|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.51 |
| Max. Negotiated Rate |
$206.44 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.10
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$160.57
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health SBD |
$144.51
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$404.64 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Cofinity Commercial |
$160.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health SBD |
$144.51
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$80.93
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$148.13 |
| Max. Negotiated Rate |
$211.62 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.83
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$164.59
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health SBD |
$148.13
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$404.64 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Cofinity Commercial |
$164.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health SBD |
$148.13
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$80.93
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.26 |
| Max. Negotiated Rate |
$353.24 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna Medicare |
$130.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.86
|
| Rate for Payer: BCBS Complete |
$70.63
|
| Rate for Payer: BCBS MAPPO |
$125.49
|
| Rate for Payer: BCN Medicare Advantage |
$125.49
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Cofinity Commercial |
$143.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.49
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Mclaren Medicaid |
$67.26
|
| Rate for Payer: Mclaren Medicare |
$125.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.76
|
| Rate for Payer: Meridian Medicaid |
$70.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: PACE Medicare |
$119.22
|
| Rate for Payer: PACE SWMI |
$125.49
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: PHP Medicare Advantage |
$125.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health Medicare |
$125.49
|
| Rate for Payer: Priority Health SBD |
$129.33
|
| Rate for Payer: Railroad Medicare Medicare |
$125.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.49
|
| Rate for Payer: UHC Medicare Advantage |
$125.49
|
| Rate for Payer: UHCCP Medicaid |
$70.65
|
| Rate for Payer: VA VA |
$125.49
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.33 |
| Max. Negotiated Rate |
$184.75 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.43
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$143.70
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health SBD |
$129.33
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.56 |
| Max. Negotiated Rate |
$423.08 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$156.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.88
|
| Rate for Payer: BCBS Complete |
$84.59
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Cofinity Commercial |
$213.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Mclaren Medicaid |
$80.56
|
| Rate for Payer: Mclaren Medicare |
$150.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.81
|
| Rate for Payer: Meridian Medicaid |
$84.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: PACE Medicare |
$142.78
|
| Rate for Payer: PACE SWMI |
$150.30
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health SBD |
$192.05
|
| Rate for Payer: Railroad Medicare Medicare |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$150.30
|
| Rate for Payer: UHCCP Medicaid |
$84.62
|
| Rate for Payer: VA VA |
$150.30
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$192.05 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health SBD |
$192.05
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,741.75 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.05
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$1,935.28
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,935.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health SBD |
$1,741.75
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,105.88 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna Medicare |
$1,382.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.05
|
| Rate for Payer: BCBS Complete |
$1,105.88
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$1,935.28
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,935.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health SBD |
$1,741.75
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Cofinity Commercial |
$1,900.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,900.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,710.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,124.80
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
IP
|
$2,715.06
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,710.49 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.79
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$1,900.54
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,900.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health SBD |
$1,710.49
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
OP
|
$2,764.69
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Cofinity Commercial |
$1,935.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,935.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,741.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,124.80
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
IP
|
$2,764.69
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,741.75 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.05
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$1,935.28
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,935.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health SBD |
$1,741.75
|
|
|
HC CITRIC ACID URINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.90 |
| Max. Negotiated Rate |
$78.25 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$28.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.75
|
| Rate for Payer: BCBS Complete |
$15.65
|
| Rate for Payer: BCBS MAPPO |
$27.80
|
| Rate for Payer: BCN Medicare Advantage |
$27.80
|
| 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 |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$14.90
|
| Rate for Payer: Mclaren Medicare |
$27.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.19
|
| Rate for Payer: Meridian Medicaid |
$15.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PACE Medicare |
$26.41
|
| Rate for Payer: PACE SWMI |
$27.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$27.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$27.80
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.80
|
| Rate for Payer: UHC Medicare Advantage |
$27.80
|
| Rate for Payer: UHCCP Medicaid |
$15.65
|
| Rate for Payer: VA VA |
$27.80
|
|
|
HC CITRIC ACID URINE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| 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 CK-MB FRACTION
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.23 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health SBD |
$64.23
|
|
|
HC CK-MB FRACTION
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.19 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$12.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.44
|
| Rate for Payer: BCBS Complete |
$6.50
|
| Rate for Payer: BCBS MAPPO |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$11.55
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.55
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Mclaren Medicaid |
$6.19
|
| Rate for Payer: Mclaren Medicare |
$11.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.13
|
| Rate for Payer: Meridian Medicaid |
$6.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: PACE Medicare |
$10.97
|
| Rate for Payer: PACE SWMI |
$11.55
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$11.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$11.55
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Railroad Medicare Medicare |
$11.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.55
|
| Rate for Payer: UHC Medicare Advantage |
$11.55
|
| Rate for Payer: UHCCP Medicaid |
$6.50
|
| Rate for Payer: VA VA |
$11.55
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CLAM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC CLAM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
OP
|
$791.29
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$712.16 |
| Rate for Payer: Aetna Commercial |
$672.60
|
| Rate for Payer: Aetna Medicare |
$395.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.34
|
| Rate for Payer: BCBS Complete |
$316.52
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$553.90
|
| Rate for Payer: Cofinity Commercial |
$680.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$553.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Healthscope Commercial |
$712.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: PHP Commercial |
$672.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.34
|
| Rate for Payer: Priority Health SBD |
$498.51
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
IP
|
$791.29
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$498.51 |
| Max. Negotiated Rate |
$712.16 |
| Rate for Payer: Aetna Commercial |
$672.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.34
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$553.90
|
| Rate for Payer: Cofinity Commercial |
$680.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$553.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Healthscope Commercial |
$712.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: PHP Commercial |
$672.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.34
|
| Rate for Payer: Priority Health SBD |
$498.51
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Cofinity Commercial |
$245.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$221.31
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$131.71
|
| Rate for Payer: VA VA |
$233.95
|
|
