|
HC BREAST BX W CLIP EACH ADDL LESION MR
|
Facility
|
IP
|
$5,179.22
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
36100413
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,262.91 |
| Max. Negotiated Rate |
$4,661.30 |
| Rate for Payer: Aetna Commercial |
$4,402.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,366.49
|
| Rate for Payer: Cash Price |
$4,143.38
|
| Rate for Payer: Cofinity Commercial |
$3,625.45
|
| Rate for Payer: Cofinity Commercial |
$4,454.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,625.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,143.38
|
| Rate for Payer: Healthscope Commercial |
$4,661.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,402.34
|
| Rate for Payer: PHP Commercial |
$4,402.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,366.49
|
| Rate for Payer: Priority Health SBD |
$3,262.91
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
OP
|
$3,670.34
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,468.14 |
| Max. Negotiated Rate |
$3,303.31 |
| Rate for Payer: Aetna Commercial |
$3,119.79
|
| Rate for Payer: Aetna Medicare |
$1,835.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,385.72
|
| Rate for Payer: BCBS Complete |
$1,468.14
|
| Rate for Payer: Cash Price |
$2,936.27
|
| Rate for Payer: Cofinity Commercial |
$2,569.24
|
| Rate for Payer: Cofinity Commercial |
$3,156.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,569.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,936.27
|
| Rate for Payer: Healthscope Commercial |
$3,303.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,119.79
|
| Rate for Payer: PHP Commercial |
$3,119.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,385.72
|
| Rate for Payer: Priority Health SBD |
$2,312.31
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
IP
|
$3,670.34
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,312.31 |
| Max. Negotiated Rate |
$3,303.31 |
| Rate for Payer: Aetna Commercial |
$3,119.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,385.72
|
| Rate for Payer: Cash Price |
$2,936.27
|
| Rate for Payer: Cofinity Commercial |
$2,569.24
|
| Rate for Payer: Cofinity Commercial |
$3,156.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,569.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,936.27
|
| Rate for Payer: Healthscope Commercial |
$3,303.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,119.79
|
| Rate for Payer: PHP Commercial |
$3,119.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,385.72
|
| Rate for Payer: Priority Health SBD |
$2,312.31
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
IP
|
$4,045.90
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,548.92 |
| Max. Negotiated Rate |
$3,641.31 |
| Rate for Payer: Aetna Commercial |
$3,439.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,629.84
|
| Rate for Payer: Cash Price |
$3,236.72
|
| Rate for Payer: Cofinity Commercial |
$2,832.13
|
| Rate for Payer: Cofinity Commercial |
$3,479.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,832.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.72
|
| Rate for Payer: Healthscope Commercial |
$3,641.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,439.01
|
| Rate for Payer: PHP Commercial |
$3,439.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,629.84
|
| Rate for Payer: Priority Health SBD |
$2,548.92
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
OP
|
$4,045.90
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,618.36 |
| Max. Negotiated Rate |
$3,641.31 |
| Rate for Payer: Aetna Commercial |
$3,439.01
|
| Rate for Payer: Aetna Medicare |
$2,022.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,629.84
|
| Rate for Payer: BCBS Complete |
$1,618.36
|
| Rate for Payer: Cash Price |
$3,236.72
|
| Rate for Payer: Cofinity Commercial |
$2,832.13
|
| Rate for Payer: Cofinity Commercial |
$3,479.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,832.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.72
|
| Rate for Payer: Healthscope Commercial |
$3,641.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,439.01
|
| Rate for Payer: PHP Commercial |
$3,439.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,629.84
|
| Rate for Payer: Priority Health SBD |
$2,548.92
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
OP
|
$3,096.85
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$2,632.32
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$2,477.48
|
| Rate for Payer: Cash Price |
$2,477.48
|
| Rate for Payer: Cofinity Commercial |
$2,167.80
|
| Rate for Payer: Cofinity Commercial |
$2,663.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,477.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,787.16
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,632.32
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$2,632.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.95
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,951.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
IP
|
$3,096.85
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,951.02 |
| Max. Negotiated Rate |
$2,787.16 |
| Rate for Payer: Aetna Commercial |
$2,632.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.95
|
| Rate for Payer: Cash Price |
$2,477.48
|
| Rate for Payer: Cofinity Commercial |
$2,167.80
|
| Rate for Payer: Cofinity Commercial |
$2,663.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,167.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,477.48
|
| Rate for Payer: Healthscope Commercial |
$2,787.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,632.32
|
| Rate for Payer: PHP Commercial |
$2,632.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.95
|
| Rate for Payer: Priority Health SBD |
$1,951.02
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
IP
|
$3,740.54
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,356.54 |
| Max. Negotiated Rate |
$3,366.49 |
| Rate for Payer: Aetna Commercial |
$3,179.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,431.35
|
| Rate for Payer: Cash Price |
$2,992.43
|
| Rate for Payer: Cofinity Commercial |
