|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: BCBS Complete |
$16.90
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$457.40 |
| Rate for Payer: Aetna Commercial |
$431.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.34
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$355.75
|
| Rate for Payer: Cofinity Commercial |
$437.07
|
| Rate for Payer: Healthscope Commercial |
$457.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: PHP Commercial |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: Priority Health SBD |
$320.18
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$457.40 |
| Rate for Payer: Aetna Commercial |
$431.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.34
|
| Rate for Payer: BCBS Complete |
$203.29
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$355.75
|
| Rate for Payer: Cofinity Commercial |
$437.07
|
| Rate for Payer: Healthscope Commercial |
$457.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: PHP Commercial |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: Priority Health SBD |
$320.18
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,899.53 |
| Max. Negotiated Rate |
$8,427.91 |
| Rate for Payer: Aetna Commercial |
$7,959.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,086.82
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$6,555.04
|
| Rate for Payer: Cofinity Commercial |
$8,053.33
|
| Rate for Payer: Healthscope Commercial |
$8,427.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: PHP Commercial |
$7,959.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: Priority Health SBD |
$5,899.53
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$834.98 |
| Max. Negotiated Rate |
$8,427.91 |
| Rate for Payer: Aetna Commercial |
$7,959.69
|
| Rate for Payer: Aetna Medicare |
$3,015.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,086.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,624.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,624.31
|
| Rate for Payer: BCBS Complete |
$1,665.44
|
| Rate for Payer: BCBS MAPPO |
$2,899.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,406.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,899.45
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$6,555.04
|
| Rate for Payer: Cofinity Commercial |
$8,053.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,899.45
|
| Rate for Payer: Healthscope Commercial |
$8,427.91
|
| Rate for Payer: Mclaren Medicaid |
$1,586.00
|
| Rate for Payer: Mclaren Medicare |
$2,899.45
|
| Rate for Payer: Meridian Medicaid |
$1,665.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,044.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,334.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: PACE Medicare |
$2,754.48
|
| Rate for Payer: PACE SWMI |
$2,899.45
|
| Rate for Payer: PHP Commercial |
$7,959.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,899.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,586.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: Priority Health Medicare |
$2,899.45
|
| Rate for Payer: Priority Health SBD |
$5,899.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,899.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.48
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,899.45
|
| Rate for Payer: UHC Exchange |
$834.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,986.43
|
| Rate for Payer: VA VA |
$2,899.45
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$29.36 |
| Rate for Payer: Aetna Commercial |
$27.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.20
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: PHP Commercial |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: Priority Health SBD |
$20.55
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$29.36 |
| Rate for Payer: Aetna Commercial |
$27.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.20
|
| Rate for Payer: BCBS Complete |
$13.05
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: PHP Commercial |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: Priority Health SBD |
$20.55
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.90
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$10.38
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Medicaid |
$10.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.76
|
| Rate for Payer: UHC Core |
$32.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: Priority Health SBD |
$18.35
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$22.57 |
| Rate for Payer: Aetna Commercial |
$21.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.30
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$17.56
|
| Rate for Payer: Cofinity Commercial |
$21.57
|
| Rate for Payer: Healthscope Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: PHP Commercial |
$21.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health SBD |
$15.80
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$27.64 |
| Rate for Payer: Aetna Commercial |
$21.32
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$21.57
|
| Rate for Payer: Cofinity Commercial |
$17.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$22.57
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$21.32
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health SBD |
$15.80
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.51
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$16.75
|
| Rate for Payer: VA VA |
$16.26
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health SBD |
$22.86
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$39.34 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.51
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Mclaren Medicaid |
$12.93
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Medicaid |
$13.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$22.86
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.37
|
| Rate for Payer: UHC Core |
$39.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.64
|
| Rate for Payer: UHC Exchange |
$23.64
|
| Rate for Payer: UHC Medicare Advantage |
$24.35
|
| Rate for Payer: VA VA |
$23.64
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.21 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.60
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$13.57
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health SBD |
$12.21
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$20.58 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$9.48
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Cofinity Commercial |
$13.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Mclaren Medicaid |
$6.62
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health SBD |
$12.21
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.53
|
| Rate for Payer: UHC Core |
$20.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.11
|
| Rate for Payer: UHC Exchange |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.90
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$10.38
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Medicaid |
$10.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.76
|
| Rate for Payer: UHC Core |
$32.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.26 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.81
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health SBD |
$17.26
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.25
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.20
|
| Rate for Payer: BCBS Trust/PPO |
$3.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.20
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Mclaren Medicaid |
$2.30
|
| Rate for Payer: Mclaren Medicare |
$4.20
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PACE Medicare |
$3.99
|
| Rate for Payer: PACE SWMI |
$4.20
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health SBD |
$17.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.04
|
| Rate for Payer: UHC Core |
$7.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.20
|
| Rate for Payer: UHC Exchange |
$4.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.33
|
| Rate for Payer: VA VA |
$4.20
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$8.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.82
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$7.86
|
| Rate for Payer: BCBS Trust/PPO |
$6.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.86
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.86
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Mclaren Medicare |
$7.86
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$7.47
|
| Rate for Payer: PACE SWMI |
$7.86
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$7.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health Medicare |
$7.86
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.43
|
| Rate for Payer: UHC Core |
$13.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.86
|
| Rate for Payer: UHC Exchange |
$7.86
|
| Rate for Payer: UHC Medicare Advantage |
$8.10
|
| Rate for Payer: VA VA |
$7.86
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.79 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$75.32
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health SBD |
$67.79
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.68
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$13.20
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$75.32
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Mclaren Medicaid |
$9.22
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Medicaid |
$9.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$67.79
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
| Rate for Payer: UHC Core |
$24.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$17.36
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$70.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.20
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$67.36
|
| Rate for Payer: BCBS Trust/PPO |
$52.75
|
| Rate for Payer: BCN Medicare Advantage |
$67.36
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.36
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Mclaren Medicaid |
$36.85
|
| Rate for Payer: Mclaren Medicare |
$67.36
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PACE Medicare |
$63.99
|
| Rate for Payer: PACE SWMI |
$67.36
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: PHP Medicare Advantage |
$67.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health Medicare |
$67.36
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: Railroad Medicare Medicare |
$67.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.83
|
| Rate for Payer: UHC Core |
$114.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.36
|
| Rate for Payer: UHC Exchange |
$67.36
|
| Rate for Payer: UHC Medicare Advantage |
$69.38
|
| Rate for Payer: VA VA |
$67.36
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$96.39 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health SBD |
$96.39
|
|
