|
HC EXC TUMOR SOFT TISSUE, NECK/ANT THORAX, SQ, 3CM OR >
|
Facility
|
IP
|
$3,690.88
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
76100291
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.25 |
| Max. Negotiated Rate |
$3,321.79 |
| Rate for Payer: Aetna Commercial |
$3,137.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.07
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cofinity Advantage |
$2,583.62
|
| Rate for Payer: Cofinity Commercial |
$3,174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,952.70
|
| Rate for Payer: Healthscope Commercial |
$3,321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.16
|
| Rate for Payer: PHP Commercial |
$3,137.25
|
| Rate for Payer: Priority Health SBD |
$2,325.25
|
|
|
HC EXC TUMOR SOFT TISSUE, NECK/ANT THORAX, SQ, 3CM OR >
|
Facility
|
OP
|
$3,690.88
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
76100291
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,450.52 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.25
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.54
|
| Rate for Payer: BCN Commercial |
$2,013.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cofinity Advantage |
$2,583.62
|
| Rate for Payer: Cofinity Commercial |
$3,174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,952.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,321.79
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.25
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.16
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.25
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.07
|
| Rate for Payer: UHC Core |
$1,922.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.52
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
76100284
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,450.66 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,950.24
|
| Rate for Payer: BCN Commercial |
$1,950.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.31
|
| Rate for Payer: UHC Core |
$1,923.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.66
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
76100284
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.49 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
|
|
HC EXC TUMOR SOFT TISSUE SHOULDER, 3CM OR >
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 23071
|
| Hospital Charge Code |
76100251
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE SHOULDER, 3CM OR >
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 23071
|
| Hospital Charge Code |
76100251
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.56
|
| Rate for Payer: BCN Commercial |
$1,928.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ <3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
76100248
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.10
|
| Rate for Payer: BCN Commercial |
$1,018.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
76100248
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ 3CM OR >
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
76100249
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,450.66 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,794.05
|
| Rate for Payer: BCN Commercial |
$1,794.05
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.31
|
| Rate for Payer: UHC Core |
$1,923.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.66
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ 3CM OR >
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
76100249
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.49 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
|
|
HC EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$4,111.63
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
76100324
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,590.33 |
| Max. Negotiated Rate |
$3,700.47 |
| Rate for Payer: Aetna Commercial |
$3,494.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,672.56
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cofinity Advantage |
$2,878.14
|
| Rate for Payer: Cofinity Commercial |
$3,536.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,289.30
|
| Rate for Payer: Healthscope Commercial |
$3,700.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,494.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,083.72
|
| Rate for Payer: PHP Commercial |
$3,494.89
|
| Rate for Payer: Priority Health SBD |
$2,590.33
|
|
|
HC EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$4,111.63
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
76100324
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,494.89
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,672.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.84
|
| Rate for Payer: BCN Commercial |
$1,755.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cofinity Advantage |
$2,878.14
|
| Rate for Payer: Cofinity Commercial |
$3,536.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,289.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,700.47
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,494.89
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,083.72
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,494.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,590.33
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,672.56
|
| Rate for Payer: UHC Core |
$2,142.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,615.87
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$8,119.20
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$6,901.32
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,277.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cofinity Advantage |
$5,683.44
|
| Rate for Payer: Cofinity Commercial |
$6,982.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,495.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,307.28
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,901.32
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,089.40
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$6,901.32
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$5,115.10
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,277.48
|
| Rate for Payer: UHC Core |
$4,230.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$3,190.85
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$8,119.20
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,115.10 |
| Max. Negotiated Rate |
$7,307.28 |
| Rate for Payer: Aetna Commercial |
$6,901.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,277.48
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cofinity Advantage |
$5,683.44
|
| Rate for Payer: Cofinity Commercial |
$6,982.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,495.36
|
| Rate for Payer: Healthscope Commercial |
$7,307.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,901.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,089.40
|
| Rate for Payer: PHP Commercial |
$6,901.32
|
| Rate for Payer: Priority Health SBD |
$5,115.10
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$2,986.24
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,881.33 |
| Max. Negotiated Rate |
$2,687.62 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.06
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Advantage |
$2,090.37
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: Priority Health SBD |
$1,881.33
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$2,986.24