$2,618.38
|
| Rate for Payer: Cofinity Commercial |
$3,216.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,618.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,992.43
|
| Rate for Payer: Healthscope Commercial |
$3,366.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,179.46
|
| Rate for Payer: PHP Commercial |
$3,179.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,431.35
|
| Rate for Payer: Priority Health SBD |
$2,356.54
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
OP
|
$3,740.54
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,179.46
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,431.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$2,992.43
|
| Rate for Payer: Cash Price |
$2,992.43
|
| Rate for Payer: Cofinity Commercial |
$2,618.38
|
| Rate for Payer: Cofinity Commercial |
$3,216.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,618.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,992.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,366.49
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,179.46
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,179.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,431.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,356.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
OP
|
$4,126.27
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$3,507.33
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,682.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,301.02
|
| Rate for Payer: Cash Price |
$3,301.02
|
| Rate for Payer: Cofinity Commercial |
$2,888.39
|
| Rate for Payer: Cofinity Commercial |
$3,548.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,888.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,713.64
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.33
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,507.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,682.08
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,599.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
IP
|
$4,126.27
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,599.55 |
| Max. Negotiated Rate |
$3,713.64 |
| Rate for Payer: Aetna Commercial |
$3,507.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,682.08
|
| Rate for Payer: Cash Price |
$3,301.02
|
| Rate for Payer: Cofinity Commercial |
$2,888.39
|
| Rate for Payer: Cofinity Commercial |
$3,548.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,888.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.02
|
| Rate for Payer: Healthscope Commercial |
$3,713.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.33
|
| Rate for Payer: PHP Commercial |
$3,507.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,682.08
|
| Rate for Payer: Priority Health SBD |
$2,599.55
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
OP
|
$363.10
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$308.63
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$290.48
|
| Rate for Payer: Cash Price |
$290.48
|
| Rate for Payer: Cofinity Commercial |
$312.27
|
| Rate for Payer: Cofinity Commercial |
$254.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$326.79
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.63
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$308.63
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.01
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$228.75
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
IP
|
$363.10
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$228.75 |
| Max. Negotiated Rate |
$326.79 |
| Rate for Payer: Aetna Commercial |
$308.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.01
|
| Rate for Payer: Cash Price |
$290.48
|
| Rate for Payer: Cofinity Commercial |
$254.17
|
| Rate for Payer: Cofinity Commercial |
$312.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.48
|
| Rate for Payer: Healthscope Commercial |
$326.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.63
|
| Rate for Payer: PHP Commercial |
$308.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.01
|
| Rate for Payer: Priority Health SBD |
$228.75
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
IP
|
$25.74
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.22 |
| Max. Negotiated Rate |
$23.17 |
| Rate for Payer: Aetna Commercial |
$21.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.73
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cofinity Commercial |
$18.02
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.59
|
| Rate for Payer: Healthscope Commercial |
$23.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.88
|
| Rate for Payer: PHP Commercial |
$21.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.73
|
| Rate for Payer: Priority Health SBD |
$16.22
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$25.74
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.22 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna Commercial |
$21.88
|
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Commercial |
$18.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$23.17
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.88
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$21.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.73
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health SBD |
$16.22
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.75
|
| Rate for Payer: UHC Core |
$19.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$19.05
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$21.55
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$258.03
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$103.21 |
| Max. Negotiated Rate |
$232.23 |
| Rate for Payer: Aetna Commercial |
$219.33
|
| Rate for Payer: Aetna Medicare |
$129.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.72
|
| Rate for Payer: BCBS Complete |
$103.21
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Commercial |
$180.62
|
| Rate for Payer: Cofinity Commercial |
$221.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$232.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.33
