|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$390.63
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$100.20 |
| Max. Negotiated Rate |
$992.77 |
| Rate for Payer: Aetna Commercial |
$332.04
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS Trust/PPO |
$419.49
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: Cash Price |
$312.50
|
| Rate for Payer: Cash Price |
$312.50
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Cofinity Commercial |
$273.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Healthscope Commercial |
$351.57
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$332.04
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PHP Commercial |
$332.04
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health SBD |
$246.10
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Exchange |
$100.20
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: VA VA |
$301.34
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$390.63
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$246.10 |
| Max. Negotiated Rate |
$351.57 |
| Rate for Payer: Aetna Commercial |
$332.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.91
|
| Rate for Payer: Cash Price |
$312.50
|
| Rate for Payer: Cofinity Commercial |
$273.44
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Healthscope Commercial |
$351.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$332.04
|
| Rate for Payer: PHP Commercial |
$332.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.44
|
| Rate for Payer: Priority Health SBD |
$246.10
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.43 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health SBD |
$38.43
|
|
|
HC IBD DIFF
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$9.44
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$38.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.43 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health SBD |
$38.43
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$9.44
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$38.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.91 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health SBD |
$35.91
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$7.04
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$9.60
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Mclaren Medicaid |
$6.70
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Medicaid |
$7.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health SBD |
$35.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$20.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Exchange |
$12.25
|
| Rate for Payer: UHC Medicare Advantage |
$12.62
|
| Rate for Payer: VA VA |
$12.25
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$24,480.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$879.18 |
| Max. Negotiated Rate |
$36,591.72 |
| Rate for Payer: Aetna Commercial |
$20,808.00
|
| Rate for Payer: Aetna Medicare |
$30,444.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,912.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,591.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,591.72
|
| Rate for Payer: BCBS Complete |
$16,814.63
|
| Rate for Payer: BCBS MAPPO |
$29,273.38
|
| Rate for Payer: BCBS Trust/PPO |
$21,199.97
|
| Rate for Payer: BCN Medicare Advantage |
$29,273.38
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cofinity Commercial |
$17,136.00
|
| Rate for Payer: Cofinity Commercial |
$21,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,273.38
|
| Rate for Payer: Healthscope Commercial |
$22,032.00
|
| Rate for Payer: Mclaren Medicaid |
$16,012.54
|
| Rate for Payer: Mclaren Medicare |
$29,273.38
|
| Rate for Payer: Meridian Medicaid |
$16,814.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,737.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,664.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,808.00
|
| Rate for Payer: PACE Medicare |
$27,809.71
|
| Rate for Payer: PACE SWMI |
$29,273.38
|
| Rate for Payer: PHP Commercial |
$20,808.00
|
| Rate for Payer: PHP Medicare Advantage |
$29,273.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,012.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,136.00
|
| Rate for Payer: Priority Health Medicare |
$29,273.38
|
| Rate for Payer: Priority Health SBD |
$15,422.40
|
| Rate for Payer: Railroad Medicare Medicare |
$29,273.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.10
|
| Rate for Payer: UHC Core |
$15,010.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,273.38
|
| Rate for Payer: UHC Exchange |
$879.18
|
| Rate for Payer: UHC Medicare Advantage |
$30,151.58
|
| Rate for Payer: VA VA |
$29,273.38
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$24,480.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,422.40 |
| Max. Negotiated Rate |
$22,032.00 |
| Rate for Payer: Aetna Commercial |
$20,808.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,912.00
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cofinity Commercial |
$17,136.00
|
| Rate for Payer: Cofinity Commercial |
$21,052.80
