|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$4.43
|
| Rate for Payer: BCN Commercial |
$4.43
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Mclaren Medicaid |
$2.68
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$2.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$7.50
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.03
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health Narrow Network |
$4.02
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.00
|
| Rate for Payer: UHC Core |
$7.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.00
|
| Rate for Payer: UHC Exchange |
$7.68
|
| Rate for Payer: UHC Medicare Advantage |
$5.00
|
| Rate for Payer: UHCCP Medicaid |
$2.82
|
| Rate for Payer: VA VA |
$5.00
|
|
|
HC CHLORIDE SERUM
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$86.63 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.75
|
| Rate for Payer: BCBS Complete |
$2.59
|
| Rate for Payer: BCBS MAPPO |
$4.60
|
| Rate for Payer: BCN Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Mclaren Medicaid |
$2.47
|
| Rate for Payer: Mclaren Medicare |
$4.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.83
|
| Rate for Payer: Meridian Medicaid |
$2.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$6.90
|
| Rate for Payer: PACE Medicare |
$4.37
|
| Rate for Payer: PACE SWMI |
$4.60
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$4.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.60
|
| Rate for Payer: Priority Health Medicare |
$4.60
|
| Rate for Payer: Priority Health Narrow Network |
$3.68
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: Railroad Medicare Medicare |
$4.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.52
|
| Rate for Payer: UHC Core |
$86.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.60
|
| Rate for Payer: UHC Exchange |
$86.63
|
| Rate for Payer: UHC Medicare Advantage |
$4.60
|
| Rate for Payer: UHCCP Medicaid |
$2.59
|
| Rate for Payer: VA VA |
$4.60
|
|
|
HC CHLORIDE SERUM
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health SBD |
$13.63
|
|
|
HC CHLORIDE URINE
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$5.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.19
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$5.75
|
| Rate for Payer: BCBS Trust/PPO |
$5.09
|
| Rate for Payer: BCN Commercial |
$5.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.75
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$3.08
|
| Rate for Payer: Mclaren Medicare |
$5.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$8.62
|
| Rate for Payer: PACE Medicare |
$5.46
|
| Rate for Payer: PACE SWMI |
$5.75
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.75
|
| Rate for Payer: Priority Health Medicare |
$5.75
|
| Rate for Payer: Priority Health Narrow Network |
$4.60
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$5.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.75
|
| Rate for Payer: UHC Medicare Advantage |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$3.24
|
| Rate for Payer: VA VA |
$5.75
|
|
|
HC CHLORIDE URINE
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
|
|
HC CHLOROZINE BATH
|
Facility
|
IP
|
$4.48
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Aetna Commercial |
$3.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.91
|
| Rate for Payer: Cash Price |
$3.58
|
| Rate for Payer: Cofinity Commercial |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$3.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$4.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.81
|
| Rate for Payer: PHP Commercial |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.91
|
| Rate for Payer: Priority Health SBD |
$2.82
|
|
|
HC CHLOROZINE BATH
|
Facility
|
OP
|
$4.48
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Aetna Commercial |
$3.81
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.91
|
| Rate for Payer: BCBS Complete |
$1.79
|
| Rate for Payer: Cash Price |
$3.58
|
| Rate for Payer: Cofinity Commercial |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$3.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$4.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.81
|
| Rate for Payer: PHP Commercial |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.91
|
| Rate for Payer: Priority Health SBD |
$2.82
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
OP
|
$572.34
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.98 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$486.49
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$900.56
|
| Rate for Payer: BCN Commercial |
$900.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$457.87
|
| Rate for Payer: Cash Price |
$457.87
|
| Rate for Payer: Cash Price |
$457.87
|
| Rate for Payer: Cofinity Commercial |
$492.21
|
| Rate for Payer: Cofinity Commercial |
$400.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$400.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$515.11
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.49
|
| Rate for Payer: Nomi Health Commercial |
$10,373.10
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$486.49
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$360.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.98
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,811.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
IP
|
$572.34
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$360.57 |
| Max. Negotiated Rate |
$515.11 |
| Rate for Payer: Aetna Commercial |
$486.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.02
|
| Rate for Payer: Cash Price |
$457.87
|
