|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.86
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.61
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$5.06
|
| Rate for Payer: BCN Commercial |
$5.06
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Advantage |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Mclaren Medicaid |
$2.48
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$7.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.39
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.75
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health SBD |
$18.81
|
| Rate for Payer: Priority Health Tiered Network |
$3.80
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.13
|
| Rate for Payer: UHC Core |
$7.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.75
|
| Rate for Payer: UHC Exchange |
$7.13
|
| Rate for Payer: UHC Medicaid |
$2.48
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.86
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.41
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Advantage |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.39
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: Priority Health SBD |
$18.81
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$168.54
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$106.18 |
| Max. Negotiated Rate |
$2,596.12 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna Medicare |
$834.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$186.26
|
| Rate for Payer: BCN Commercial |
$186.26
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Advantage |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Mclaren Medicaid |
$419.85
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$842.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$2,408.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,596.12
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health SBD |
$106.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,076.90
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.35
|
| Rate for Payer: UHC Core |
$1,225.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,225.35
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$168.54
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$106.18 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.55
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Advantage |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: Priority Health SBD |
$106.18
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$6.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: BCBS Complete |
$3.18
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$3.03
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: Meridian Medicaid |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$8.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.79
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: Priority Health Tiered Network |
$4.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.69
|
| Rate for Payer: UHC Core |
$8.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.79
|
| Rate for Payer: UHC Exchange |
$8.69
|
| Rate for Payer: UHC Medicaid |
$3.03
|
| Rate for Payer: UHCCP Medicaid |
$3.03
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health SBD |
$29.76
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$31.94
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$28.75 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.76
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Advantage |
$22.36
|
| Rate for Payer: Cofinity Commercial |
$27.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Healthscope Commercial |
$28.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: PHP Commercial |
$27.15
|
| Rate for Payer: Priority Health SBD |
$20.12
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.94
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$28.75 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$15.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.76
|
| Rate for Payer: BCBS Complete |
$12.78
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Advantage |
$22.36
|
| Rate for Payer: Cofinity Commercial |
$27.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Healthscope Commercial |
$28.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: PHP Commercial |
$27.15
|
| Rate for Payer: Priority Health SBD |
$20.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.34
|
| Rate for Payer: UHC Core |
$24.34
|
| Rate for Payer: UHC Exchange |
$24.34
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$281.22
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$177.17 |
| Max. Negotiated Rate |
$253.10 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.79
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Advantage |
$196.85
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: Priority Health SBD |
$177.17
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$281.22
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$110.52 |
| Max. Negotiated Rate |
$880.16 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: Aetna Medicare |
$140.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.79
|
| Rate for Payer: BCBS Complete |
$112.49
|
| Rate for Payer: BCBS Trust/PPO |
$880.16
|
| Rate for Payer: BCN Commercial |
$880.16
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Advantage |
$196.85
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$224.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$322.97
|
| Rate for Payer: Priority Health SBD |
$177.17
|
| Rate for Payer: Priority Health Tiered Network |
$258.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.79
|
| Rate for Payer: UHC Core |
$146.52
|
| Rate for Payer: UHC Exchange |
$110.52
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$18,094.29
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,399.40 |
| Max. Negotiated Rate |
$16,284.86 |
| Rate for Payer: Aetna Commercial |
$15,380.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,761.29
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Advantage |
$12,666.00
|
| Rate for Payer: Cofinity Commercial |
$15,561.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Healthscope Commercial |
$16,284.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PHP Commercial |
