|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$224.86
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$88.37 |
| Max. Negotiated Rate |
$241.31 |
| Rate for Payer: Aetna Commercial |
$191.13
|
| Rate for Payer: Aetna Medicare |
$112.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.16
|
| Rate for Payer: BCBS Complete |
$89.94
|
| Rate for Payer: BCBS Trust/PPO |
$241.31
|
| Rate for Payer: BCN Commercial |
$241.31
|
| Rate for Payer: Cash Price |
$179.89
|
| Rate for Payer: Cash Price |
$179.89
|
| Rate for Payer: Cofinity Advantage |
$157.40
|
| Rate for Payer: Cofinity Commercial |
$193.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.89
|
| Rate for Payer: Healthscope Commercial |
$202.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.65
|
| Rate for Payer: PHP Commercial |
$191.13
|
| Rate for Payer: Priority Health SBD |
$141.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.16
|
| Rate for Payer: UHC Core |
$117.15
|
| Rate for Payer: UHC Exchange |
$88.37
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$609.12
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$383.75 |
| Max. Negotiated Rate |
$548.21 |
| Rate for Payer: Aetna Commercial |
$517.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.93
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cofinity Advantage |
$426.38
|
| Rate for Payer: Cofinity Commercial |
$523.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.30
|
| Rate for Payer: Healthscope Commercial |
$548.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.84
|
| Rate for Payer: PHP Commercial |
$517.75
|
| Rate for Payer: Priority Health SBD |
$383.75
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$609.12
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$548.21 |
| Rate for Payer: Aetna Commercial |
$517.75
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$269.44
|
| Rate for Payer: BCN Commercial |
$269.44
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cofinity Advantage |
$426.38
|
| Rate for Payer: Cofinity Commercial |
$523.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$548.21
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.75
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.84
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$517.75
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$383.75
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.93
|
| Rate for Payer: UHC Core |
$317.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$239.38
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$718.69
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$452.77 |
| Max. Negotiated Rate |
$646.82 |
| Rate for Payer: Aetna Commercial |
$610.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.15
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cofinity Advantage |
$503.08
|
| Rate for Payer: Cofinity Commercial |
$618.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.95
|
| Rate for Payer: Healthscope Commercial |
$646.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.02
|
| Rate for Payer: PHP Commercial |
$610.89
|
| Rate for Payer: Priority Health SBD |
$452.77
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$718.69
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$646.82 |
| Rate for Payer: Aetna Commercial |
$610.89
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$333.12
|
| Rate for Payer: BCN Commercial |
$333.12
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cofinity Advantage |
$503.08
|
| Rate for Payer: Cofinity Commercial |
$618.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$646.82
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.89
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.02
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$610.89
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$452.77
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.15
|
| Rate for Payer: UHC Core |
$374.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$282.45
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$664.15
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$597.74 |
| Rate for Payer: Aetna Commercial |
$564.53
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$500.40
|
| Rate for Payer: BCN Commercial |
$500.40
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cofinity Advantage |
$464.90
|
| Rate for Payer: Cofinity Commercial |
$571.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$597.74
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.53
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.11
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$564.53
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$418.41
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.70
|
| Rate for Payer: UHC Core |
$346.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$261.01
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$664.15
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$418.41 |
| Max. Negotiated Rate |
$597.74 |
| Rate for Payer: Aetna Commercial |
$564.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.70
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cofinity Advantage |
$464.90
|
| Rate for Payer: Cofinity Commercial |
$571.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.32
|
| Rate for Payer: Healthscope Commercial |
$597.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.11
|
| Rate for Payer: PHP Commercial |
$564.53
|
| Rate for Payer: Priority Health SBD |
$418.41
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$527.06
|
| Rate for Payer: BCN Commercial |
$527.06
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$287.20
|
| Rate for Payer: BCN Commercial |
$287.20
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$749.63
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna Commercial |
$637.19
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$278.33
|
| Rate for Payer: BCN Commercial |
$278.33
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cofinity Advantage |
$524.74
|
| Rate for Payer: Cofinity Commercial |
$644.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$674.67
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.19
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.22
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$637.19
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$472.27
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.26
|
| Rate for Payer: UHC Core |
$390.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$294.60
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$749.63
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$472.27 |
| Max. Negotiated Rate |
$674.67 |
| Rate for Payer: Aetna Commercial |
$637.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.26
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cofinity Advantage |
$524.74
|
| Rate for Payer: Cofinity Commercial |
$644.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.70
|
| Rate for Payer: Healthscope Commercial |
$674.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.22
|
| Rate for Payer: PHP Commercial |
$637.19
|
| Rate for Payer: Priority Health SBD |
$472.27
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$382.48
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$240.96 |
| Max. Negotiated Rate |
$344.23 |
| Rate for Payer: Aetna Commercial |
$325.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.61
|
| Rate for Payer: Cash Price |
$305.98
|
| Rate for Payer: Cofinity Advantage |
$267.74
|
| Rate for Payer: Cofinity Commercial |
$328.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.98
|
| Rate for Payer: Healthscope Commercial |
$344.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.86
|
| Rate for Payer: PHP Commercial |
$325.11
|
| Rate for Payer: Priority Health SBD |
$240.96
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$382.48
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$150.31 |
| Max. Negotiated Rate |
$344.23 |
| Rate for Payer: Aetna Commercial |
$325.11
