|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$244.82 |
| Max. Negotiated Rate |
$550.85 |
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna Medicare |
$306.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.83
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$428.44
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health SBD |
$385.59
|
| Rate for Payer: UHC Core |
$452.92
|
| Rate for Payer: UHC Exchange |
$452.92
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$118.05 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$74.95 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$93.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: BCBS Complete |
$74.95
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
| Rate for Payer: UHC Core |
$138.66
|
| Rate for Payer: UHC Exchange |
$138.66
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$376.22
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$441.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$441.91
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$376.22 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health SBD |
$376.22
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$443.90
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$521.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$521.40
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$443.90 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health SBD |
$443.90
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$410.21
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$481.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$481.84
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$410.21 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health SBD |
$410.21
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$514.42 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$604.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$604.24
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$514.42 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$604.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$604.24
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$170.98
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$463.01 |
| Max. Negotiated Rate |
$661.44 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.70
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health SBD |
$463.01
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Cofinity Commercial |
$514.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$463.01
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$543.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$543.85
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$170.98
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$149.99 |
| Max. Negotiated Rate |
$337.48 |
| Rate for Payer: Aetna Commercial |
$318.73
|
| Rate for Payer: Aetna Medicare |
$187.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.74
|
| Rate for Payer: BCBS Complete |
$149.99
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Cofinity Commercial |
$322.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: PHP Commercial |
$318.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health SBD |
$236.24
|
| Rate for Payer: UHC Core |
$277.49
|
| Rate for Payer: UHC Exchange |
$277.49
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$236.24 |
| Max. Negotiated Rate |
$337.48 |
| Rate for Payer: Aetna Commercial |
$318.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.74
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Cofinity Commercial |
$322.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: PHP Commercial |
$318.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health SBD |
$236.24
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$181.64 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: Aetna Medicare |
$227.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.16
|
| Rate for Payer: BCBS Complete |
$181.64
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health SBD |
$286.08
|
| Rate for Payer: UHC Core |
$336.03
|
| Rate for Payer: UHC Exchange |
$336.03
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$286.08 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.16
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health SBD |
$286.08
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$358.33 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Cofinity Commercial |
$278.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$250.83
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$294.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$294.62
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$250.83 |
| Max. Negotiated Rate |
$358.33 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.79
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$278.70
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health SBD |
$250.83
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Cofinity Commercial |
$307.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$276.58
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$324.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$324.87
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$276.58 |
| Max. Negotiated Rate |
$395.11 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.36
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$307.31
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health SBD |
$276.58
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$289.52 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$321.69
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health SBD |
$289.52
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Commercial |
$321.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$289.52
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$340.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$340.07
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
