|
HC COVERED STENT GRAFT
|
Facility
|
IP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,110.71 |
| Max. Negotiated Rate |
$5,872.45 |
| Rate for Payer: Aetna Commercial |
$5,546.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.21
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$4,567.46
|
| Rate for Payer: Cofinity Commercial |
$5,611.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: PHP Commercial |
$5,546.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health SBD |
$4,110.71
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,609.98 |
| Max. Negotiated Rate |
$5,872.45 |
| Rate for Payer: Aetna Commercial |
$5,546.20
|
| Rate for Payer: Aetna Medicare |
$3,262.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.21
|
| Rate for Payer: BCBS Complete |
$2,609.98
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$4,567.46
|
| Rate for Payer: Cofinity Commercial |
$5,611.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: PHP Commercial |
$5,546.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health SBD |
$4,110.71
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health SBD |
$44.57
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$118.59 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.13
|
| Rate for Payer: UHC Medicare Advantage |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$23.72
|
| Rate for Payer: VA VA |
$42.13
|
|
|
HC COVID 19 PCR
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.66 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health SBD |
$78.66
|
|
|
HC COVID 19 PCR
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$144.43 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$78.66
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$28.89
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$144.43 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Cofinity Commercial |
$105.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$95.04
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$28.89
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$95.04 |
| Max. Negotiated Rate |
$135.77 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.06
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health SBD |
$95.04
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.45 |
| Max. Negotiated Rate |
$401.49 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$80.27
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$76.45
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$80.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.69
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.63
|
| Rate for Payer: UHC Medicare Advantage |
$142.63
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
| Rate for Payer: VA VA |
$142.63
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$160.59 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.69
|
| Rate for Payer: Priority Health SBD |
$160.59
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.53 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: Priority Health SBD |
$27.53
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.15
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.12
|
| Rate for Payer: BCN Medicare Advantage |
$12.12
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.12
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Mclaren Medicaid |
$6.50
|
| Rate for Payer: Mclaren Medicare |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.73
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: PACE Medicare |
$11.51
|
| Rate for Payer: PACE SWMI |
$12.12
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$12.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: Priority Health Medicare |
$12.12
|
| Rate for Payer: Priority Health SBD |
$27.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.12
|
| Rate for Payer: UHC Medicare Advantage |
$12.12
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: VA VA |
$12.12
|
|
|
HC COXSACKIE A AB CMPT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200266
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$36.68 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC COXSACKIE A AB CMPT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200266
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC COXSACKIE B AB CMPT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC COXSACKIE B AB CMPT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$36.68 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$58.58 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.81
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$11.72
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.59 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health SBD |
$23.59
|
|
|
HC CPK
|
Facility
|
IP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.55 |
| Max. Negotiated Rate |
$47.93 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.62
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$37.28
|
| Rate for Payer: Cofinity Commercial |
$45.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Healthscope Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: PHP Commercial |
$45.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: Priority Health SBD |
$33.55
|
|
|
HC CPK
|
Facility
|
OP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$47.93 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$6.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.14
|
| Rate for Payer: BCBS Complete |
$3.66
|
| Rate for Payer: BCBS MAPPO |
$6.51
|
| Rate for Payer: BCN Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$45.80
|
| Rate for Payer: Cofinity Commercial |
$37.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.51
|
| Rate for Payer: Healthscope Commercial |
$47.93
|
| Rate for Payer: Mclaren Medicaid |
$3.49
|
| Rate for Payer: Mclaren Medicare |
$6.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.84
|
| Rate for Payer: Meridian Medicaid |
$3.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: PACE Medicare |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.51
|
| Rate for Payer: PHP Commercial |
$45.27
|
| Rate for Payer: PHP Medicare Advantage |
$6.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health SBD |
$33.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.51
|
| Rate for Payer: UHC Medicare Advantage |
$6.51
|
| Rate for Payer: UHCCP Medicaid |
$3.67
|
| Rate for Payer: VA VA |
$6.51
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
OP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.99 |
| Max. Negotiated Rate |
$441.09 |
| Rate for Payer: Aetna Commercial |
$350.45
|
| Rate for Payer: Aetna Medicare |
$162.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$354.57
|
| Rate for Payer: Cofinity Commercial |
$288.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$371.06
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$350.45
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health SBD |
$259.74
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$88.22
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
IP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$259.74 |
| Max. Negotiated Rate |
$371.06 |
| Rate for Payer: Aetna Commercial |
$350.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.99
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$288.60
|
| Rate for Payer: Cofinity Commercial |
$354.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Healthscope Commercial |
$371.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: PHP Commercial |
$350.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: Priority Health SBD |
$259.74
|
|
|
HC CPR
|
Facility
|
OP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$882.01 |
| Rate for Payer: Aetna Commercial |
$833.01
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$842.81
|
| Rate for Payer: Cofinity Commercial |
$686.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$882.01
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$833.01
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$617.41
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$170.98
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC CPR
|
Facility
|
IP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$617.41 |
| Max. Negotiated Rate |
$882.01 |
| Rate for Payer: Aetna Commercial |
$833.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.01
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$686.01
|
| Rate for Payer: Cofinity Commercial |
$842.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Healthscope Commercial |
$882.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: PHP Commercial |
$833.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: Priority Health SBD |
$617.41
|
|
|
HC CRAB IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
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
|
|