| Rate for Payer: Cofinity Commercial |
$400.64
|
| Rate for Payer: Cofinity Commercial |
$492.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$400.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.87
|
| Rate for Payer: Healthscope Commercial |
$515.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.49
|
| Rate for Payer: PHP Commercial |
$486.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.02
|
| Rate for Payer: Priority Health SBD |
$360.57
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
OP
|
$3,683.04
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$219.53 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$3,130.58
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,393.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,813.67
|
| Rate for Payer: BCN Commercial |
$2,813.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,167.41
|
| Rate for Payer: Cofinity Commercial |
$2,578.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,578.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$3,314.74
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$10,373.10
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,130.58
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$2,320.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.53
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,811.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
IP
|
$3,683.04
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.32 |
| Max. Negotiated Rate |
$3,314.74 |
| Rate for Payer: Aetna Commercial |
$3,130.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,393.98
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$2,578.13
|
| Rate for Payer: Cofinity Commercial |
$3,167.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,578.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Healthscope Commercial |
$3,314.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: PHP Commercial |
$3,130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health SBD |
$2,320.32
|
|
|
HC CHOLESTEROL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$18.98 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.33
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.48
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health Narrow Network |
$3.58
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.22
|
| Rate for Payer: UHC Core |
$18.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Exchange |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
| Rate for Payer: UHCCP Medicaid |
$2.45
|
| Rate for Payer: VA VA |
$4.35
|
|
|
HC CHOLESTEROL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$18.98 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$2.33
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.48
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health Narrow Network |
$3.58
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.22
|
| Rate for Payer: UHC Core |
$18.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Exchange |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
| Rate for Payer: UHCCP Medicaid |
$2.45
|
| Rate for Payer: VA VA |
$4.35
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.83 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
|
|
HC CHOLETEC PER STUDY
|
Facility
|
IP
|
$463.94
|
|
|
Service Code
|
HCPCS A9537
|
| Hospital Charge Code |
34300003
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$292.28 |
| Max. Negotiated Rate |
$417.55 |
| Rate for Payer: Aetna Commercial |
$394.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.56
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cofinity Commercial |
$324.76
|
| Rate for Payer: Cofinity Commercial |
$398.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.15
|
| Rate for Payer: Healthscope Commercial |
$417.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.35
|
| Rate for Payer: PHP Commercial |
$394.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.56
|
| Rate for Payer: Priority Health SBD |
$292.28
|
|
|
HC CHOLETEC PER STUDY
|
Facility
|
OP
|
$463.94
|
|
|
Service Code
|
HCPCS A9537
|
| Hospital Charge Code |
34300003
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$82.37 |
| Max. Negotiated Rate |
$417.55 |
| Rate for Payer: Aetna Commercial |
$394.35
|
| Rate for Payer: Aetna Medicare |
$231.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.56
|
| Rate for Payer: BCBS Complete |
$185.58
|
| Rate for Payer: BCBS Trust/PPO |
$82.37
|
| Rate for Payer: BCN Commercial |
$82.37
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cofinity Commercial |
$324.76
|
| Rate for Payer: Cofinity Commercial |
$398.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.15
|
| Rate for Payer: Healthscope Commercial |
$417.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.35
|
| Rate for Payer: PHP Commercial |
$394.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.56
|
| Rate for Payer: Priority Health SBD |
$292.28
|
|
|
HC CHOLINESTERASE RBC
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.26
|
| Rate for Payer: BCBS Complete |
$5.52
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCN Commercial |
$8.69
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$5.26
|
| Rate for Payer: Mclaren Medicare |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.30
|
| Rate for Payer: Meridian Medicaid |
$5.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$14.72
|
| Rate for Payer: PACE Medicare |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.81
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Narrow Network |
$7.85
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.77
