|
HC CT PELVIS ANGIO
|
Facility
|
OP
|
$1,949.22
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,754.30 |
| Rate for Payer: Aetna Commercial |
$1,656.84
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,676.33
|
| Rate for Payer: Cofinity Commercial |
$1,364.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,364.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,228.01
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,442.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,442.42
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT PELVIS W CON
|
Facility
|
IP
|
$1,936.78
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,220.17 |
| Max. Negotiated Rate |
$1,743.10 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.91
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cofinity Commercial |
$1,355.75
|
| Rate for Payer: Cofinity Commercial |
$1,665.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,355.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.42
|
| Rate for Payer: Healthscope Commercial |
$1,743.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,646.26
|
| Rate for Payer: PHP Commercial |
$1,646.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.91
|
| Rate for Payer: Priority Health SBD |
$1,220.17
|
|
|
HC CT PELVIS W CON
|
Facility
|
OP
|
$1,936.78
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,743.10 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cofinity Commercial |
$1,665.63
|
| Rate for Payer: Cofinity Commercial |
$1,355.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,355.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,743.10
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,646.26
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,646.26
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.91
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,220.17
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,433.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,433.22
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,420.15
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$894.69 |
| Max. Negotiated Rate |
$1,278.13 |
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.10
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Cofinity Commercial |
$994.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$994.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Healthscope Commercial |
$1,278.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,207.13
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.10
|
| Rate for Payer: Priority Health SBD |
$894.69
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,420.15
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,278.13 |
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$994.11
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$994.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,278.13
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,207.13
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.10
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$894.69
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,050.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$1,050.91
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
OP
|
$2,205.70
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,985.13 |
| Rate for Payer: Aetna Commercial |
$1,874.85
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cofinity Commercial |
$1,896.90
|
| Rate for Payer: Cofinity Commercial |
$1,543.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,985.13
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.85
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,874.85
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.70
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,389.59
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,632.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,632.22
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
IP
|
$2,205.70
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,389.59 |
| Max. Negotiated Rate |
$1,985.13 |
| Rate for Payer: Aetna Commercial |
$1,874.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.70
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cofinity Commercial |
$1,543.99
|
| Rate for Payer: Cofinity Commercial |
$1,896.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.56
|
| Rate for Payer: Healthscope Commercial |
$1,985.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.85
|
| Rate for Payer: PHP Commercial |
$1,874.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.70
|
| Rate for Payer: Priority Health SBD |
$1,389.59
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$619.91 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$339.48
|
| Rate for Payer: VA VA |
$602.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$339.48
|
| Rate for Payer: VA VA |
$602.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$619.91 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$690.85 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$438.63 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UHC Core |
$811.47
|
| Rate for Payer: UHC Exchange |
$811.47
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$637.52 |
| Rate for Payer: Aetna Commercial |
$507.19
|
| Rate for Payer: Aetna Medicare |
$235.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$507.19
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health SBD |
$375.92
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$127.51
|
| Rate for Payer: VA VA |
$226.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.92 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna Commercial |
$507.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: PHP Commercial |
$507.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health SBD |
$375.92
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$522.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$522.06
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$444.46 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$522.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$522.06
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$444.46 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$522.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$522.06
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$444.46 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,029.58
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,209.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,209.35
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,029.58 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health SBD |
$1,029.58
|
|
