|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.55 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.44
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health SBD |
$59.55
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$59.55
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$34.98
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCN Commercial |
$4.63
|
| 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: Nomi Health Commercial |
$7.83
|
| 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 HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| 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 CORN POLLEN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORN POLLEN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCN Commercial |
$4.63
|
| 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: Nomi Health Commercial |
$7.83
|
| 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 HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| 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 CORO ANGIOS W RHC
|
Facility
|
OP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,121.74 |
| Max. Negotiated Rate |
$9,904.74 |
| Rate for Payer: Aetna Commercial |
$7,619.75
|
| Rate for Payer: Aetna Medicare |
$3,277.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,826.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,573.45
|
| Rate for Payer: BCN Commercial |
$3,573.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$6,275.09
|
| Rate for Payer: Cofinity Commercial |
$7,709.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,275.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$8,067.97
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$6,617.88
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$7,619.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,904.74
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$7,923.79
|
| Rate for Payer: Priority Health SBD |
$5,647.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.74
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$7,322.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,774.22
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,647.58 |
| Max. Negotiated Rate |
$8,067.97 |
| Rate for Payer: Aetna Commercial |
$7,619.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,826.87
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$6,275.09
|
| Rate for Payer: Cofinity Commercial |
$7,709.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,275.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Healthscope Commercial |
$8,067.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: PHP Commercial |
$7,619.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health SBD |
$5,647.58
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,480.52 |
| Max. Negotiated Rate |
$6,400.75 |
| Rate for Payer: Aetna Commercial |
$6,045.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,622.76
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$4,978.36
|
| Rate for Payer: Cofinity Commercial |
$6,116.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,978.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Healthscope Commercial |
$6,400.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: PHP Commercial |
$6,045.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health SBD |
$4,480.52
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$9,904.74 |
| Rate for Payer: Aetna Commercial |
$6,045.15
|
| Rate for Payer: Aetna Medicare |
$3,277.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,622.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,851.06
|
| Rate for Payer: BCN Commercial |
$3,851.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$4,978.36
|
| Rate for Payer: Cofinity Commercial |
$6,116.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,978.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$6,400.75
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$6,617.88
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$6,045.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,904.74
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$7,923.79
|
| Rate for Payer: Priority Health SBD |
$4,480.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,223.44
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$7,322.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,774.22
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,756.73 |
| Max. Negotiated Rate |
$6,795.33 |
| Rate for Payer: Aetna Commercial |
$6,417.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,907.74
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$5,285.26
|
| Rate for Payer: Cofinity Commercial |
$6,493.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,285.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Healthscope Commercial |
$6,795.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: PHP Commercial |
$6,417.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health SBD |
$4,756.73
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$900.56 |
| Max. Negotiated Rate |
$9,904.74 |
| Rate for Payer: Aetna Commercial |
$6,417.81
|
| Rate for Payer: Aetna Medicare |
$3,277.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,907.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,920.77
|
| Rate for Payer: BCN Commercial |
$2,920.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$5,285.26
|
| Rate for Payer: Cofinity Commercial |
$6,493.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,285.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$6,795.33
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,617.88
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$6,417.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,904.74
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$7,923.79
|
| Rate for Payer: Priority Health SBD |
$4,756.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$900.56
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$7,322.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,774.22
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$3,992.60 |
| Max. Negotiated Rate |
$5,703.71 |
| Rate for Payer: Aetna Commercial |
$5,386.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,119.35
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$4,436.22
|
| Rate for Payer: Cofinity Commercial |
$5,450.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,436.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Healthscope Commercial |
$5,703.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: PHP Commercial |
$5,386.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: Priority Health SBD |
$3,992.60
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$983.75 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.98
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,093.06
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,093.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health SBD |
$983.75
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna Medicare |
$780.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.98
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,093.06
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,093.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health SBD |
$983.75
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,004.57 |
| Max. Negotiated Rate |
$10,006.52 |
| Rate for Payer: Aetna Commercial |
$9,450.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,226.93
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$7,782.85
|
| Rate for Payer: Cofinity Commercial |
$9,561.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,782.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Healthscope Commercial |
$10,006.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: PHP Commercial |
$9,450.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: Priority Health SBD |
$7,004.57
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,447.34 |
| Max. Negotiated Rate |
$10,006.52 |
| Rate for Payer: Aetna Commercial |
$9,450.61
|
| Rate for Payer: Aetna Medicare |
$5,559.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,226.93
|
| Rate for Payer: BCBS Complete |
$4,447.34
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$7,782.85
|
| Rate for Payer: Cofinity Commercial |
$9,561.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,782.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Healthscope Commercial |
$10,006.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: PHP Commercial |
$9,450.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: Priority Health SBD |
$7,004.57
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$166.85 |
| Max. Negotiated Rate |
$3,657.56 |
| Rate for Payer: Aetna Commercial |
$3,454.37
|
| Rate for Payer: Aetna Medicare |
$2,031.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.57
|
| Rate for Payer: BCBS Complete |
$1,625.58
|
| Rate for Payer: BCBS Trust/PPO |
$166.85
|
| Rate for Payer: BCN Commercial |
$166.85
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,495.01
|
| Rate for Payer: Cofinity Commercial |
$2,844.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,844.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Healthscope Commercial |
$3,657.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: PHP Commercial |
$3,454.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: Priority Health SBD |
$2,560.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.48
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$940.00
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,560.29 |
| Max. Negotiated Rate |
$3,657.56 |
| Rate for Payer: Aetna Commercial |
$3,454.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.57
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$2,844.77
|
| Rate for Payer: Cofinity Commercial |
$3,495.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,844.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Healthscope Commercial |
$3,657.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: PHP Commercial |
$3,454.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: Priority Health SBD |
$2,560.29
|
|
|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$335.94 |
| Max. Negotiated Rate |
$3,132.99 |
| Rate for Payer: Aetna Commercial |
$1,827.93
|
| Rate for Payer: Aetna Medicare |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$751.60
|
| Rate for Payer: BCN Commercial |
$751.60
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$1,849.44
|
| Rate for Payer: Cofinity Commercial |
$1,505.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,505.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$1,935.46
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$1,827.93
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$1,354.82
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$1,591.38
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$561.21
|
| Rate for Payer: VA VA |
$996.82
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,354.82 |
| Max. Negotiated Rate |
$1,935.46 |
| Rate for Payer: Aetna Commercial |
$1,827.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.83
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$1,505.36
|
| Rate for Payer: Cofinity Commercial |
$1,849.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,505.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Healthscope Commercial |
$1,935.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: PHP Commercial |
$1,827.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: Priority Health SBD |
$1,354.82
|
|
|
HC CORTICOL SALIVA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.44
|
| Rate for Payer: BCN Commercial |
$14.44
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$13.42
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$20.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$9.18
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTICOL SALIVA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
|
