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Service Code CPT 62321
Hospital Charge Code 36100538
Hospital Revenue Code 361
Min. Negotiated Rate $541.27
Max. Negotiated Rate $773.24
Rate for Payer: Aetna Commercial $730.29
Rate for Payer: Aetna New Business (MI Preferred) $558.45
Rate for Payer: Cash Price $687.33
Rate for Payer: Cofinity Commercial $738.88
Rate for Payer: Cofinity Commercial $601.41
Rate for Payer: Healthscope Commercial $773.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $730.29
Rate for Payer: PHP Commercial $730.29
Rate for Payer: Priority Health Cigna Priority Health $601.41
Rate for Payer: Priority Health SBD $541.27
Service Code CPT 62323
Hospital Charge Code 36100539
Hospital Revenue Code 361
Min. Negotiated Rate $568.34
Max. Negotiated Rate $811.91
Rate for Payer: Aetna Commercial $766.80
Rate for Payer: Aetna New Business (MI Preferred) $586.38
Rate for Payer: Cash Price $721.70
Rate for Payer: Cofinity Commercial $775.82
Rate for Payer: Cofinity Commercial $631.48
Rate for Payer: Healthscope Commercial $811.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $766.80
Rate for Payer: PHP Commercial $766.80
Rate for Payer: Priority Health Cigna Priority Health $631.48
Rate for Payer: Priority Health SBD $568.34
Service Code CPT 62323
Hospital Charge Code 36100539
Hospital Revenue Code 361
Min. Negotiated Rate $96.92
Max. Negotiated Rate $1,932.06
Rate for Payer: Aetna Commercial $766.80
Rate for Payer: Aetna Medicare $639.94
Rate for Payer: Aetna New Business (MI Preferred) $586.38
Rate for Payer: Allen County Amish Medical Aid Commercial $769.16
Rate for Payer: Amish Plain Church Group Commercial $769.16
Rate for Payer: BCBS Complete $353.45
Rate for Payer: BCBS MAPPO $615.33
Rate for Payer: BCBS Trust/PPO $550.13
Rate for Payer: BCN Medicare Advantage $615.33
Rate for Payer: Cash Price $721.70
Rate for Payer: Cash Price $721.70
Rate for Payer: Cofinity Commercial $775.82
Rate for Payer: Cofinity Commercial $631.48
Rate for Payer: Health Alliance Plan Medicare Advantage $615.33
Rate for Payer: Healthscope Commercial $811.91
Rate for Payer: Mclaren Medicaid $336.59
Rate for Payer: Mclaren Medicare $615.33
Rate for Payer: Meridian Medicaid $353.45
Rate for Payer: Meridian Wellcare - Medicare Advantage $646.10
Rate for Payer: MI Amish Medical Board Commercial $707.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $766.80
Rate for Payer: PACE Medicare $584.56
Rate for Payer: PACE SWMI $615.33
Rate for Payer: PHP Commercial $766.80
Rate for Payer: PHP Medicare Advantage $615.33
Rate for Payer: Priority Health Choice Medicaid $336.59
Rate for Payer: Priority Health Cigna Priority Health $631.48
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,932.06
Rate for Payer: Priority Health Medicare $615.33
Rate for Payer: Priority Health Narrow Network $1,545.65
Rate for Payer: Priority Health SBD $568.34
Rate for Payer: Railroad Medicare Medicare $615.33
Rate for Payer: UHC All Payor (Choice/PPO) $106.61
Rate for Payer: UHC Core $1,463.00
Rate for Payer: UHC Dual Complete DSNP $615.33
Rate for Payer: UHC Exchange $96.92
Rate for Payer: UHC Medicare Advantage $633.79
Rate for Payer: VA VA $615.33
Service Code CPT 20526
Hospital Charge Code 76100182
Hospital Revenue Code 761