|
| Rate for Payer: PHP Commercial |
$219.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.72
|
| Rate for Payer: Priority Health SBD |
$162.56
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$258.03
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$162.56 |
| Max. Negotiated Rate |
$232.23 |
| Rate for Payer: Aetna Commercial |
$219.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.72
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Commercial |
$180.62
|
| Rate for Payer: Cofinity Commercial |
$221.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$232.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.33
|
| Rate for Payer: PHP Commercial |
$219.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.72
|
| Rate for Payer: Priority Health SBD |
$162.56
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,103.68
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,955.32 |
| Max. Negotiated Rate |
$2,793.31 |
| Rate for Payer: Aetna Commercial |
$2,638.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,017.39
|
| Rate for Payer: Cash Price |
$2,482.94
|
| Rate for Payer: Cofinity Commercial |
$2,172.58
|
| Rate for Payer: Cofinity Commercial |
$2,669.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,482.94
|
| Rate for Payer: Healthscope Commercial |
$2,793.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,638.13
|
| Rate for Payer: PHP Commercial |
$2,638.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,017.39
|
| Rate for Payer: Priority Health SBD |
$1,955.32
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,103.68
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,241.47 |
| Max. Negotiated Rate |
$2,793.31 |
| Rate for Payer: Aetna Commercial |
$2,638.13
|
| Rate for Payer: Aetna Medicare |
$1,551.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,017.39
|
| Rate for Payer: BCBS Complete |
$1,241.47
|
| Rate for Payer: Cash Price |
$2,482.94
|
| Rate for Payer: Cofinity Commercial |
$2,172.58
|
| Rate for Payer: Cofinity Commercial |
$2,669.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,482.94
|
| Rate for Payer: Healthscope Commercial |
$2,793.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,638.13
|
| Rate for Payer: PHP Commercial |
$2,638.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,017.39
|
| Rate for Payer: Priority Health SBD |
$1,955.32
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$273.76
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$172.47 |
| Max. Negotiated Rate |
$246.38 |
| Rate for Payer: Aetna Commercial |
$232.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.94
|
| Rate for Payer: Cash Price |
$219.01
|
| Rate for Payer: Cofinity Commercial |
$191.63
|
| Rate for Payer: Cofinity Commercial |
$235.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.01
|
| Rate for Payer: Healthscope Commercial |
$246.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.70
|
| Rate for Payer: PHP Commercial |
$232.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.94
|
| Rate for Payer: Priority Health SBD |
$172.47
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$273.76
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$232.70
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$219.01
|
| Rate for Payer: Cash Price |
$219.01
|
| Rate for Payer: Cofinity Commercial |
$235.43
|
| Rate for Payer: Cofinity Commercial |
$191.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$246.38
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.70
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$232.70
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.94
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$172.47
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$202.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$202.58
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
OP
|
$263.12
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$223.65
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$210.50
|
| Rate for Payer: Cash Price |
$210.50
|
| Rate for Payer: Cofinity Commercial |
$226.28
|
| Rate for Payer: Cofinity Commercial |
$184.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$236.81
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.65
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$223.65
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.03
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$165.77
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$194.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$263.12
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$165.77 |
| Max. Negotiated Rate |
$236.81 |
| Rate for Payer: Aetna Commercial |
$223.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.03
|
| Rate for Payer: Cash Price |
$210.50
|
| Rate for Payer: Cofinity Commercial |
$184.18
|
| Rate for Payer: Cofinity Commercial |
$226.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.50
|
| Rate for Payer: Healthscope Commercial |
$236.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.65
|
| Rate for Payer: PHP Commercial |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.03
|
| Rate for Payer: Priority Health SBD |
$165.77
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,564.80
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,615.82 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,667.12
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$1,795.36
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,795.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health SBD |
$1,615.82
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,564.80
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,025.92 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: Aetna Medicare |
$1,282.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,667.12
|
| Rate for Payer: BCBS Complete |
$1,025.92
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$1,795.36
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,795.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health SBD |
$1,615.82
|
|
