|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: BCBS Complete |
$16.44
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$15.66
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$16.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.21
|
| Rate for Payer: UHC Medicare Advantage |
$29.21
|
| Rate for Payer: UHCCP Medicaid |
$16.45
|
| Rate for Payer: VA VA |
$29.21
|
|
|
HC ENDO BIOPSY
|
Facility
|
OP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$258.74 |
| Rate for Payer: Aetna Commercial |
$244.37
|
| Rate for Payer: Aetna Medicare |
$143.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.87
|
| Rate for Payer: BCBS Complete |
$115.00
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$201.24
|
| Rate for Payer: Cofinity Commercial |
$247.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: PHP Commercial |
$244.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health SBD |
$181.12
|
|
|
HC ENDO BIOPSY
|
Facility
|
IP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$181.12 |
| Max. Negotiated Rate |
$258.74 |
| Rate for Payer: Aetna Commercial |
$244.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.87
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$201.24
|
| Rate for Payer: Cofinity Commercial |
$247.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: PHP Commercial |
$244.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health SBD |
$181.12
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.04 |
| Max. Negotiated Rate |
$2,390.47 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna Medicare |
$883.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,061.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,061.53
|
| Rate for Payer: BCBS Complete |
$477.94
|
| Rate for Payer: BCBS MAPPO |
$849.22
|
| Rate for Payer: BCN Medicare Advantage |
$849.22
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Cofinity Commercial |
$473.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$473.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.22
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$455.18
|
| Rate for Payer: Mclaren Medicare |
$849.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.68
|
| Rate for Payer: Meridian Medicaid |
$477.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$976.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: PACE Medicare |
$806.76
|
| Rate for Payer: PACE SWMI |
$849.22
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: PHP Medicare Advantage |
$849.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health Medicare |
$849.22
|
| Rate for Payer: Priority Health SBD |
$426.04
|
| Rate for Payer: Railroad Medicare Medicare |
$849.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,390.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.22
|
| Rate for Payer: UHC Medicare Advantage |
$849.22
|
| Rate for Payer: UHCCP Medicaid |
$478.11
|
| Rate for Payer: VA VA |
$849.22
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.04 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.57
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$473.38
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$473.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health SBD |
$426.04
|
|
|
HC ENDO CLIPPING
|
Facility
|
IP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$203.70 |
| Max. Negotiated Rate |
$291.01 |
| Rate for Payer: Aetna Commercial |
$274.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.17
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Cofinity Commercial |
$278.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: PHP Commercial |
$274.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health SBD |
$203.70
|
|
|
HC ENDO CLIPPING
|
Facility
|
OP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$129.34 |
| Max. Negotiated Rate |
$291.01 |
| Rate for Payer: Aetna Commercial |
$274.84
|
| Rate for Payer: Aetna Medicare |
$161.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.17
|
| Rate for Payer: BCBS Complete |
$129.34
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Cofinity Commercial |
$278.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: PHP Commercial |
$274.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health SBD |
$203.70
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
OP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$722.18 |
| Max. Negotiated Rate |
$1,624.91 |
| Rate for Payer: Aetna Commercial |
$1,534.64
|
| Rate for Payer: Aetna Medicare |
$902.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.55
|
| Rate for Payer: BCBS Complete |
$722.18
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,263.82
|
| Rate for Payer: Cofinity Commercial |
$1,552.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,263.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: PHP Commercial |
$1,534.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health SBD |
$1,137.44
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
IP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,137.44 |
| Max. Negotiated Rate |
$1,624.91 |
| Rate for Payer: Aetna Commercial |
$1,534.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.55
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,263.82
|
| Rate for Payer: Cofinity Commercial |
$1,552.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,263.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: PHP Commercial |
$1,534.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health SBD |
$1,137.44
|
|
|
HC ENDO DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$838.15 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.75
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Cofinity Commercial |
$931.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$931.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health SBD |
$838.15
|
|
|
HC ENDO DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.16 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: Aetna Medicare |
$665.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.75
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Cofinity Commercial |
$931.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$931.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health SBD |
$838.15
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
OP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$429.81 |
| Max. Negotiated Rate |
$967.08 |
| Rate for Payer: Aetna Commercial |
$913.35