|
| Rate for Payer: Healthscope Commercial |
$22,032.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,808.00
|
| Rate for Payer: PHP Commercial |
$20,808.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,136.00
|
| Rate for Payer: Priority Health SBD |
$15,422.40
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,220.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,068.60 |
| Max. Negotiated Rate |
$10,098.00 |
| Rate for Payer: Aetna Commercial |
$9,537.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,293.00
|
| Rate for Payer: Cash Price |
$8,976.00
|
| Rate for Payer: Cofinity Commercial |
$9,649.20
|
| Rate for Payer: Cofinity Commercial |
$7,854.00
|
| Rate for Payer: Healthscope Commercial |
$10,098.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,537.00
|
| Rate for Payer: PHP Commercial |
$9,537.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,854.00
|
| Rate for Payer: Priority Health SBD |
$7,068.60
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,220.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$356.26 |
| Max. Negotiated Rate |
$71,799.35 |
| Rate for Payer: Aetna Commercial |
$9,537.00
|
| Rate for Payer: Aetna Medicare |
$21,812.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,293.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,217.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,217.10
|
| Rate for Payer: BCBS Complete |
$12,047.28
|
| Rate for Payer: BCBS MAPPO |
$20,973.68
|
| Rate for Payer: BCBS Trust/PPO |
$19,582.92
|
| Rate for Payer: BCN Medicare Advantage |
$20,973.68
|
| Rate for Payer: Cash Price |
$8,976.00
|
| Rate for Payer: Cash Price |
$8,976.00
|
| Rate for Payer: Cofinity Commercial |
$7,854.00
|
| Rate for Payer: Cofinity Commercial |
$9,649.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,973.68
|
| Rate for Payer: Healthscope Commercial |
$10,098.00
|
| Rate for Payer: Mclaren Medicaid |
$11,472.60
|
| Rate for Payer: Mclaren Medicare |
$20,973.68
|
| Rate for Payer: Meridian Medicaid |
$12,047.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,022.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,119.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,537.00
|
| Rate for Payer: PACE Medicare |
$19,925.00
|
| Rate for Payer: PACE SWMI |
$20,973.68
|
| Rate for Payer: PHP Commercial |
$9,537.00
|
| Rate for Payer: PHP Medicare Advantage |
$20,973.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,472.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71,799.35
|
| Rate for Payer: Priority Health Medicare |
$20,973.68
|
| Rate for Payer: Priority Health Narrow Network |
$57,439.48
|
| Rate for Payer: Priority Health SBD |
$7,068.60
|
| Rate for Payer: Railroad Medicare Medicare |
$20,973.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.89
|
| Rate for Payer: UHC Core |
$15,010.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,973.68
|
| Rate for Payer: UHC Exchange |
$356.26
|
| Rate for Payer: UHC Medicare Advantage |
$21,602.89
|
| Rate for Payer: VA VA |
$20,973.68
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,664.59
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,678.69 |
| Max. Negotiated Rate |
$2,398.13 |
| Rate for Payer: Aetna Commercial |
$2,264.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,731.98
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cofinity Commercial |
$1,865.21
|
| Rate for Payer: Cofinity Commercial |
$2,291.55
|
| Rate for Payer: Healthscope Commercial |
$2,398.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,264.90
|
| Rate for Payer: PHP Commercial |
$2,264.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,865.21
|
| Rate for Payer: Priority Health SBD |
$1,678.69
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,664.59
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$833.01 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Commercial |
$2,264.90
|
| Rate for Payer: Aetna Medicare |
$3,633.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,731.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,367.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,367.78
|
| Rate for Payer: BCBS Complete |
$2,007.08
|
| Rate for Payer: BCBS MAPPO |
$3,494.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,332.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,494.22
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cofinity Commercial |
$1,865.21
|
| Rate for Payer: Cofinity Commercial |
$2,291.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,494.22
|
| Rate for Payer: Healthscope Commercial |
$2,398.13
|
| Rate for Payer: Mclaren Medicaid |
$1,911.34
|
| Rate for Payer: Mclaren Medicare |
$3,494.22
|
| Rate for Payer: Meridian Medicaid |
$2,007.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,668.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,018.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,264.90
|
| Rate for Payer: PACE Medicare |
$3,319.51
|
| Rate for Payer: PACE SWMI |
$3,494.22
|
| Rate for Payer: PHP Commercial |
$2,264.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,494.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,865.21
