|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.47 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$29.25 |
| Max. Negotiated Rate |
$41.79 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.18
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health SBD |
$29.25
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$29.25 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$29.25
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$34.36
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.47 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Cofinity Commercial |
$251.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$225.91
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$265.35
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$225.91 |
| Max. Negotiated Rate |
$322.72 |
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.08
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$251.01
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health SBD |
$225.91
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.47 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$189.43
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$222.50
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$189.43 |
| Max. Negotiated Rate |
$270.61 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health SBD |
$189.43
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$73.51 |
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.09
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$57.18
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health SBD |
$51.46
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Cofinity Commercial |
$57.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$51.46
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$60.44
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.30 |
| Max. Negotiated Rate |
$93.28 |
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.37
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$72.56
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health SBD |
$65.30
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.30 |
| Max. Negotiated Rate |
$436.65 |
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: Aetna Medicare |
$144.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.66
|
| Rate for Payer: BCBS Complete |
$78.19
|
| Rate for Payer: BCBS MAPPO |
$138.93
|
| Rate for Payer: BCBS Trust/PPO |
$413.30
|
| Rate for Payer: BCN Commercial |
$413.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.93
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$72.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Mclaren Medicaid |
$74.47
|
| Rate for Payer: Mclaren Medicare |
$138.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.88
|
| Rate for Payer: Meridian Medicaid |
$78.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: Nomi Health Commercial |
$416.79
|
| Rate for Payer: PACE Medicare |
$131.98
|
| Rate for Payer: PACE SWMI |
$138.93
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: PHP Medicare Advantage |
$138.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.65
|
| Rate for Payer: Priority Health Medicare |
$138.93
|
| Rate for Payer: Priority Health Narrow Network |
$349.32
|
| Rate for Payer: Priority Health SBD |
$65.30
|
| Rate for Payer: Railroad Medicare Medicare |
$138.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.93
|
| Rate for Payer: UHC Exchange |
$76.70
|
| Rate for Payer: UHC Medicare Advantage |
$138.93
|
| Rate for Payer: UHCCP Medicaid |
$78.22
|
| Rate for Payer: VA VA |
$138.93
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$15.59
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health SBD |
$14.03
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$120.87 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$2.64
|
| Rate for Payer: BCN Commercial |
$2.64
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Cofinity Commercial |
$15.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$115.38
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.87
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$96.70
|
| Rate for Payer: Priority Health SBD |
$14.03
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$21.65
|
| Rate for Payer: VA VA |
$38.46
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$118.23 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$229.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.71
|
| Rate for Payer: BCBS Complete |
$124.14
|
| Rate for Payer: BCBS MAPPO |
$220.57
|
| Rate for Payer: BCBS Trust/PPO |
$563.09
|
| Rate for Payer: BCN Commercial |
$563.09
|
| Rate for Payer: BCN Medicare Advantage |
$220.57
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Mclaren Medicaid |
$118.23
|
| Rate for Payer: Mclaren Medicare |
$220.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.60
|
| Rate for Payer: Meridian Medicaid |
$124.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$661.71
|
| Rate for Payer: PACE Medicare |
$209.54
|
| Rate for Payer: PACE SWMI |
$220.57
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$220.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.23
|
| Rate for Payer: Priority Health Medicare |
$220.57
|
| Rate for Payer: Priority Health Narrow Network |
$554.58
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: Railroad Medicare Medicare |
$220.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.57
|
| Rate for Payer: UHC Exchange |
$1,132.20
|
| Rate for Payer: UHC Medicare Advantage |
$220.57
|
| Rate for Payer: UHCCP Medicaid |
$124.18
|
| Rate for Payer: VA VA |
$220.57
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$963.90 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$22.10
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$34.76
|
| Rate for Payer: BCN Commercial |
$34.76
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Cofinity Commercial |
$107.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Mclaren Medicaid |
$21.04
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$22.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$58.89
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.26
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$31.41
|
| Rate for Payer: Priority Health SBD |
$97.16
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Medicare Advantage |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$22.10
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.16 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.24
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$107.95
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health SBD |
$97.16
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,282.32 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.03
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health SBD |
$1,282.32
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$814.17 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: Aetna Medicare |
$1,017.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.03
|
| Rate for Payer: BCBS Complete |
$814.17
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health SBD |
$1,282.32
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,365.78 |
| Max. Negotiated Rate |
$1,951.12 |
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.14
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,517.54
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,517.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: PHP Commercial |
$1,842.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health SBD |
$1,365.78
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.09 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.14
|
| 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 |
$965.26
|
| Rate for Payer: BCN Commercial |
$965.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,517.54
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,517.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| 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 |
$1,842.72
|
| 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 |
$1,842.72
|
| 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 |
$1,409.14
|
| 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 |
$1,365.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.09
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| 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 BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.29 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.04
|
| 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 |
$965.26
|
| Rate for Payer: BCN Commercial |
$965.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,445.27
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,445.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| 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 |
$1,754.97
|
| 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 |
$1,754.97
|
| 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 |
$1,342.04
|
| 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 |
$1,300.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.29
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| 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 BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,300.74 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.04
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,445.27
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,445.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health SBD |
$1,300.74
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,530.29 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.87
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health SBD |
$1,530.29
|
|