|
| Rate for Payer: Aetna Medicare |
$537.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.44
|
| Rate for Payer: BCBS Complete |
$429.81
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$752.17
|
| Rate for Payer: Cofinity Commercial |
$924.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$752.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Healthscope Commercial |
$967.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: PHP Commercial |
$913.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: Priority Health SBD |
$676.95
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
IP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$676.95 |
| Max. Negotiated Rate |
$967.08 |
| Rate for Payer: Aetna Commercial |
$913.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.44
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$752.17
|
| Rate for Payer: Cofinity Commercial |
$924.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$752.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Healthscope Commercial |
$967.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: PHP Commercial |
$913.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: Priority Health SBD |
$676.95
|
|
|
HC ENDOFORM 2X2
|
Facility
|
IP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.58 |
| Max. Negotiated Rate |
$35.12 |
| Rate for Payer: Aetna Commercial |
$33.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.36
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$27.31
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: PHP Commercial |
$33.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health SBD |
$24.58
|
|
|
HC ENDOFORM 2X2
|
Facility
|
OP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$35.12 |
| Rate for Payer: Aetna Commercial |
$33.17
|
| Rate for Payer: Aetna Medicare |
$19.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.36
|
| Rate for Payer: BCBS Complete |
$15.61
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$27.31
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: PHP Commercial |
$33.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health SBD |
$24.58
|
|
|
HC ENDOFORM 4X4
|
Facility
|
IP
|
$135.72
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.22
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Cofinity Commercial |
$95.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.36
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.22
|
| Rate for Payer: Priority Health SBD |
$85.50
|
|
|
HC ENDOFORM 4X4
|
Facility
|
OP
|
$135.72
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.29 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: Aetna Medicare |
$67.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.22
|
| Rate for Payer: BCBS Complete |
$54.29
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Cofinity Commercial |
$95.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.36
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.22
|
| Rate for Payer: Priority Health SBD |
$85.50
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
IP
|
$125.46
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$79.04 |
| Max. Negotiated Rate |
$112.91 |
| Rate for Payer: Aetna Commercial |
$106.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.55
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$107.90
|
| Rate for Payer: Cofinity Commercial |
$87.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Healthscope Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: PHP Commercial |
$106.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: Priority Health SBD |
$79.04
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
OP
|
$125.46
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$50.18 |
| Max. Negotiated Rate |
$112.91 |
| Rate for Payer: Aetna Commercial |
$106.64
|
| Rate for Payer: Aetna Medicare |
$62.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.55
|
| Rate for Payer: BCBS Complete |
$50.18
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$107.90
|
| Rate for Payer: Cofinity Commercial |
$87.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Healthscope Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: PHP Commercial |
$106.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: Priority Health SBD |
$79.04
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$417.32 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.96 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
OP
|
$5,097.96
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,039.18 |
| Max. Negotiated Rate |
$4,588.16 |
| Rate for Payer: Aetna Commercial |
$4,333.27
|
| Rate for Payer: Aetna Medicare |
$2,548.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,313.67
|
| Rate for Payer: BCBS Complete |
$2,039.18
|
| Rate for Payer: Cash Price |
$4,078.37
|
| Rate for Payer: Cofinity Commercial |
$3,568.57
|
| Rate for Payer: Cofinity Commercial |
$4,384.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,568.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,078.37
|
| Rate for Payer: Healthscope Commercial |
$4,588.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,333.27
|
| Rate for Payer: PHP Commercial |
$4,333.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,313.67
|
| Rate for Payer: Priority Health SBD |
$3,211.71
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
IP
|
$5,097.96
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,211.71 |
| Max. Negotiated Rate |
$4,588.16 |
| Rate for Payer: Aetna Commercial |
$4,333.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,313.67
|
| Rate for Payer: Cash Price |
$4,078.37
|
| Rate for Payer: Cofinity Commercial |
$3,568.57
|
| Rate for Payer: Cofinity Commercial |
$4,384.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,568.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,078.37
|
| Rate for Payer: Healthscope Commercial |
$4,588.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,333.27
|
| Rate for Payer: PHP Commercial |
$4,333.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,313.67
|
| Rate for Payer: Priority Health SBD |
$3,211.71
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,552.11 |
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna Medicare |
$5,007.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,710.52
|
| Rate for Payer: VA VA |
$4,814.42
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,412.72 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
|