|
| Rate for Payer: Priority Health Medicare |
$3,494.22
|
| Rate for Payer: Priority Health SBD |
$1,678.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,494.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.31
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,494.22
|
| Rate for Payer: UHC Exchange |
$833.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,599.05
|
| Rate for Payer: VA VA |
$3,494.22
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,102.18
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$395.88 |
| Max. Negotiated Rate |
$5,332.95 |
| Rate for Payer: Aetna Commercial |
$2,636.85
|
| Rate for Payer: Aetna Medicare |
$1,687.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,016.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,028.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,028.30
|
| Rate for Payer: BCBS Complete |
$932.04
|
| Rate for Payer: BCBS MAPPO |
$1,622.64
|
| Rate for Payer: BCBS Trust/PPO |
$781.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,622.64
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cofinity Commercial |
$2,171.53
|
| Rate for Payer: Cofinity Commercial |
$2,667.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,622.64
|
| Rate for Payer: Healthscope Commercial |
$2,791.96
|
| Rate for Payer: Mclaren Medicaid |
$887.58
|
| Rate for Payer: Mclaren Medicare |
$1,622.64
|
| Rate for Payer: Meridian Medicaid |
$932.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,703.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,866.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,636.85
|
| Rate for Payer: PACE Medicare |
$1,541.51
|
| Rate for Payer: PACE SWMI |
$1,622.64
|
| Rate for Payer: PHP Commercial |
$2,636.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,622.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,332.95
|
| Rate for Payer: Priority Health Medicare |
$1,622.64
|
| Rate for Payer: Priority Health Narrow Network |
$4,266.36
|
| Rate for Payer: Priority Health SBD |
$1,954.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,622.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.47
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,622.64
|
| Rate for Payer: UHC Exchange |
$395.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,671.32
|
| Rate for Payer: VA VA |
$1,622.64
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,102.18
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,954.37 |
| Max. Negotiated Rate |
$2,791.96 |
| Rate for Payer: Aetna Commercial |
$2,636.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,016.42
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cofinity Commercial |
$2,171.53
|
| Rate for Payer: Cofinity Commercial |
$2,667.87
|
| Rate for Payer: Healthscope Commercial |
$2,791.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,636.85
|
| Rate for Payer: PHP Commercial |
$2,636.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.53
|
| Rate for Payer: Priority Health SBD |
$1,954.37
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$17,340.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,924.20 |
| Max. Negotiated Rate |
$15,606.00 |
| Rate for Payer: Aetna Commercial |
$14,739.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,271.00
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cofinity Commercial |
$12,138.00
|
| Rate for Payer: Cofinity Commercial |
$14,912.40
|
| Rate for Payer: Healthscope Commercial |
$15,606.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,739.00
|
| Rate for Payer: PHP Commercial |
$14,739.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,138.00
|
| Rate for Payer: Priority Health SBD |
$10,924.20
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$17,340.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$879.18 |
| Max. Negotiated Rate |
$36,591.72 |
| Rate for Payer: Aetna Commercial |
$14,739.00
|
| Rate for Payer: Aetna Medicare |
$30,444.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,271.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,591.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,591.72
|
| Rate for Payer: BCBS Complete |
$16,814.63
|
| Rate for Payer: BCBS MAPPO |
$29,273.38
|
| Rate for Payer: BCBS Trust/PPO |
$21,199.97
|
| Rate for Payer: BCN Medicare Advantage |
$29,273.38
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cofinity Commercial |
$14,912.40
|
| Rate for Payer: Cofinity Commercial |
$12,138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,273.38
|
| Rate for Payer: Healthscope Commercial |
$15,606.00
|
| Rate for Payer: Mclaren Medicaid |
$16,012.54
|
| Rate for Payer: Mclaren Medicare |
$29,273.38
|
| Rate for Payer: Meridian Medicaid |
$16,814.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,737.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,664.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,739.00
|
| Rate for Payer: PACE Medicare |
$27,809.71
|
| Rate for Payer: PACE SWMI |
$29,273.38
|
| Rate for Payer: PHP Commercial |
$14,739.00
|
| Rate for Payer: PHP Medicare Advantage |