Min. Negotiated Rate $55.67
Max. Negotiated Rate $340.78
Rate for Payer: Aetna Commercial $321.84
Rate for Payer: Aetna Medicare $274.08
Rate for Payer: Aetna New Business (MI Preferred) $246.12
Rate for Payer: Allen County Amish Medical Aid Commercial $329.42
Rate for Payer: Amish Plain Church Group Commercial $329.42
Rate for Payer: BCBS Complete $151.38
Rate for Payer: BCBS MAPPO $263.54
Rate for Payer: BCBS Trust/PPO $169.96
Rate for Payer: BCN Medicare Advantage $263.54
Rate for Payer: Cash Price $302.91
Rate for Payer: Cash Price $302.91
Rate for Payer: Cofinity Commercial $265.05
Rate for Payer: Cofinity Commercial $325.63
Rate for Payer: Health Alliance Plan Medicare Advantage $263.54
Rate for Payer: Healthscope Commercial $340.78
Rate for Payer: Mclaren Medicaid $144.16
Rate for Payer: Mclaren Medicare $263.54
Rate for Payer: Meridian Medicaid $151.38
Rate for Payer: Meridian Wellcare - Medicare Advantage $276.72
Rate for Payer: MI Amish Medical Board Commercial $303.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $321.84
Rate for Payer: PACE Medicare $250.36
Rate for Payer: PACE SWMI $263.54
Rate for Payer: PHP Commercial $321.84
Rate for Payer: PHP Medicare Advantage $263.54
Rate for Payer: Priority Health Choice Medicaid $144.16
Rate for Payer: Priority Health Cigna Priority Health $265.05
Rate for Payer: Priority Health Medicare $263.54
Rate for Payer: Priority Health SBD $238.54
Rate for Payer: Railroad Medicare Medicare $263.54
Rate for Payer: UHC All Payor (Choice/PPO) $61.24
Rate for Payer: UHC Dual Complete DSNP $263.54
Rate for Payer: UHC Exchange $55.67
Rate for Payer: UHC Medicare Advantage $271.45
Rate for Payer: VA VA $263.54
Service Code CPT 20526
Hospital Charge Code 76100182
Hospital Revenue Code 761
Min. Negotiated Rate $238.54
Max. Negotiated Rate $340.78
Rate for Payer: Aetna Commercial $321.84
Rate for Payer: Aetna New Business (MI Preferred) $246.12
Rate for Payer: Cash Price $302.91
Rate for Payer: Cofinity Commercial $325.63
Rate for Payer: Cofinity Commercial $265.05
Rate for Payer: Healthscope Commercial $340.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $321.84
Rate for Payer: PHP Commercial $321.84
Rate for Payer: Priority Health Cigna Priority Health $265.05
Rate for Payer: Priority Health SBD $238.54
Service Code CPT 64408
Hospital Charge Code 76100381
Hospital Revenue Code 761
Min. Negotiated Rate $43.88
Max. Negotiated Rate $684.00
Rate for Payer: Aetna Commercial $646.00
Rate for Payer: Aetna Medicare $274.08
Rate for Payer: Aetna New Business (MI Preferred) $494.00
Rate for Payer: Allen County Amish Medical Aid Commercial $329.42
Rate for Payer: Amish Plain Church Group Commercial $329.42
Rate for Payer: BCBS Complete $151.38
Rate for Payer: BCBS MAPPO $263.54
Rate for Payer: BCBS Trust/PPO $72.84
Rate for Payer: BCN Medicare Advantage $263.54
Rate for Payer: Cash Price $608.00
Rate for Payer: Cash Price $608.00
Rate for Payer: Cofinity Commercial $532.00
Rate for Payer: Cofinity Commercial $653.60
Rate for Payer: Health Alliance Plan Medicare Advantage $263.54
Rate for Payer: Healthscope Commercial $684.00
Rate for Payer: Mclaren Medicaid $144.16
Rate for Payer: Mclaren Medicare $263.54
Rate for Payer: Meridian Medicaid $151.38
Rate for Payer: Meridian Wellcare - Medicare Advantage $276.72
