|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$7,108.93
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,478.63 |
| Max. Negotiated Rate |
$6,398.04 |
| Rate for Payer: Aetna Commercial |
$6,042.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,620.80
|
| Rate for Payer: Cash Price |
$5,687.14
|
| Rate for Payer: Cofinity Advantage |
$4,976.25
|
| Rate for Payer: Cofinity Commercial |
$6,113.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,687.14
|
| Rate for Payer: Healthscope Commercial |
$6,398.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,042.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,331.70
|
| Rate for Payer: PHP Commercial |
$6,042.59
|
| Rate for Payer: Priority Health SBD |
$4,478.63
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$8,271.18
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Commercial |
$7,030.50
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,376.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,331.22
|
| Rate for Payer: BCCCP Commercial |
$295.08
|
| Rate for Payer: BCN Commercial |
$2,331.22
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Advantage |
$5,789.83
|
| Rate for Payer: Cofinity Commercial |
$7,113.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,444.06
|
| Rate for Payer: Mclaren Medicaid |
$1,686.93
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$7,030.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$5,210.84
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,376.27
|
| Rate for Payer: UHC Core |
$4,309.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$3,250.57
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$8,271.18
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,210.84 |
| Max. Negotiated Rate |
$7,444.06 |
| Rate for Payer: Aetna Commercial |
$7,030.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,376.27
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Advantage |
$5,789.83
|
| Rate for Payer: Cofinity Commercial |
$7,113.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Healthscope Commercial |
$7,444.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PHP Commercial |
$7,030.50
|
| Rate for Payer: Priority Health SBD |
$5,210.84
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
IP
|
$290.77
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.19 |
| Max. Negotiated Rate |
$261.69 |
| Rate for Payer: Aetna Commercial |
$247.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.00
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cofinity Advantage |
$203.54
|
| Rate for Payer: Cofinity Commercial |
$250.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.62
|
| Rate for Payer: Healthscope Commercial |
$261.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.08
|
| Rate for Payer: PHP Commercial |
$247.15
|
| Rate for Payer: Priority Health SBD |
$183.19
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
OP
|
$290.77
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna Commercial |
$247.15
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$120.44
|
| Rate for Payer: BCCCP Commercial |
$122.41
|
| Rate for Payer: BCN Commercial |
$120.44
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cash Price |
$232.62
|
| Rate for Payer: Cofinity Advantage |
$203.54
|
| Rate for Payer: Cofinity Commercial |
$250.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$261.69
|
| Rate for Payer: Mclaren Medicaid |
$105.35
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.15
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.08
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$247.15
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$183.19
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.00
|
| Rate for Payer: UHC Core |
$151.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$114.27
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
OP
|
$434.56
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna Commercial |
$369.38
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$154.52
|
| Rate for Payer: BCCCP Commercial |
$146.69
|
| Rate for Payer: BCN Commercial |
$154.52
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Advantage |
$304.19
|
| Rate for Payer: Cofinity Commercial |
$373.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$391.10
|
| Rate for Payer: Mclaren Medicaid |
$158.80
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$369.38
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$273.77
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.46
|
| Rate for Payer: UHC Core |
$226.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$170.78
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
IP
|
$434.56
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.77 |
| Max. Negotiated Rate |
$391.10 |
| Rate for Payer: Aetna Commercial |
$369.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.46
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Advantage |
$304.19
|
| Rate for Payer: Cofinity Commercial |
$373.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Healthscope Commercial |
$391.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PHP Commercial |
$369.38
|
| Rate for Payer: Priority Health SBD |
$273.77
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
IP
|
$434.56
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.77 |
| Max. Negotiated Rate |
$391.10 |
| Rate for Payer: Aetna Commercial |
$369.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.46
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Advantage |
$304.19
|
| Rate for Payer: Cofinity Commercial |
$373.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Healthscope Commercial |
$391.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PHP Commercial |
$369.38
|
| Rate for Payer: Priority Health SBD |
$273.77
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
OP
|
$434.56
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.18 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna Commercial |
$369.38
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$163.65
|
| Rate for Payer: BCCCP Commercial |
$157.18
|
| Rate for Payer: BCN Commercial |
$163.65
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cash Price |
$347.65
|
| Rate for Payer: Cofinity Advantage |
$304.19
|
| Rate for Payer: Cofinity Commercial |
$373.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$391.10
|
| Rate for Payer: Mclaren Medicaid |
$158.80
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.38
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.92
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$369.38
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$273.77
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.46
|
| Rate for Payer: UHC Core |
$226.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$170.78
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
IP
|
$375.67
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.67 |
| Max. Negotiated Rate |
$338.10 |
| Rate for Payer: Aetna Commercial |
$319.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.19
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cofinity Advantage |
$262.97
|
| Rate for Payer: Cofinity Commercial |
$323.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.54
|
| Rate for Payer: Healthscope Commercial |
$338.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.75
|
| Rate for Payer: PHP Commercial |
$319.32
|
| Rate for Payer: Priority Health SBD |
$236.67
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
OP
|
$375.67
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.64 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna Commercial |
$319.32
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$172.94
|
| Rate for Payer: BCCCP Commercial |
$164.88
|
| Rate for Payer: BCN Commercial |
$172.94
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cash Price |
$300.54
|
| Rate for Payer: Cofinity Advantage |
$262.97
|
| Rate for Payer: Cofinity Commercial |
$323.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$338.10
|
| Rate for Payer: Mclaren Medicaid |
$158.80
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.32
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.75
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$319.32
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$236.67
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.19