$15,380.15
|
| Rate for Payer: Priority Health SBD |
$11,399.40
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$18,094.29
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$900.12 |
| Max. Negotiated Rate |
$84,223.52 |
| Rate for Payer: Aetna Commercial |
$15,380.15
|
| Rate for Payer: Aetna Medicare |
$27,085.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,761.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,554.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,554.84
|
| Rate for Payer: BCBS Complete |
$14,303.29
|
| Rate for Payer: BCBS MAPPO |
$26,043.87
|
| Rate for Payer: BCBS Trust/PPO |
$900.12
|
| Rate for Payer: BCN Commercial |
$900.12
|
| Rate for Payer: BCN Medicare Advantage |
$26,043.87
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Advantage |
$12,666.00
|
| Rate for Payer: Cofinity Commercial |
$15,561.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,043.87
|
| Rate for Payer: Healthscope Commercial |
$16,284.86
|
| Rate for Payer: Mclaren Medicaid |
$13,620.94
|
| Rate for Payer: Mclaren Medicare |
$26,043.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,346.06
|
| Rate for Payer: Meridian Medicaid |
$27,346.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,950.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,648.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$78,131.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PACE Medicare |
$24,741.68
|
| Rate for Payer: PACE SWMI |
$26,043.87
|
| Rate for Payer: PHP Commercial |
$15,380.15
|
| Rate for Payer: PHP Medicare Advantage |
$26,043.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,620.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$84,223.52
|
| Rate for Payer: Priority Health Medicare |
$26,043.87
|
| Rate for Payer: Priority Health SBD |
$11,399.40
|
| Rate for Payer: Priority Health Tiered Network |
$67,378.82
|
| Rate for Payer: Railroad Medicare Medicare |
$26,043.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,043.87
|
| Rate for Payer: UHC Medicaid |
$13,620.94
|
| Rate for Payer: UHCCP Medicaid |
$13,620.94
|
| Rate for Payer: VA VA |
$26,043.87
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$18,094.29
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,079.27 |
| Max. Negotiated Rate |
$84,223.52 |
| Rate for Payer: Aetna Commercial |
$15,380.15
|
| Rate for Payer: Aetna Medicare |
$27,085.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,761.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,554.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,554.84
|
| Rate for Payer: BCBS Complete |
$14,303.29
|
| Rate for Payer: BCBS MAPPO |
$26,043.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.27
|
| Rate for Payer: BCN Commercial |
$1,079.27
|
| Rate for Payer: BCN Medicare Advantage |
$26,043.87
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Advantage |
$12,666.00
|
| Rate for Payer: Cofinity Commercial |
$15,561.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,043.87
|
| Rate for Payer: Healthscope Commercial |
$16,284.86
|
| Rate for Payer: Mclaren Medicaid |
$13,620.94
|
| Rate for Payer: Mclaren Medicare |
$26,043.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,346.06
|
| Rate for Payer: Meridian Medicaid |
$27,346.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,950.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,648.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$78,131.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PACE Medicare |
$24,741.68
|
| Rate for Payer: PACE SWMI |
$26,043.87
|
| Rate for Payer: PHP Commercial |
$15,380.15
|
| Rate for Payer: PHP Medicare Advantage |
$26,043.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,620.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$84,223.52
|
| Rate for Payer: Priority Health Medicare |
$26,043.87
|
| Rate for Payer: Priority Health SBD |
$11,399.40
|
| Rate for Payer: Priority Health Tiered Network |
$67,378.82
|
| Rate for Payer: Railroad Medicare Medicare |
$26,043.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,043.87
|
| Rate for Payer: UHC Medicaid |
$13,620.94
|
| Rate for Payer: UHCCP Medicaid |
$13,620.94
|
| Rate for Payer: VA VA |
$26,043.87
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$18,094.29
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,399.40 |
| Max. Negotiated Rate |
$16,284.86 |
| Rate for Payer: Aetna Commercial |
$15,380.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,761.29
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Advantage |
$12,666.00
|
| Rate for Payer: Cofinity Commercial |
$15,561.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Healthscope Commercial |
$16,284.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PHP Commercial |
$15,380.15
|
| Rate for Payer: Priority Health SBD |
$11,399.40
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,572.41
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,770.62 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,922.07
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Advantage |
$5,300.69
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: Priority Health SBD |
$4,770.62
|
|
|
HC EP AFTER DRUGS
|
Facility
|
OP
|
$7,572.41
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,028.96 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: Aetna Medicare |
$3,786.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,922.07
|
| Rate for Payer: BCBS Complete |
$3,028.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,577.22
|
| Rate for Payer: BCN Commercial |
$4,577.22
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Advantage |
$5,300.69
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,057.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: Priority Health SBD |
$4,770.62
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
OP
|
$3,409.67
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,340.00 |
| Max. Negotiated Rate |
$3,068.70 |
| Rate for Payer: Aetna Commercial |
$2,898.22
|
| Rate for Payer: Aetna Medicare |
$1,704.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,216.29
|
| Rate for Payer: BCBS Complete |
$1,363.87
|
| Rate for Payer: Cash Price |
$2,727.74
|
| Rate for Payer: Cofinity Advantage |
$2,386.77
|