Rate for Payer: MI Amish Medical Board Commercial $303.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $646.00
Rate for Payer: PACE Medicare $250.36
Rate for Payer: PACE SWMI $263.54
Rate for Payer: PHP Commercial $646.00
Rate for Payer: PHP Medicare Advantage $263.54
Rate for Payer: Priority Health Choice Medicaid $144.16
Rate for Payer: Priority Health Cigna Priority Health $532.00
Rate for Payer: Priority Health Medicare $263.54
Rate for Payer: Priority Health SBD $478.80
Rate for Payer: Railroad Medicare Medicare $263.54
Rate for Payer: UHC All Payor (Choice/PPO) $48.27
Rate for Payer: UHC Dual Complete DSNP $263.54
Rate for Payer: UHC Exchange $43.88
Rate for Payer: UHC Medicare Advantage $271.45
Rate for Payer: VA VA $263.54
Service Code CPT 64408
Hospital Charge Code 76100381
Hospital Revenue Code 761
Min. Negotiated Rate $478.80
Max. Negotiated Rate $684.00
Rate for Payer: Aetna Commercial $646.00
Rate for Payer: Aetna New Business (MI Preferred) $494.00
Rate for Payer: Cash Price $608.00
Rate for Payer: Cofinity Commercial $532.00
Rate for Payer: Cofinity Commercial $653.60
Rate for Payer: Healthscope Commercial $684.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $646.00
Rate for Payer: PHP Commercial $646.00
Rate for Payer: Priority Health Cigna Priority Health $532.00
Rate for Payer: Priority Health SBD $478.80
Service Code CPT J0129
Hospital Charge Code 63600087
Hospital Revenue Code 636
Min. Negotiated Rate $1,927.80
Max. Negotiated Rate $2,754.00
Rate for Payer: Aetna Commercial $2,601.00
Rate for Payer: Aetna New Business (MI Preferred) $1,989.00
Rate for Payer: Cash Price $2,448.00
Rate for Payer: Cofinity Commercial $2,142.00
Rate for Payer: Cofinity Commercial $2,631.60
Rate for Payer: Healthscope Commercial $2,754.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $2,601.00
Rate for Payer: PHP Commercial $2,601.00
Rate for Payer: Priority Health Cigna Priority Health $2,142.00
Rate for Payer: Priority Health SBD $1,927.80
Service Code CPT J0129
Hospital Charge Code 63600087
Hospital Revenue Code 636
Min. Negotiated Rate $23.61
Max. Negotiated Rate $2,754.00
Rate for Payer: Aetna Commercial $2,601.00
Rate for Payer: Aetna Medicare $44.89
Rate for Payer: Aetna New Business (MI Preferred) $1,989.00
Rate for Payer: Allen County Amish Medical Aid Commercial $53.95
Rate for Payer: Amish Plain Church Group Commercial $53.95
Rate for Payer: BCBS Complete $24.79
Rate for Payer: BCBS MAPPO $43.16
Rate for Payer: BCBS Trust/PPO $151.56
Rate for Payer: BCN Medicare Advantage $43.16
Rate for Payer: Cash Price $2,448.00
Rate for Payer: Cash Price $2,448.00
Rate for Payer: Cofinity Commercial $2,631.60
Rate for Payer: Cofinity Commercial $2,142.00
Rate for Payer: Health Alliance Plan Medicare Advantage $43.16
Rate for Payer: Healthscope Commercial $2,754.00
Rate for Payer: Mclaren Medicaid $23.61
Rate for Payer: Mclaren Medicare $43.16
Rate for Payer: Meridian Medicaid $24.79
Rate for Payer: Meridian Wellcare - Medicare Advantage $45.32
Rate for Payer: MI Amish Medical Board Commercial $49.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $2,601.00
Rate for Payer: PACE Medicare $41.00
Rate for Payer: PACE SWMI $43.16
Rate for Payer: PHP Commercial $2,601.00