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$984.16
|
| Rate for Payer: BCN Commercial |
$984.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Advantage |
$2,090.37
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,881.33
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,941.06
|
| Rate for Payer: UHC Core |
$1,555.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,173.59
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
IP
|
$1,040.64
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$936.58 |
| Rate for Payer: Aetna Commercial |
$884.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.42
|
| Rate for Payer: Cash Price |
$832.51
|
| Rate for Payer: Cofinity Advantage |
$728.45
|
| Rate for Payer: Cofinity Commercial |
$894.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.51
|
| Rate for Payer: Healthscope Commercial |
$936.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.48
|
| Rate for Payer: PHP Commercial |
$884.54
|
| Rate for Payer: Priority Health SBD |
$655.60
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
OP
|
$1,040.64
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$416.26 |
| Max. Negotiated Rate |
$936.58 |
| Rate for Payer: Aetna Commercial |
$884.54
|
| Rate for Payer: Aetna Medicare |
$520.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.42
|
| Rate for Payer: BCBS Complete |
$416.26
|
| Rate for Payer: BCBS Trust/PPO |
$564.06
|
| Rate for Payer: BCN Commercial |
$564.06
|
| Rate for Payer: Cash Price |
$832.51
|
| Rate for Payer: Cash Price |
$832.51
|
| Rate for Payer: Cofinity Advantage |
$728.45
|
| Rate for Payer: Cofinity Commercial |
$894.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.51
|
| Rate for Payer: Healthscope Commercial |
$936.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$832.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.48
|
| Rate for Payer: PHP Commercial |
$884.54
|
| Rate for Payer: Priority Health SBD |
$655.60
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
IP
|
$349.77
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$220.36 |
| Max. Negotiated Rate |
$314.79 |
| Rate for Payer: Aetna Commercial |
$297.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.35
|
| Rate for Payer: Cash Price |
$279.82
|
| Rate for Payer: Cofinity Advantage |
$244.84
|
| Rate for Payer: Cofinity Commercial |
$300.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.82
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.33
|
| Rate for Payer: PHP Commercial |
$297.30
|
| Rate for Payer: Priority Health SBD |
$220.36
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
OP
|
$349.77
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$297.30
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.35
|
| 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 |
$259.10
|
| Rate for Payer: BCN Commercial |
$259.10
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$279.82
|
| Rate for Payer: Cash Price |
$279.82
|
| Rate for Payer: Cofinity Advantage |
$244.84
|
| Rate for Payer: Cofinity Commercial |
$300.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| 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 |
$297.30
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.33
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$297.30
|
| 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 |
$220.36
|
| 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) |
$227.35
|
| Rate for Payer: UHC Core |
$182.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$137.46
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
OP
|
$138.98
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$196.91 |
| Rate for Payer: Aetna Commercial |
$118.13
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$196.91
|
| Rate for Payer: BCN Commercial |
$196.91
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$111.18
|
| Rate for Payer: Cash Price |
$111.18
|
| Rate for Payer: Cofinity Advantage |
$97.29
|
| Rate for Payer: Cofinity Commercial |
$119.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$125.08
|
| Rate for Payer: Mclaren Medicaid |
$30.74
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.13
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.23
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$118.13
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$87.56
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.34
|
| Rate for Payer: UHC Core |
$72.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$54.62
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
IP
|
$138.98
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$87.56 |
| Max. Negotiated Rate |
$125.08 |
| Rate for Payer: Aetna Commercial |
$118.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.34
|
| Rate for Payer: Cash Price |
$111.18
|
| Rate for Payer: Cofinity Advantage |
$97.29
|
| Rate for Payer: Cofinity Commercial |
$119.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.18
|
| Rate for Payer: Healthscope Commercial |
$125.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.23
|
| Rate for Payer: PHP Commercial |
$118.13
|
| Rate for Payer: Priority Health SBD |
$87.56
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
IP
|
$1,981.19
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,248.15 |
| Max. Negotiated Rate |
$1,783.07 |
| Rate for Payer: Aetna Commercial |
$1,684.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.77
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cofinity Advantage |
$1,386.83
|
| Rate for Payer: Cofinity Commercial |
$1,703.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.95
|
| Rate for Payer: Healthscope Commercial |
$1,783.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.89
|
| Rate for Payer: PHP Commercial |
$1,684.01
|
| Rate for Payer: Priority Health SBD |
$1,248.15
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
OP
|
$1,981.19
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$587.69 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,684.01
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$587.69
|
| Rate for Payer: BCN Commercial |
$587.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cofinity Advantage |
$1,386.83
|
| Rate for Payer: Cofinity Commercial |
$1,703.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,783.07
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.01
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.89
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,684.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,248.15
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.77
|
| Rate for Payer: UHC Core |
$1,032.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$778.61
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXTENDED RECOVERY 0-6 HRS
|
Facility
|
IP
|
$1,796.14
|
|
| Hospital Charge Code |
71000005
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,131.57 |
| Max. Negotiated Rate |
$1,616.53 |
| Rate for Payer: Aetna Commercial |
$1,526.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.49
|
| Rate for Payer: Cash Price |
$1,436.91
|
| Rate for Payer: Cofinity Advantage |
$1,257.30
|
| Rate for Payer: Cofinity Commercial |
$1,544.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.91
|
| Rate for Payer: Healthscope Commercial |
$1,616.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,347.11
|
| Rate for Payer: PHP Commercial |
$1,526.72
|
| Rate for Payer: Priority Health SBD |
$1,131.57
|
|
