|
HC DRAINAGE TENDON SHEATH DIGIT AND/OR PALM EACH
|
Facility
|
IP
|
$9,998.00
|
|
|
Service Code
|
CPT 26020
|
| Hospital Charge Code |
45000107
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,298.74 |
| Max. Negotiated Rate |
$8,998.20 |
| Rate for Payer: Aetna Commercial |
$8,498.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,498.70
|
| Rate for Payer: Cash Price |
$7,998.40
|
| Rate for Payer: Cofinity Advantage |
$6,998.60
|
| Rate for Payer: Cofinity Commercial |
$8,598.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,998.40
|
| Rate for Payer: Healthscope Commercial |
$8,998.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,498.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,498.50
|
| Rate for Payer: PHP Commercial |
$8,498.30
|
| Rate for Payer: Priority Health SBD |
$6,298.74
|
|
|
HC DRAINAGE TENDON SHEATH DIGIT AND/OR PALM EACH
|
Facility
|
OP
|
$9,998.00
|
|
|
Service Code
|
CPT 26020
|
| Hospital Charge Code |
45000107
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Commercial |
$8,498.30
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,498.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,395.52
|
| Rate for Payer: BCN Commercial |
$1,395.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$7,998.40
|
| Rate for Payer: Cash Price |
$7,998.40
|
| Rate for Payer: Cash Price |
$7,998.40
|
| Rate for Payer: Cofinity Advantage |
$6,998.60
|
| Rate for Payer: Cofinity Commercial |
$8,598.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,998.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$8,998.20
|
| Rate for Payer: Mclaren Medicaid |
$1,705.10
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,498.30
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,498.50
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$8,498.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$6,298.74
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$144.00
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$4,145.71
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,611.80 |
| Max. Negotiated Rate |
$3,731.14 |
| Rate for Payer: Aetna Commercial |
$3,523.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,694.71
|
| Rate for Payer: Cash Price |
$3,316.57
|
| Rate for Payer: Cofinity Advantage |
$2,902.00
|
| Rate for Payer: Cofinity Commercial |
$3,565.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.57
|
| Rate for Payer: Healthscope Commercial |
$3,731.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,109.28
|
| Rate for Payer: PHP Commercial |
$3,523.85
|
| Rate for Payer: Priority Health SBD |
$2,611.80
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$4,145.71
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$700.64 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,523.85
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,694.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$700.64
|
| Rate for Payer: BCN Commercial |
$700.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,316.57
|
| Rate for Payer: Cash Price |
$3,316.57
|
| Rate for Payer: Cash Price |
$3,316.57
|
| Rate for Payer: Cofinity Advantage |
$2,902.00
|
| Rate for Payer: Cofinity Commercial |
$3,565.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,731.14
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.85
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,109.28
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,523.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,611.80
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
OP
|
$4,176.90
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.72 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,550.36
|
| Rate for Payer: Aetna Commercial |
$5,325.55
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,072.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$126.72
|
| Rate for Payer: BCBS Trust/PPO |
$126.72
|
| Rate for Payer: BCN Commercial |
$126.72
|
| Rate for Payer: BCN Commercial |
$126.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cash Price |
$5,012.28
|
| Rate for Payer: Cash Price |
$5,012.28
|
| Rate for Payer: Cash Price |
$5,012.28
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cofinity Advantage |
$4,385.74
|
| Rate for Payer: Cofinity Advantage |
$2,923.83
|
| Rate for Payer: Cofinity Commercial |
$3,592.13
|
| Rate for Payer: Cofinity Commercial |
$5,388.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,012.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,759.21
|
| Rate for Payer: Healthscope Commercial |
$5,638.81
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,550.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,325.55
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,699.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,132.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,550.36
|
| Rate for Payer: PHP Commercial |
$5,325.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$3,947.17
|
| Rate for Payer: Priority Health SBD |
$2,631.45
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,714.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,072.48
|
| Rate for Payer: UHC Core |
$3,264.25
|
| Rate for Payer: UHC Core |
$2,176.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,462.28
|
| Rate for Payer: UHC Exchange |
$1,641.52
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
IP
|
$4,176.90
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,631.45 |
| Max. Negotiated Rate |
$3,759.21 |
| Rate for Payer: Aetna Commercial |
$3,550.36
|
| Rate for Payer: Aetna Commercial |
$5,325.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,072.48
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cash Price |