Rate for Payer: PHP Medicare Advantage $43.16
Rate for Payer: Priority Health Choice Medicaid $23.61
Rate for Payer: Priority Health Cigna Priority Health $2,142.00
Rate for Payer: Priority Health Medicare $43.16
Rate for Payer: Priority Health SBD $1,927.80
Rate for Payer: Railroad Medicare Medicare $43.16
Rate for Payer: UHC Dual Complete DSNP $43.16
Rate for Payer: UHC Medicare Advantage $44.46
Rate for Payer: VA VA $43.16
Service Code CPT J0696
Hospital Charge Code 63600088
Hospital Revenue Code 636
Min. Negotiated Rate $38.56
Max. Negotiated Rate $55.08
Rate for Payer: Aetna Commercial $52.02
Rate for Payer: Aetna New Business (MI Preferred) $39.78
Rate for Payer: Cash Price $48.96
Rate for Payer: Cofinity Commercial $52.63
Rate for Payer: Cofinity Commercial $42.84
Rate for Payer: Healthscope Commercial $55.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $52.02
Rate for Payer: PHP Commercial $52.02
Rate for Payer: Priority Health Cigna Priority Health $42.84
Rate for Payer: Priority Health SBD $38.56
Service Code CPT J0696
Hospital Charge Code 63600088
Hospital Revenue Code 636
Min. Negotiated Rate $1.45
Max. Negotiated Rate $55.08
Rate for Payer: Aetna Commercial $52.02
Rate for Payer: Aetna New Business (MI Preferred) $39.78
Rate for Payer: BCBS Complete $24.48
Rate for Payer: BCBS Trust/PPO $1.45
Rate for Payer: Cash Price $48.96
Rate for Payer: Cash Price $48.96
Rate for Payer: Cofinity Commercial $42.84
Rate for Payer: Cofinity Commercial $52.63
Rate for Payer: Healthscope Commercial $55.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $52.02
Rate for Payer: PHP Commercial $52.02
Rate for Payer: Priority Health Cigna Priority Health $42.84
Rate for Payer: Priority Health SBD $38.56
Service Code CPT J0717
Hospital Charge Code 63600090
Hospital Revenue Code 636
Min. Negotiated Rate $2.63
Max. Negotiated Rate $14.24
Rate for Payer: Aetna Commercial $8.50
Rate for Payer: Aetna Medicare $5.01
Rate for Payer: Aetna New Business (MI Preferred) $6.50
Rate for Payer: Allen County Amish Medical Aid Commercial $6.02
Rate for Payer: Amish Plain Church Group Commercial $6.02
Rate for Payer: BCBS Complete $2.77
Rate for Payer: BCBS MAPPO $4.82
Rate for Payer: BCBS Trust/PPO $14.24
Rate for Payer: BCN Medicare Advantage $4.82
Rate for Payer: Cash Price $8.00
Rate for Payer: Cash Price $8.00
Rate for Payer: Cofinity Commercial $8.60
Rate for Payer: Cofinity Commercial $7.00
Rate for Payer: Health Alliance Plan Medicare Advantage $4.82
Rate for Payer: Healthscope Commercial $9.00
Rate for Payer: Mclaren Medicaid $2.63
Rate for Payer: Mclaren Medicare $4.82
Rate for Payer: Meridian Medicaid $2.77
Rate for Payer: Meridian Wellcare - Medicare Advantage $5.06
Rate for Payer: MI Amish Medical Board Commercial $5.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $8.50
Rate for Payer: PACE Medicare $4.58
Rate for Payer: PACE SWMI $4.82
Rate for Payer: PHP Commercial $8.50
Rate for Payer: PHP Medicare Advantage $4.82
Rate for Payer: Priority Health Choice Medicaid $2.63
Rate for Payer: Priority Health Cigna Priority Health $7.00
Rate for Payer: Priority Health Medicare $4.82
Rate for Payer: Priority Health SBD $6.30
Rate for Payer: Railroad Medicare Medicare $4.82
Rate for Payer: UHC Dual Complete DSNP $4.82