|
| Rate for Payer: Aetna Medicare |
$191.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.61
|
| Rate for Payer: BCBS Complete |
$152.99
|
| Rate for Payer: BCBS Trust/PPO |
$185.07
|
| Rate for Payer: BCN Commercial |
$185.07
|
| Rate for Payer: Cash Price |
$305.98
|
| Rate for Payer: Cash Price |
$305.98
|
| Rate for Payer: Cofinity Advantage |
$267.74
|
| Rate for Payer: Cofinity Commercial |
$328.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.98
|
| Rate for Payer: Healthscope Commercial |
$344.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.86
|
| Rate for Payer: PHP Commercial |
$325.11
|
| Rate for Payer: Priority Health SBD |
$240.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.61
|
| Rate for Payer: UHC Core |
$199.27
|
| Rate for Payer: UHC Exchange |
$150.31
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$463.17
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$182.03 |
| Max. Negotiated Rate |
$416.85 |
| Rate for Payer: Aetna Commercial |
$393.69
|
| Rate for Payer: Aetna Medicare |
$231.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.06
|
| Rate for Payer: BCBS Complete |
$185.27
|
| Rate for Payer: BCBS Trust/PPO |
$217.62
|
| Rate for Payer: BCN Commercial |
$217.62
|
| Rate for Payer: Cash Price |
$370.54
|
| Rate for Payer: Cash Price |
$370.54
|
| Rate for Payer: Cofinity Advantage |
$324.22
|
| Rate for Payer: Cofinity Commercial |
$398.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.54
|
| Rate for Payer: Healthscope Commercial |
$416.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$370.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.38
|
| Rate for Payer: PHP Commercial |
$393.69
|
| Rate for Payer: Priority Health SBD |
$291.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.06
|
| Rate for Payer: UHC Core |
$241.31
|
| Rate for Payer: UHC Exchange |
$182.03
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$463.17
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$291.80 |
| Max. Negotiated Rate |
$416.85 |
| Rate for Payer: Aetna Commercial |
$393.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.06
|
| Rate for Payer: Cash Price |
$370.54
|
| Rate for Payer: Cofinity Advantage |
$324.22
|
| Rate for Payer: Cofinity Commercial |
$398.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.54
|
| Rate for Payer: Healthscope Commercial |
$416.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.38
|
| Rate for Payer: PHP Commercial |
$393.69
|
| Rate for Payer: Priority Health SBD |
$291.80
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$406.10
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$255.84 |
| Max. Negotiated Rate |
$365.49 |
| Rate for Payer: Aetna Commercial |
$345.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.96
|
| Rate for Payer: Cash Price |
$324.88
|
| Rate for Payer: Cofinity Advantage |
$284.27
|
| Rate for Payer: Cofinity Commercial |
$349.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.88
|
| Rate for Payer: Healthscope Commercial |
$365.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.57
|
| Rate for Payer: PHP Commercial |
$345.19
|
| Rate for Payer: Priority Health SBD |
$255.84
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$406.10
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$345.19
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$288.70
|
| Rate for Payer: BCN Commercial |
$288.70
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$324.88
|
| Rate for Payer: Cash Price |
$324.88
|
| Rate for Payer: Cofinity Advantage |
$284.27
|
| Rate for Payer: Cofinity Commercial |
$349.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$365.49
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.19
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.57
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$345.19
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$255.84
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.96
|
| Rate for Payer: UHC Core |
$211.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$159.60
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$447.79
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$414.63 |
| Rate for Payer: Aetna Commercial |
$380.62
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$300.54
|
| Rate for Payer: BCN Commercial |
$300.54
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$358.23
|
| Rate for Payer: Cash Price |
$358.23
|
| Rate for Payer: Cofinity Advantage |
$313.45
|
| Rate for Payer: Cofinity Commercial |
$385.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$403.01
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.62
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.84
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$380.62
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$282.11
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.06
|
| Rate for Payer: UHC Core |
$233.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$175.98
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$447.79
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$282.11 |
| Max. Negotiated Rate |
$403.01 |
| Rate for Payer: Aetna Commercial |
$380.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.06
|
| Rate for Payer: Cash Price |
$358.23
|
| Rate for Payer: Cofinity Advantage |
$313.45
|
| Rate for Payer: Cofinity Commercial |
$385.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.23
|
| Rate for Payer: Healthscope Commercial |
$403.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.84
|
| Rate for Payer: PHP Commercial |
$380.62
|
| Rate for Payer: Priority Health SBD |
$282.11
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$468.74
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$295.31 |
| Max. Negotiated Rate |
$421.87 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.68
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Advantage |
$328.12
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: Priority Health SBD |
$295.31
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$468.74
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$167.28
|
| Rate for Payer: BCN Commercial |
$167.28
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Advantage |
$328.12
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$295.31
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.68
|
| Rate for Payer: UHC Core |
$244.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$184.21
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$283.43
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$434.91 |
| Rate for Payer: Aetna Commercial |
$240.92
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$434.91
|
| Rate for Payer: BCN Commercial |
$434.91
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$226.74
|
| Rate for Payer: Cash Price |
$226.74
|
| Rate for Payer: Cofinity Advantage |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$243.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$255.09
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.92
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.57
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$240.92
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$178.56
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.23
|
| Rate for Payer: UHC Core |
$147.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$111.39
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$283.43
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$178.56 |
| Max. Negotiated Rate |
$255.09 |
| Rate for Payer: Aetna Commercial |
$240.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.23
|
| Rate for Payer: Cash Price |
$226.74
|
| Rate for Payer: Cofinity Advantage |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$243.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.74
|
| Rate for Payer: Healthscope Commercial |
$255.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.57
|
| Rate for Payer: PHP Commercial |
$240.92
|
| Rate for Payer: Priority Health SBD |
$178.56
|
|
