|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.24 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health SBD |
$32.24
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.53
|
| Rate for Payer: BCN Commercial |
$22.53
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: Nomi Health Commercial |
$38.18
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.45
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$20.36
|
| Rate for Payer: Priority Health SBD |
$32.24
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$14.33
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$324.79 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.10
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$360.88
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health SBD |
$324.79
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: Aetna Medicare |
$257.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.10
|
| Rate for Payer: BCBS Complete |
$206.22
|
| Rate for Payer: BCBS Trust/PPO |
$151.20
|
| Rate for Payer: BCN Commercial |
$151.20
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$360.88
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health SBD |
$324.79
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$157.84 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$391.31
|
| Rate for Payer: BCN Commercial |
$391.31
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$707.29
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$830.79
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$171.77
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$707.29 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health SBD |
$707.29
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$112.17 |
| Max. Negotiated Rate |
$2,015.13 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: Aetna Medicare |
$666.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.44
|
| Rate for Payer: BCBS Complete |
$360.84
|
| Rate for Payer: BCBS MAPPO |
$641.15
|
| Rate for Payer: BCBS Trust/PPO |
$359.76
|
| Rate for Payer: BCN Commercial |
$359.76
|
| Rate for Payer: BCN Medicare Advantage |
$641.15
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$838.50
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.15
|
| Rate for Payer: Healthscope Commercial |
$1,078.06
|
| Rate for Payer: Mclaren Medicaid |
$343.66
|
| Rate for Payer: Mclaren Medicare |
$641.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.21
|
| Rate for Payer: Meridian Medicaid |
$360.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: Nomi Health Commercial |
$1,923.45
|
| Rate for Payer: PACE Medicare |
$609.09
|
| Rate for Payer: PACE SWMI |
$641.15
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: PHP Medicare Advantage |
$641.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,015.13
|
| Rate for Payer: Priority Health Medicare |
$641.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.10
|
| Rate for Payer: Priority Health SBD |
$754.65
|
| Rate for Payer: Railroad Medicare Medicare |
$641.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.17
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.15
|
| Rate for Payer: UHC Exchange |
$886.41
|
| Rate for Payer: UHC Medicare Advantage |
$641.15
|
| Rate for Payer: UHCCP Medicaid |
$360.97
|
| Rate for Payer: VA VA |
$641.15
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$754.65 |
| Max. Negotiated Rate |
$1,078.06 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.60
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Cofinity Commercial |
$838.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Healthscope Commercial |
$1,078.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health SBD |
$754.65
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$628.87 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.83
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$698.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health SBD |
$628.87
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$399.28 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: Aetna Medicare |
$499.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.83
|
| Rate for Payer: BCBS Complete |
$399.28
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$698.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health SBD |
$628.87
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$91.74 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$30.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.49
|
| Rate for Payer: BCBS Complete |
$16.43
|
| Rate for Payer: BCBS MAPPO |
$29.19
|
| Rate for Payer: BCBS Trust/PPO |
$13.28
|
| Rate for Payer: BCN Commercial |
$13.28
|
| Rate for Payer: BCN Medicare Advantage |
$29.19
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.19
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$15.65
|
| Rate for Payer: Mclaren Medicare |
$29.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.65
|
| Rate for Payer: Meridian Medicaid |
$16.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$87.57
|
| Rate for Payer: PACE Medicare |
$27.73
|
| Rate for Payer: PACE SWMI |
$29.19
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$29.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.74
|
| Rate for Payer: Priority Health Medicare |
$29.19
|
| Rate for Payer: Priority Health Narrow Network |
$73.39
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$29.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.19
|
| Rate for Payer: UHC Medicare Advantage |
$29.19
|
| Rate for Payer: UHCCP Medicaid |
$16.43
|
| Rate for Payer: VA VA |
$29.19
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health SBD |
$33.43
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$41.65 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.20
|
| Rate for Payer: BCBS Complete |
$51.82
|
| Rate for Payer: BCBS Trust/PPO |
$82.70
|
| Rate for Payer: BCN Commercial |
$82.70
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$90.68
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.06
|
| Rate for Payer: Priority Health Narrow Network |
$41.65
|
| Rate for Payer: Priority Health SBD |
$81.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.11
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$81.61 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.20
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Cofinity Commercial |
$90.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health SBD |
$81.61
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$30.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.43
|
| Rate for Payer: BCN Commercial |
$35.43
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.90
|
| Rate for Payer: Priority Health Narrow Network |
$19.12
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.78
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.78 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health SBD |
$51.78
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$91.74 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$30.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.49
|
| Rate for Payer: BCBS Complete |
$16.43
|
| Rate for Payer: BCBS MAPPO |
$29.19
|
| Rate for Payer: BCBS Trust/PPO |
$90.19
|
| Rate for Payer: BCN Commercial |
$90.19
|
| Rate for Payer: BCN Medicare Advantage |
$29.19
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.19
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Mclaren Medicaid |
$15.65
|
| Rate for Payer: Mclaren Medicare |
$29.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.65
|
| Rate for Payer: Meridian Medicaid |
$16.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$87.57
|
| Rate for Payer: PACE Medicare |
$27.73
|
| Rate for Payer: PACE SWMI |
$29.19
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$29.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.74
|
| Rate for Payer: Priority Health Medicare |
$29.19
|
| Rate for Payer: Priority Health Narrow Network |
$73.39
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: Railroad Medicare Medicare |
$29.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.19
|
| Rate for Payer: UHC Medicare Advantage |
$29.19
|
| Rate for Payer: UHCCP Medicaid |
$16.43
|
| Rate for Payer: VA VA |
$29.19
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$4,647.60 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.93
|
| Rate for Payer: BCN Commercial |
$14.93
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$25.30
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.87
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$13.50
|
| Rate for Payer: Priority Health SBD |
$37.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.24
|
| Rate for Payer: UHC Core |
$4,647.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$4,647.60
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.50
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.45
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: Priority Health SBD |
$37.27
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UHC Core |
$107.36
|
| Rate for Payer: UHC Exchange |
$107.36
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.10 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health SBD |
$95.10
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$4,647.60 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$9.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.52
|
| Rate for Payer: BCBS Complete |
$5.19
|
| Rate for Payer: BCBS MAPPO |
$9.22
|
| Rate for Payer: BCBS Trust/PPO |
$8.17
|
| Rate for Payer: BCN Commercial |
$8.17
|
| Rate for Payer: BCN Medicare Advantage |
$9.22
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Mclaren Medicaid |
$4.94
|
| Rate for Payer: Mclaren Medicare |
$9.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.68
|
| Rate for Payer: Meridian Medicaid |
$5.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: PACE Medicare |
$8.76
|
| Rate for Payer: PACE SWMI |
$9.22
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Medicare Advantage |
$9.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.49
|
| Rate for Payer: Priority Health Medicare |
$9.22
|
| Rate for Payer: Priority Health Narrow Network |
$7.59
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.06
|
| Rate for Payer: UHC Core |
$4,647.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.22
|
| Rate for Payer: UHC Exchange |
$4,647.60
|
| Rate for Payer: UHC Medicare Advantage |
$9.22
|
| Rate for Payer: UHCCP Medicaid |
$5.19
|
| Rate for Payer: VA VA |
$9.22
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$457.71 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.24
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$508.57
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$508.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health SBD |
$457.71
|
|