Rate for Payer: UHC Medicare Advantage $4.96
Rate for Payer: VA VA $4.82
Service Code CPT J0717
Hospital Charge Code 63600090
Hospital Revenue Code 636
Min. Negotiated Rate $6.30
Max. Negotiated Rate $9.00
Rate for Payer: Aetna Commercial $8.50
Rate for Payer: Aetna New Business (MI Preferred) $6.50
Rate for Payer: Cash Price $8.00
Rate for Payer: Cofinity Commercial $7.00
Rate for Payer: Cofinity Commercial $8.60
Rate for Payer: Healthscope Commercial $9.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $8.50
Rate for Payer: PHP Commercial $8.50
Rate for Payer: Priority Health Cigna Priority Health $7.00
Rate for Payer: Priority Health SBD $6.30
Service Code CPT 62291
Hospital Charge Code 36100283
Hospital Revenue Code 361
Min. Negotiated Rate $624.41
Max. Negotiated Rate $892.02
Rate for Payer: Aetna Commercial $842.46
Rate for Payer: Aetna New Business (MI Preferred) $644.23
Rate for Payer: Cash Price $792.90
Rate for Payer: Cofinity Commercial $693.79
Rate for Payer: Cofinity Commercial $852.37
Rate for Payer: Healthscope Commercial $892.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $842.46
Rate for Payer: PHP Commercial $842.46
Rate for Payer: Priority Health Cigna Priority Health $693.79
Rate for Payer: Priority Health SBD $624.41
Service Code CPT 62291
Hospital Charge Code 36100283
Hospital Revenue Code 361
Min. Negotiated Rate $138.18
Max. Negotiated Rate $892.02
Rate for Payer: Aetna Commercial $842.46
Rate for Payer: Aetna New Business (MI Preferred) $644.23
Rate for Payer: BCBS Complete $396.45
Rate for Payer: BCBS Trust/PPO $662.62
Rate for Payer: Cash Price $792.90
Rate for Payer: Cash Price $792.90
Rate for Payer: Cofinity Commercial $852.37
Rate for Payer: Cofinity Commercial $693.79
Rate for Payer: Healthscope Commercial $892.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $842.46
Rate for Payer: PHP Commercial $842.46
Rate for Payer: Priority Health Cigna Priority Health $693.79
Rate for Payer: Priority Health SBD $624.41
Rate for Payer: UHC All Payor (Choice/PPO) $152.00
Rate for Payer: UHC Core $878.00
Rate for Payer: UHC Exchange $138.18
Service Code CPT 49424
Hospital Charge Code 36100223
Hospital Revenue Code 361
Min. Negotiated Rate $35.69
Max. Negotiated Rate $898.99
Rate for Payer: Aetna Commercial $849.05
Rate for Payer: Aetna New Business (MI Preferred) $649.27
Rate for Payer: BCBS Complete $399.55
Rate for Payer: BCBS Trust/PPO $176.45
Rate for Payer: Cash Price $799.10
Rate for Payer: Cash Price $799.10
Rate for Payer: Cofinity Commercial $859.04
Rate for Payer: Cofinity Commercial $699.22
Rate for Payer: Healthscope Commercial $898.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $849.05
Rate for Payer: PHP Commercial $849.05
Rate for Payer: Priority Health Cigna Priority Health $699.22
Rate for Payer: Priority Health SBD $629.29
Rate for Payer: UHC All Payor (Choice/PPO) $39.26
Rate for Payer: UHC Core $878.00
Rate for Payer: UHC Exchange $35.69
Service Code CPT 49424
Hospital Charge Code 36100223
Hospital Revenue Code 361
Min. Negotiated Rate $629.29
Max. Negotiated Rate $898.99
Rate for Payer: Aetna Commercial $849.05
Rate for Payer: Aetna New Business (MI Preferred) $649.27
Rate for Payer: Cash Price $799.10
Rate for Payer: Cofinity Commercial $699.22
