6,067.98
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.77 |
| Max. Negotiated Rate |
$1,581.23 |
| Rate for Payer: Aetna Commercial |
$1,493.38
|
| Rate for Payer: Aetna Medicare |
$878.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.00
|
| Rate for Payer: BCBS Complete |
$702.77
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,229.84
|
| Rate for Payer: Cofinity Commercial |
$1,510.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,229.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Healthscope Commercial |
$1,581.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: PHP Commercial |
$1,493.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: Priority Health SBD |
$1,106.86
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,106.86 |
| Max. Negotiated Rate |
$1,581.23 |
| Rate for Payer: Aetna Commercial |
$1,493.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.00
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,229.84
|
| Rate for Payer: Cofinity Commercial |
$1,510.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,229.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Healthscope Commercial |
$1,581.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: PHP Commercial |
$1,493.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: Priority Health SBD |
$1,106.86
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$551.32 |
| Max. Negotiated Rate |
$787.60 |
| Rate for Payer: Aetna Commercial |
$743.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.82
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$612.58
|
| Rate for Payer: Cofinity Commercial |
$752.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Healthscope Commercial |
$787.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: PHP Commercial |
$743.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: Priority Health SBD |
$551.32
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$39.09 |
| Max. Negotiated Rate |
$787.60 |
| Rate for Payer: Aetna Commercial |
$743.84
|
| Rate for Payer: Aetna Medicare |
$207.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.10
|
| Rate for Payer: BCBS Complete |
$112.15
|
| Rate for Payer: BCBS MAPPO |
$199.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.38
|
| Rate for Payer: BCN Commercial |
$165.38
|
| Rate for Payer: BCN Medicare Advantage |
$199.28
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$752.59
|
| Rate for Payer: Cofinity Commercial |
$612.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.28
|
| Rate for Payer: Healthscope Commercial |
$787.60
|
| Rate for Payer: Mclaren Medicaid |
$106.81
|
| Rate for Payer: Mclaren Medicare |
$199.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.24
|
| Rate for Payer: Meridian Medicaid |
$112.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: Nomi Health Commercial |
$597.84
|
| Rate for Payer: PACE Medicare |
$189.32
|
| Rate for Payer: PACE SWMI |
$199.28
|
| Rate for Payer: PHP Commercial |
$743.84
|
| Rate for Payer: PHP Medicare Advantage |
$199.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.34
|
| Rate for Payer: Priority Health Medicare |
$199.28
|
| Rate for Payer: Priority Health Narrow Network |
$501.07
|
| Rate for Payer: Priority Health SBD |
$551.32
|
| Rate for Payer: Railroad Medicare Medicare |
$199.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.28
|
| Rate for Payer: UHC Exchange |
$647.58
|
| Rate for Payer: UHC Medicare Advantage |
$199.28
|
| Rate for Payer: UHCCP Medicaid |
$112.19
|
| Rate for Payer: VA VA |
$199.28
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
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 BIRCH IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
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 BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$815.48 |
| Max. Negotiated Rate |
$1,834.82 |
| Rate for Payer: Aetna Commercial |
$1,732.89
|
| Rate for Payer: Aetna Medicare |
$1,019.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,325.15
|
| Rate for Payer: BCBS Complete |
$815.48
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,427.08
|
| Rate for Payer: Cofinity Commercial |
$1,753.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,427.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Healthscope Commercial |
$1,834.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: PHP Commercial |
$1,732.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: Priority Health SBD |
$1,284.37
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,284.37 |
| Max. Negotiated Rate |
$1,834.82 |
| Rate for Payer: Aetna Commercial |
$1,732.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,325.15
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,427.08
|
| Rate for Payer: Cofinity Commercial |
$1,753.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,427.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Healthscope Commercial |
$1,834.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: PHP Commercial |
$1,732.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: Priority Health SBD |
$1,284.37
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,174.57 |
| Max. Negotiated Rate |
$25,142.78 |
| Rate for Payer: Aetna Commercial |
$23,745.96
|
| Rate for Payer: Aetna Medicare |
$13,968.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,158.67
|
| Rate for Payer: BCBS Complete |
$11,174.57
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$19,555.49
|
| Rate for Payer: Cofinity Commercial |
$24,025.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$19,555.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Healthscope Commercial |
$25,142.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: PHP Commercial |
$23,745.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: Priority Health SBD |
$17,599.94
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$17,599.94 |
| Max. Negotiated Rate |
$25,142.78 |
| Rate for Payer: Aetna Commercial |
$23,745.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,158.67
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$19,555.49
|
| Rate for Payer: Cofinity Commercial |
$24,025.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$19,555.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Healthscope Commercial |
$25,142.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: PHP Commercial |
$23,745.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: Priority Health SBD |
$17,599.94
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$37.92
|
| Rate for Payer: BCN Commercial |
$37.92
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$71.44
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.44 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.71
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health SBD |
$71.44
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$279.85
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.31 |
| Max. Negotiated Rate |
$251.86 |
| Rate for Payer: Aetna Commercial |
$237.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.90
|
| Rate for Payer: Cash Price |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$195.90
|
| Rate for Payer: Cofinity Commercial |
$240.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.88
|
| Rate for Payer: Healthscope Commercial |
$251.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.87
|
| Rate for Payer: PHP Commercial |
$237.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.90
|
| Rate for Payer: Priority Health SBD |
$176.31
|
|