$5,012.28
|
| Rate for Payer: Cofinity Advantage |
$2,923.83
|
| Rate for Payer: Cofinity Advantage |
$4,385.74
|
| Rate for Payer: Cofinity Commercial |
$3,592.13
|
| Rate for Payer: Cofinity Commercial |
$5,388.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,012.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Healthscope Commercial |
$5,638.81
|
| Rate for Payer: Healthscope Commercial |
$3,759.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,550.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,325.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,132.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,699.01
|
| Rate for Payer: PHP Commercial |
$3,550.36
|
| Rate for Payer: PHP Commercial |
$5,325.55
|
| Rate for Payer: Priority Health SBD |
$2,631.45
|
| Rate for Payer: Priority Health SBD |
$3,947.17
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$1,485.16
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.68 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$1,262.39
|
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$274.68
|
| Rate for Payer: BCBS Trust/PPO |
$274.68
|
| Rate for Payer: BCN Commercial |
$274.68
|
| Rate for Payer: BCN Commercial |
$274.68
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,188.13
|
| Rate for Payer: Cash Price |
$1,188.13
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$1,188.13
|
| Rate for Payer: Cofinity Advantage |
$693.07
|
| Rate for Payer: Cofinity Advantage |
$1,039.61
|
| Rate for Payer: Cofinity Commercial |
$1,277.24
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,188.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,336.64
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.87
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,262.39
|
| Rate for Payer: PHP Commercial |
$841.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$623.76
|
| Rate for Payer: Priority Health SBD |
$935.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.57
|
| Rate for Payer: UHC Core |
$515.84
|
| Rate for Payer: UHC Core |
$773.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$389.11
|
| Rate for Payer: UHC Exchange |
$583.67
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$1,485.16
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$935.65 |
| Max. Negotiated Rate |
$1,336.64 |
| Rate for Payer: Aetna Commercial |
$1,262.39
|
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.57
|
| Rate for Payer: Cash Price |
$1,188.13
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Advantage |
$1,039.61
|
| Rate for Payer: Cofinity Advantage |
$693.07
|
| Rate for Payer: Cofinity Commercial |
$1,277.24
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,188.13
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Healthscope Commercial |
$1,336.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: PHP Commercial |
$1,262.39
|
| Rate for Payer: PHP Commercial |
$841.59
|
| Rate for Payer: Priority Health SBD |
$935.65
|
| Rate for Payer: Priority Health SBD |
$623.76
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS Trust/PPO |
$7.19
|
| Rate for Payer: BCN Commercial |
$7.19
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$14.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.09
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$7.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.64
|
| Rate for Payer: UHC Core |
$13.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$13.64
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: VA VA |
$9.34
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
OP
|
$377.81
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna Commercial |
$321.14
|
| Rate for Payer: Aetna Medicare |
$188.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.58
|
| Rate for Payer: BCBS Complete |
$151.12
|
| Rate for Payer: BCBS Trust/PPO |
$40.00
|
| Rate for Payer: BCN Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$302.25
|
| Rate for Payer: Cash Price |
$302.25
|
| Rate for Payer: Cofinity Advantage |
$264.47
|
| Rate for Payer: Cofinity Commercial |
$324.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.25
|
| Rate for Payer: Healthscope Commercial |
$340.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.36
|
| Rate for Payer: PHP Commercial |
$321.14
|
| Rate for Payer: Priority Health SBD |
$238.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.58
|
| Rate for Payer: UHC Core |
$196.84
|
| Rate for Payer: UHC Exchange |
$148.48
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
IP
|
$377.81
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$238.02 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna Commercial |
$321.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.58
|
| Rate for Payer: Cash Price |
$302.25
|
| Rate for Payer: Cofinity Advantage |
$264.47
|
| Rate for Payer: Cofinity Commercial |
$324.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.25
|
| Rate for Payer: Healthscope Commercial |
$340.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.36
|
| Rate for Payer: PHP Commercial |
$321.14
|
| Rate for Payer: Priority Health SBD |
$238.02
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
IP
|
$5.75
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Aetna Commercial |
$4.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.74
|
| Rate for Payer: Cash Price |
$4.60
|
| Rate for Payer: Cofinity Advantage |
$4.03
|
| Rate for Payer: Cofinity Commercial |
$4.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$5.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.31
|
| Rate for Payer: PHP Commercial |
$4.89
|
| Rate for Payer: Priority Health SBD |
$3.62