Rate for Payer: Cofinity Commercial $859.04
Rate for Payer: Healthscope Commercial $898.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $849.05
Rate for Payer: PHP Commercial $849.05
Rate for Payer: Priority Health Cigna Priority Health $699.22
Rate for Payer: Priority Health SBD $629.29
Service Code CPT J0897
Hospital Charge Code 63600091
Hospital Revenue Code 636
Min. Negotiated Rate $15.75
Max. Negotiated Rate $22.50
Rate for Payer: Aetna Commercial $21.25
Rate for Payer: Aetna New Business (MI Preferred) $16.25
Rate for Payer: Cash Price $20.00
Rate for Payer: Cofinity Commercial $17.50
Rate for Payer: Cofinity Commercial $21.50
Rate for Payer: Healthscope Commercial $22.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $21.25
Rate for Payer: PHP Commercial $21.25
Rate for Payer: Priority Health Cigna Priority Health $17.50
Rate for Payer: Priority Health SBD $15.75
Service Code CPT J0897
Hospital Charge Code 63600091
Hospital Revenue Code 636
Min. Negotiated Rate $13.78
Max. Negotiated Rate $74.59
Rate for Payer: Aetna Commercial $21.25
Rate for Payer: Aetna Medicare $26.21
Rate for Payer: Aetna New Business (MI Preferred) $16.25
Rate for Payer: Allen County Amish Medical Aid Commercial $31.50
Rate for Payer: Amish Plain Church Group Commercial $31.50
Rate for Payer: BCBS Complete $14.47
Rate for Payer: BCBS MAPPO $25.20
Rate for Payer: BCBS Trust/PPO $74.59
Rate for Payer: BCN Medicare Advantage $25.20
Rate for Payer: Cash Price $20.00
Rate for Payer: Cash Price $20.00
Rate for Payer: Cofinity Commercial $21.50
Rate for Payer: Cofinity Commercial $17.50
Rate for Payer: Health Alliance Plan Medicare Advantage $25.20
Rate for Payer: Healthscope Commercial $22.50
Rate for Payer: Mclaren Medicaid $13.78
Rate for Payer: Mclaren Medicare $25.20
Rate for Payer: Meridian Medicaid $14.47
Rate for Payer: Meridian Wellcare - Medicare Advantage $26.46
Rate for Payer: MI Amish Medical Board Commercial $28.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $21.25
Rate for Payer: PACE Medicare $23.94
Rate for Payer: PACE SWMI $25.20
Rate for Payer: PHP Commercial $21.25
Rate for Payer: PHP Medicare Advantage $25.20
Rate for Payer: Priority Health Choice Medicaid $13.78
Rate for Payer: Priority Health Cigna Priority Health $17.50
Rate for Payer: Priority Health Medicare $25.20
Rate for Payer: Priority Health SBD $15.75
Rate for Payer: Railroad Medicare Medicare $25.20
Rate for Payer: UHC Dual Complete DSNP $25.20
Rate for Payer: UHC Medicare Advantage $25.95
Rate for Payer: VA VA $25.20
Service Code CPT J1000
Hospital Charge Code 63600092
Hospital Revenue Code 636
Min. Negotiated Rate $5.71
Max. Negotiated Rate $105.83
Rate for Payer: Aetna Commercial $12.14
Rate for Payer: Aetna New Business (MI Preferred) $9.28
Rate for Payer: BCBS Complete $5.71
Rate for Payer: BCBS Trust/PPO $105.83
Rate for Payer: Cash Price $11.42
Rate for Payer: Cash Price $11.42
Rate for Payer: Cofinity Commercial $10.00
Rate for Payer: Cofinity Commercial $12.28
Rate for Payer: Healthscope Commercial $12.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $12.14
Rate for Payer: PHP Commercial $12.14
Rate for Payer: Priority Health Cigna Priority Health $10.00
Rate for Payer: Priority Health SBD $9.00
Service Code CPT J1000
Hospital Charge Code 63600092