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.81
|
| Rate for Payer: UHC Exchange |
$28.67
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$5.52
|
| Rate for Payer: VA VA |
$9.81
|
|
|
HC CHOLINESTERASE RBC
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
OP
|
$680.42
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$143.08 |
| Max. Negotiated Rate |
$2,681.40 |
| Rate for Payer: Aetna Commercial |
$578.36
|
| Rate for Payer: Aetna Medicare |
$887.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,066.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,066.41
|
| Rate for Payer: BCBS Complete |
$480.14
|
| Rate for Payer: BCBS MAPPO |
$853.13
|
| Rate for Payer: BCBS Trust/PPO |
$452.82
|
| Rate for Payer: BCN Commercial |
$452.82
|
| Rate for Payer: BCN Medicare Advantage |
$853.13
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cofinity Commercial |
$585.16
|
| Rate for Payer: Cofinity Commercial |
$476.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$612.38
|
| Rate for Payer: Mclaren Medicaid |
$457.28
|
| Rate for Payer: Mclaren Medicare |
$853.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.79
|
| Rate for Payer: Meridian Medicaid |
$480.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$981.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.36
|
| Rate for Payer: Nomi Health Commercial |
$1,791.57
|
| Rate for Payer: PACE Medicare |
$810.47
|
| Rate for Payer: PACE SWMI |
$853.13
|
| Rate for Payer: PHP Commercial |
$578.36
|
| Rate for Payer: PHP Medicare Advantage |
$853.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,681.40
|
| Rate for Payer: Priority Health Medicare |
$853.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,145.12
|
| Rate for Payer: Priority Health SBD |
$428.66
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.08
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.13
|
| Rate for Payer: UHC Exchange |
$503.51
|
| Rate for Payer: UHC Medicare Advantage |
$853.13
|
| Rate for Payer: UHCCP Medicaid |
$480.31
|
| Rate for Payer: VA VA |
$853.13
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
IP
|
$680.42
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$428.66 |
| Max. Negotiated Rate |
$612.38 |
| Rate for Payer: Aetna Commercial |
$578.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.27
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cofinity Commercial |
$476.29
|
| Rate for Payer: Cofinity Commercial |
$585.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.34
|
| Rate for Payer: Healthscope Commercial |
$612.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.36
|
| Rate for Payer: PHP Commercial |
$578.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.27
|
| Rate for Payer: Priority Health SBD |
$428.66
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
IP
|
$236.55
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$149.03 |
| Max. Negotiated Rate |
$212.90 |
| Rate for Payer: Aetna Commercial |
$201.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.76
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cofinity Commercial |
$165.58
|
| Rate for Payer: Cofinity Commercial |
$203.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.24
|
| Rate for Payer: Healthscope Commercial |
$212.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.07
|
| Rate for Payer: PHP Commercial |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.76
|
| Rate for Payer: Priority Health SBD |
$149.03
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
OP
|
$236.55
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.51 |
| Max. Negotiated Rate |
$216.92 |
| Rate for Payer: Aetna Commercial |
$201.07
|
| Rate for Payer: Aetna Medicare |
$150.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.76
|
| Rate for Payer: BCBS Complete |
$81.39
|
| Rate for Payer: BCBS MAPPO |
$144.61
|
| Rate for Payer: BCBS Trust/PPO |
$128.02
|
| Rate for Payer: BCN Commercial |
$128.02
|
| Rate for Payer: BCN Medicare Advantage |
$144.61
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cofinity Commercial |
$203.43
|
| Rate for Payer: Cofinity Commercial |
$165.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.61
|
| Rate for Payer: Healthscope Commercial |
$212.90
|
| Rate for Payer: Mclaren Medicaid |
$77.51
|
| Rate for Payer: Mclaren Medicare |
$144.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.84
|
| Rate for Payer: Meridian Medicaid |
$81.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.07
|
| Rate for Payer: Nomi Health Commercial |
$216.92
|
| Rate for Payer: PACE Medicare |
$137.38
|
| Rate for Payer: PACE SWMI |
$144.61
|
| Rate for Payer: PHP Commercial |
$201.07
|
| Rate for Payer: PHP Medicare Advantage |
$144.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.61
|
| Rate for Payer: Priority Health Medicare |
$144.61
|
| Rate for Payer: Priority Health Narrow Network |
$115.69
|
| Rate for Payer: Priority Health SBD |
$149.03
|
| Rate for Payer: Railroad Medicare Medicare |
$144.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.61
|
| Rate for Payer: UHC Medicare Advantage |
$144.61
|
| Rate for Payer: UHCCP Medicaid |
$81.42
|
| Rate for Payer: VA VA |
$144.61
|
|
|
HC CHROMATIN DNP
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200432
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$15.88
|
| Rate for Payer: BCN Commercial |
$15.88
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$10.09
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC CHROMATIN DNP
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200432
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.16 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
|