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
OP
|
$5.75
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$50.03 |
| Rate for Payer: Aetna Commercial |
$4.89
|
| Rate for Payer: Aetna Medicare |
$2.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.74
|
| Rate for Payer: BCBS Complete |
$2.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.03
|
| Rate for Payer: BCN Commercial |
$50.03
|
| Rate for Payer: Cash Price |
$4.60
|
| Rate for Payer: Cash Price |
$4.60
|
| Rate for Payer: Cofinity Advantage |
$4.03
|
| Rate for Payer: Cofinity Commercial |
$4.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$5.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.31
|
| Rate for Payer: PHP Commercial |
$4.89
|
| Rate for Payer: Priority Health SBD |
$3.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.74
|
| Rate for Payer: UHC Core |
$3.00
|
| Rate for Payer: UHC Exchange |
$2.26
|
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
IP
|
$27.90
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
62300222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: Aetna Commercial |
$23.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cofinity Advantage |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.93
|
| Rate for Payer: PHP Commercial |
$23.71
|
| Rate for Payer: Priority Health SBD |
$17.58
|
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
OP
|
$27.90
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
62300222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.96 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$23.71
|
| Rate for Payer: Aetna Medicare |
$13.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: BCBS Complete |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$40.00
|
| Rate for Payer: BCN Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cofinity Advantage |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.93
|
| Rate for Payer: PHP Commercial |
$23.71
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$14.54
|
| Rate for Payer: UHC Exchange |
$10.96
|
|
|
HC DRUG SCREEN 10 URINE
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$66.26
|
| Rate for Payer: BCN Commercial |
$66.26
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$32.50
|
| 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 |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC DRUG SCREEN 10 URINE
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health SBD |
$66.86
|
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 99000
|
| Hospital Charge Code |
98300005
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 99000
|
| Hospital Charge Code |
98300005
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$14.43
|
| Rate for Payer: BCN Commercial |
$14.43
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
IP
|
$49.19
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100652
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.99 |
| Max. Negotiated Rate |
$44.27 |
| Rate for Payer: Aetna Commercial |
$41.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.97
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cofinity Advantage |
$34.43
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.35
|
| Rate for Payer: Healthscope Commercial |
$44.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.89
|
| Rate for Payer: PHP Commercial |
$41.81
|
| Rate for Payer: Priority Health SBD |
$30.99
|
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
OP
|
$49.19
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100652
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$44.27 |
| Rate for Payer: Aetna Commercial |
$41.81
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$13.43
|
| Rate for Payer: BCN Commercial |
$13.43
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cofinity Advantage |
$34.43
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$44.27
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.81
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.89
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$41.81
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$30.99
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100732
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.21 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: BCBS Complete |
$31.21
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100732
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.16 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
OP
|
$40.30
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$36.27 |
| Rate for Payer: Aetna Commercial |
$34.26
|
| Rate for Payer: Aetna Medicare |
$14.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$14.66
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$32.24
|
| Rate for Payer: Cash Price |
$32.24
|
| Rate for Payer: Cofinity Advantage |
$28.21
|
| Rate for Payer: Cofinity Commercial |
$34.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$36.27
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$14.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.26
|
| Rate for Payer: Nomi Health Commercial |
$20.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.23
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$34.26
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.74
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health SBD |
$25.39
|
| Rate for Payer: Priority Health Tiered Network |
$10.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.61
|
| Rate for Payer: UHC Core |
$20.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.74
|
| Rate for Payer: UHC Exchange |
$20.61
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$13.74
|
|