$29,273.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,012.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,138.00
|
| Rate for Payer: Priority Health Medicare |
$29,273.38
|
| Rate for Payer: Priority Health SBD |
$10,924.20
|
| Rate for Payer: Railroad Medicare Medicare |
$29,273.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.10
|
| Rate for Payer: UHC Core |
$15,010.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,273.38
|
| Rate for Payer: UHC Exchange |
$879.18
|
| Rate for Payer: UHC Medicare Advantage |
$30,151.58
|
| Rate for Payer: VA VA |
$29,273.38
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$1,957.50
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$783.00 |
| Max. Negotiated Rate |
$1,761.75 |
| Rate for Payer: Aetna Commercial |
$1,663.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.38
|
| Rate for Payer: BCBS Complete |
$783.00
|
| Rate for Payer: Cash Price |
$1,566.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.25
|
| Rate for Payer: Cofinity Commercial |
$1,683.45
|
| Rate for Payer: Healthscope Commercial |
$1,761.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,663.88
|
| Rate for Payer: PHP Commercial |
$1,663.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.25
|
| Rate for Payer: Priority Health SBD |
$1,233.22
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$1,957.50
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.22 |
| Max. Negotiated Rate |
$1,761.75 |
| Rate for Payer: Aetna Commercial |
$1,663.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.38
|
| Rate for Payer: Cash Price |
$1,566.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.25
|
| Rate for Payer: Cofinity Commercial |
$1,683.45
|
| Rate for Payer: Healthscope Commercial |
$1,761.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,663.88
|
| Rate for Payer: PHP Commercial |
$1,663.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.25
|
| Rate for Payer: Priority Health SBD |
$1,233.22
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$253.98
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.99 |
| Max. Negotiated Rate |
$228.58 |
| Rate for Payer: Aetna Commercial |
$215.88
|
| Rate for Payer: Aetna Medicare |
$184.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.64
|
| Rate for Payer: BCBS Complete |
$101.85
|
| Rate for Payer: BCBS MAPPO |
$177.31
|
| Rate for Payer: BCBS Trust/PPO |
$111.35
|
| Rate for Payer: BCN Medicare Advantage |
$177.31
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$177.79
|
| Rate for Payer: Cofinity Commercial |
$218.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.31
|
| Rate for Payer: Healthscope Commercial |
$228.58
|
| Rate for Payer: Mclaren Medicaid |
$96.99
|
| Rate for Payer: Mclaren Medicare |
$177.31
|
| Rate for Payer: Meridian Medicaid |
$101.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.88
|
| Rate for Payer: PACE Medicare |
$168.44
|
| Rate for Payer: PACE SWMI |
$177.31
|
| Rate for Payer: PHP Commercial |
$215.88
|
| Rate for Payer: PHP Medicare Advantage |
$177.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.79
|
| Rate for Payer: Priority Health Medicare |
$177.31
|
| Rate for Payer: Priority Health SBD |
$160.01
|
| Rate for Payer: Railroad Medicare Medicare |
$177.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.31
|
| Rate for Payer: UHC Exchange |
$109.69
|
| Rate for Payer: UHC Medicare Advantage |
$182.63
|
| Rate for Payer: VA VA |
$177.31
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$253.98
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.01 |
| Max. Negotiated Rate |
$228.58 |
| Rate for Payer: Aetna Commercial |
$215.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.09
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$177.79
|
| Rate for Payer: Cofinity Commercial |
$218.42
|
| Rate for Payer: Healthscope Commercial |
$228.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.88
|
| Rate for Payer: PHP Commercial |
$215.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.79
|
| Rate for Payer: Priority Health SBD |
$160.01
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.44 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.88
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health SBD |
$18.44
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$4.06
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.88
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$18.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Core |
$8.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$525.01
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$472.51 |
| Rate for Payer: Aetna Commercial |
$446.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.26
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.01
|
| Rate for Payer: Cofinity Commercial |
$367.51
|
| Rate for Payer: Cofinity Commercial |
$451.51
|
| Rate for Payer: Healthscope Commercial |
$472.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.26
|
| Rate for Payer: PHP Commercial |
$446.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.51
|
| Rate for Payer: Priority Health SBD |
$330.76
|
|