|
| Rate for Payer: UHC Core |
$195.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$147.64
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
IP
|
$888.23
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$559.58 |
| Max. Negotiated Rate |
$799.41 |
| Rate for Payer: Aetna Commercial |
$755.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.35
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Advantage |
$621.76
|
| Rate for Payer: Cofinity Commercial |
$763.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Healthscope Commercial |
$799.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: PHP Commercial |
$755.00
|
| Rate for Payer: Priority Health SBD |
$559.58
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
OP
|
$888.23
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$349.07 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Commercial |
$755.00
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cash Price |
$710.58
|
| Rate for Payer: Cofinity Advantage |
$621.76
|
| Rate for Payer: Cofinity Commercial |
$763.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$799.41
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.00
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.17
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$755.00
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$559.58
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.35
|
| Rate for Payer: UHC Core |
$462.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$349.07
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
IP
|
$430.93
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.49 |
| Max. Negotiated Rate |
$387.84 |
| Rate for Payer: Aetna Commercial |
$366.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.10
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cofinity Advantage |
$301.65
|
| Rate for Payer: Cofinity Commercial |
$370.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.74
|
| Rate for Payer: Healthscope Commercial |
$387.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.20
|
| Rate for Payer: PHP Commercial |
$366.29
|
| Rate for Payer: Priority Health SBD |
$271.49
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
OP
|
$430.93
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.70 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna Commercial |
$366.29
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$52.70
|
| Rate for Payer: BCN Commercial |
$52.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cash Price |
$344.74
|
| Rate for Payer: Cofinity Advantage |
$301.65
|
| Rate for Payer: Cofinity Commercial |
$370.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$387.84
|
| Rate for Payer: Mclaren Medicaid |
$158.80
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.29
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.20
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$366.29
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$271.49
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.10
|
| Rate for Payer: UHC Core |
$224.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$169.36
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
IP
|
$335.35
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.27 |
| Max. Negotiated Rate |
$301.81 |
| Rate for Payer: Aetna Commercial |
$285.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.98
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cofinity Advantage |
$234.75
|
| Rate for Payer: Cofinity Commercial |
$288.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.28
|
| Rate for Payer: Healthscope Commercial |
$301.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.51
|
| Rate for Payer: PHP Commercial |
$285.05
|
| Rate for Payer: Priority Health SBD |
$211.27
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
OP
|
$335.35
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna Commercial |
$285.05
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$93.56
|
| Rate for Payer: BCN Commercial |
$93.56
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cash Price |
$268.28
|
| Rate for Payer: Cofinity Advantage |
$234.75
|
| Rate for Payer: Cofinity Commercial |
$288.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$301.81
|
| Rate for Payer: Mclaren Medicaid |
$105.35
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.05
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.51
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$285.05
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$211.27
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.98
|
| Rate for Payer: UHC Core |
$174.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$131.79
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna Commercial |
$740.56
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$64.92
|
| Rate for Payer: BCN Commercial |
$64.92
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Advantage |
$609.88
|
| Rate for Payer: Cofinity Commercial |
$749.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$784.12
|
| Rate for Payer: Mclaren Medicaid |
$158.80
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.56
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$740.56
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$548.89
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.31
|
| Rate for Payer: UHC Core |
$453.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$342.40
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$548.89 |
| Max. Negotiated Rate |
$784.12 |
| Rate for Payer: Aetna Commercial |
$740.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.31
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Advantage |
$609.88
|
| Rate for Payer: Cofinity Commercial |
$749.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Healthscope Commercial |
$784.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| Rate for Payer: PHP Commercial |
$740.56
|
| Rate for Payer: Priority Health SBD |
$548.89
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
IP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.34 |
| Max. Negotiated Rate |
$113.34 |
| Rate for Payer: Aetna Commercial |
$107.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.85
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Advantage |
$88.15
|
| Rate for Payer: Cofinity Commercial |
$108.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: PHP Commercial |
$107.04
|
| Rate for Payer: Priority Health SBD |
$79.34
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
OP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.49 |
| Max. Negotiated Rate |
$113.34 |
| Rate for Payer: Aetna Commercial |
$107.04
|
| Rate for Payer: Aetna Medicare |
$62.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.85
|
| Rate for Payer: BCBS Complete |
$50.37
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Advantage |
$88.15
|
| Rate for Payer: Cofinity Commercial |
$108.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: PHP Commercial |
$107.04
|
| Rate for Payer: Priority Health SBD |
$79.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.85
|
| Rate for Payer: UHC Core |
$65.61
|
| Rate for Payer: UHC Exchange |
$49.49
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$712.05 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna Medicare |
$108.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.41
|
| Rate for Payer: BCBS Complete |
$87.02
|
| Rate for Payer: BCBS Trust/PPO |
$712.05
|
| Rate for Payer: BCN Commercial |
$712.05
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Advantage |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$329.08
|
| Rate for Payer: Priority Health SBD |
$137.06
|
| Rate for Payer: Priority Health Tiered Network |
$263.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.56
|
| Rate for Payer: UHC Core |
$571.56
|
| Rate for Payer: UHC Exchange |
$571.56
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.06 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.41
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Advantage |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health SBD |
$137.06
|
|
|
HC COMMON REED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC COMMON REED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| 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 |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