Hospital Revenue Code 636
Min. Negotiated Rate $9.00
Max. Negotiated Rate $12.85
Rate for Payer: Aetna Commercial $12.14
Rate for Payer: Aetna New Business (MI Preferred) $9.28
Rate for Payer: Cash Price $11.42
Rate for Payer: Cofinity Commercial $10.00
Rate for Payer: Cofinity Commercial $12.28
Rate for Payer: Healthscope Commercial $12.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $12.14
Rate for Payer: PHP Commercial $12.14
Rate for Payer: Priority Health Cigna Priority Health $10.00
Rate for Payer: Priority Health SBD $9.00
Service Code HCPCS J1200
Hospital Charge Code 63600167
Hospital Revenue Code 636
Min. Negotiated Rate $1.29
Max. Negotiated Rate $1.84
Rate for Payer: Aetna Commercial $1.73
Rate for Payer: Aetna New Business (MI Preferred) $1.33
Rate for Payer: Cash Price $1.63
Rate for Payer: Cofinity Commercial $1.43
Rate for Payer: Cofinity Commercial $1.75
Rate for Payer: Healthscope Commercial $1.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1.73
Rate for Payer: PHP Commercial $1.73
Rate for Payer: Priority Health Cigna Priority Health $1.43
Rate for Payer: Priority Health SBD $1.29
Service Code HCPCS J1200
Hospital Charge Code 63600167
Hospital Revenue Code 636
Min. Negotiated Rate $0.82
Max. Negotiated Rate $2.35
Rate for Payer: Aetna Commercial $1.73
Rate for Payer: Aetna New Business (MI Preferred) $1.33
Rate for Payer: BCBS Complete $0.82
Rate for Payer: BCBS Trust/PPO $2.35
Rate for Payer: Cash Price $1.63
Rate for Payer: Cash Price $1.63
Rate for Payer: Cofinity Commercial $1.43
Rate for Payer: Cofinity Commercial $1.75
Rate for Payer: Healthscope Commercial $1.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1.73
Rate for Payer: PHP Commercial $1.73
Rate for Payer: Priority Health Cigna Priority Health $1.43
Rate for Payer: Priority Health SBD $1.29
Service Code CPT 24220
Hospital Charge Code 36100038
Hospital Revenue Code 361
Min. Negotiated Rate $64.18
Max. Negotiated Rate $998.89
Rate for Payer: Aetna Commercial $943.40
Rate for Payer: Aetna New Business (MI Preferred) $721.42
Rate for Payer: BCBS Complete $443.95
Rate for Payer: BCBS Trust/PPO $240.24
Rate for Payer: Cash Price $887.90
Rate for Payer: Cash Price $887.90
Rate for Payer: Cofinity Commercial $776.92
Rate for Payer: Cofinity Commercial $954.50
Rate for Payer: Healthscope Commercial $998.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $943.40
Rate for Payer: PHP Commercial $943.40
Rate for Payer: Priority Health Cigna Priority Health $776.92
Rate for Payer: Priority Health SBD $699.22
Rate for Payer: UHC All Payor (Choice/PPO) $70.60
Rate for Payer: UHC Core $878.00
Rate for Payer: UHC Exchange $64.18
Service Code CPT 24220
Hospital Charge Code 36100038
Hospital Revenue Code 361
Min. Negotiated Rate $699.22
Max. Negotiated Rate $998.89
Rate for Payer: Aetna Commercial $943.40
Rate for Payer: Aetna New Business (MI Preferred) $721.42
Rate for Payer: Cash Price $887.90
Rate for Payer: Cofinity Commercial $776.92
Rate for Payer: Cofinity Commercial $954.50
Rate for Payer: Healthscope Commercial $998.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $943.40
Rate for Payer: PHP Commercial $943.40
Rate for Payer: Priority Health Cigna Priority Health $776.92
Rate for Payer: Priority Health SBD $699.22