| Rate for Payer: Cofinity Commercial |
$2,932.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,727.74
|
| Rate for Payer: Healthscope Commercial |
$3,068.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,727.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,898.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,557.25
|
| Rate for Payer: PHP Commercial |
$2,898.22
|
| Rate for Payer: Priority Health SBD |
$2,148.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,216.29
|
| Rate for Payer: UHC Core |
$1,776.44
|
| Rate for Payer: UHC Exchange |
$1,340.00
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
IP
|
$3,409.67
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,148.09 |
| Max. Negotiated Rate |
$3,068.70 |
| Rate for Payer: Aetna Commercial |
$2,898.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,216.29
|
| Rate for Payer: Cash Price |
$2,727.74
|
| Rate for Payer: Cofinity Advantage |
$2,386.77
|
| Rate for Payer: Cofinity Commercial |
$2,932.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,727.74
|
| Rate for Payer: Healthscope Commercial |
$3,068.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,898.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,557.25
|
| Rate for Payer: PHP Commercial |
$2,898.22
|
| Rate for Payer: Priority Health SBD |
$2,148.09
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
IP
|
$2,436.41
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,534.94 |
| Max. Negotiated Rate |
$2,192.77 |
| Rate for Payer: Aetna Commercial |
$2,070.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,583.67
|
| Rate for Payer: Cash Price |
$1,949.13
|
| Rate for Payer: Cofinity Advantage |
$1,705.49
|
| Rate for Payer: Cofinity Commercial |
$2,095.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,949.13
|
| Rate for Payer: Healthscope Commercial |
$2,192.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,070.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.31
|
| Rate for Payer: PHP Commercial |
$2,070.95
|
| Rate for Payer: Priority Health SBD |
$1,534.94
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
OP
|
$2,436.41
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$974.56 |
| Max. Negotiated Rate |
$2,192.77 |
| Rate for Payer: Aetna Commercial |
$2,070.95
|
| Rate for Payer: Aetna Medicare |
$1,218.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,583.67
|
| Rate for Payer: BCBS Complete |
$974.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.40
|
| Rate for Payer: BCN Commercial |
$1,181.40
|
| Rate for Payer: Cash Price |
$1,949.13
|
| Rate for Payer: Cash Price |
$1,949.13
|
| Rate for Payer: Cofinity Advantage |
$1,705.49
|
| Rate for Payer: Cofinity Commercial |
$2,095.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,949.13
|
| Rate for Payer: Healthscope Commercial |
$2,192.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,949.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,070.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.31
|
| Rate for Payer: PHP Commercial |
$2,070.95
|
| Rate for Payer: Priority Health SBD |
$1,534.94
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
IP
|
$2,233.25
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.95 |
| Max. Negotiated Rate |
$2,009.92 |
| Rate for Payer: Aetna Commercial |
$1,898.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.61
|
| Rate for Payer: Cash Price |
$1,786.60
|
| Rate for Payer: Cofinity Advantage |
$1,563.28
|
| Rate for Payer: Cofinity Commercial |
$1,920.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,786.60
|
| Rate for Payer: Healthscope Commercial |
$2,009.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,898.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,674.94
|
| Rate for Payer: PHP Commercial |
$1,898.26
|
| Rate for Payer: Priority Health SBD |
$1,406.95
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
OP
|
$2,233.25
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$893.30 |
| Max. Negotiated Rate |
$2,009.92 |
| Rate for Payer: Aetna Commercial |
$1,898.26
|
| Rate for Payer: Aetna Medicare |
$1,116.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.61
|
| Rate for Payer: BCBS Complete |
$893.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.95
|
| Rate for Payer: BCN Commercial |
$1,139.95
|
| Rate for Payer: Cash Price |
$1,786.60
|
| Rate for Payer: Cash Price |
$1,786.60
|
| Rate for Payer: Cofinity Advantage |
$1,563.28
|
| Rate for Payer: Cofinity Commercial |
$1,920.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,786.60
|
| Rate for Payer: Healthscope Commercial |
$2,009.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,786.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,898.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,674.94
|
| Rate for Payer: PHP Commercial |
$1,898.26
|
| Rate for Payer: Priority Health SBD |
$1,406.95
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
IP
|
$688.50
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$433.75 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Advantage |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health SBD |
$433.75
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
OP
|
$688.50
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$270.58 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna Medicare |
$344.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Advantage |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health SBD |
$433.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.52
|
| Rate for Payer: UHC Core |
$358.71
|
| Rate for Payer: UHC Exchange |
$270.58
|
|
|
HC EPIDURAL PREP (OB)
|
Facility
|
IP
|
$659.01
|
|
| Hospital Charge Code |
37000003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$415.18 |
| Max. Negotiated Rate |
$593.11 |
| Rate for Payer: Aetna Commercial |
$560.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.36
|
| Rate for Payer: Cash Price |
$527.21
|
| Rate for Payer: Cofinity Advantage |
$461.31
|
| Rate for Payer: Cofinity Commercial |
$566.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.21
|
| Rate for Payer: Healthscope Commercial |
$593.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.26
|
| Rate for Payer: PHP Commercial |
$560.16
|
| Rate for Payer: Priority Health SBD |
$415.18
|
|
