|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
IP
|
$223.09
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$140.55 |
| Max. Negotiated Rate |
$200.78 |
| Rate for Payer: Aetna Commercial |
$189.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.01
|
| Rate for Payer: Cash Price |
$178.47
|
| Rate for Payer: Cofinity Advantage |
$156.16
|
| Rate for Payer: Cofinity Commercial |
$191.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.47
|
| Rate for Payer: Healthscope Commercial |
$200.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.32
|
| Rate for Payer: PHP Commercial |
$189.63
|
| Rate for Payer: Priority Health SBD |
$140.55
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
OP
|
$223.09
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.88 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna Commercial |
$189.63
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$132.88
|
| Rate for Payer: BCN Commercial |
$132.88
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$178.47
|
| Rate for Payer: Cash Price |
$178.47
|
| Rate for Payer: Cofinity Advantage |
$156.16
|
| Rate for Payer: Cofinity Commercial |
$191.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$200.78
|
| Rate for Payer: Mclaren Medicaid |
$186.79
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.63
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.32
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$189.63
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$140.55
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC FLUID CREATININE
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC FLUID CREATININE
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$5.53
|
| Rate for Payer: BCN Commercial |
$5.53
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
OP
|
$110.36
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$93.81
|
| Rate for Payer: Aetna Medicare |
$55.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.73
|
| Rate for Payer: BCBS Complete |
$44.14
|
| Rate for Payer: BCBS Trust/PPO |
$14.62
|
| Rate for Payer: BCN Commercial |
$14.62
|
| Rate for Payer: Cash Price |
$88.29
|
| Rate for Payer: Cash Price |
$88.29
|
| Rate for Payer: Cash Price |
$88.29
|
| Rate for Payer: Cofinity Advantage |
$77.25
|
| Rate for Payer: Cofinity Commercial |
$94.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.29
|
| Rate for Payer: Healthscope Commercial |
$99.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.81
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.77
|
| Rate for Payer: PHP Commercial |
$93.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.00
|
| Rate for Payer: Priority Health SBD |
$69.53
|
| Rate for Payer: Priority Health Tiered Network |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.73
|
| Rate for Payer: UHC Core |
$57.50
|
| Rate for Payer: UHC Exchange |
$43.37
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
IP
|
$110.36
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$69.53 |
| Max. Negotiated Rate |
$99.32 |
| Rate for Payer: Aetna Commercial |
$93.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.73
|
| Rate for Payer: Cash Price |
$88.29
|
| Rate for Payer: Cofinity Advantage |
$77.25
|
| Rate for Payer: Cofinity Commercial |
$94.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.29
|
| Rate for Payer: Healthscope Commercial |
$99.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.77
|
| Rate for Payer: PHP Commercial |
$93.81
|
| Rate for Payer: Priority Health SBD |
$69.53
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
IP
|
$134.34
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$84.63 |
| Max. Negotiated Rate |
$120.91 |
| Rate for Payer: Aetna Commercial |
$114.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.32
|
| Rate for Payer: Cash Price |
$107.47
|
| Rate for Payer: Cofinity Advantage |
$94.04
|
| Rate for Payer: Cofinity Commercial |
$115.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.47
|
| Rate for Payer: Healthscope Commercial |
$120.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.75
|
| Rate for Payer: PHP Commercial |
$114.19
|
| Rate for Payer: Priority Health SBD |
$84.63
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
OP
|
$134.34
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$120.91 |
| Rate for Payer: Aetna Commercial |
$114.19
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$82.34
|
| Rate for Payer: BCN Commercial |
$82.34
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$107.47
|
| Rate for Payer: Cash Price |
$107.47
|
| Rate for Payer: Cofinity Advantage |
$94.04
|
| Rate for Payer: Cofinity Commercial |
$115.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$120.91
|
| Rate for Payer: Mclaren Medicaid |
$19.47
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.19
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.75
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$114.19
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.88
|
| Rate for Payer: UHC Core |
$58.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$58.88
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
OP
|
$114.19
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$97.06
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$82.34
|
| Rate for Payer: BCN Commercial |
$82.34
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Cofinity Advantage |
$79.93
|
| Rate for Payer: Cofinity Commercial |
$98.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$102.77
|
| Rate for Payer: Mclaren Medicaid |
$19.47
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.06
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.64
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$97.06
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$71.94
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.88
|
| Rate for Payer: UHC Core |
$58.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$58.88
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
IP
|
$114.19
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$71.94 |
| Max. Negotiated Rate |
$102.77 |
| Rate for Payer: Aetna Commercial |
$97.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.22
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Cofinity Advantage |
$79.93
|
| Rate for Payer: Cofinity Commercial |
$98.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.35
|
| Rate for Payer: Healthscope Commercial |
$102.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.64
|
| Rate for Payer: PHP Commercial |
$97.06
|
| Rate for Payer: Priority Health SBD |
$71.94
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
IP
|
$121.06
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.27 |
| Max. Negotiated Rate |
$108.95 |
| Rate for Payer: Aetna Commercial |
$102.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.69
|
| Rate for Payer: Cash Price |
$96.85
|
| Rate for Payer: Cofinity Advantage |
$84.74
|
| Rate for Payer: Cofinity Commercial |
$104.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.85
|
| Rate for Payer: Healthscope Commercial |
$108.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.80
|
| Rate for Payer: PHP Commercial |
$102.90
|
| Rate for Payer: Priority Health SBD |
$76.27
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
OP
|
$121.06
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.58 |
| Max. Negotiated Rate |
$108.95 |
| Rate for Payer: Aetna Commercial |
$102.90
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.69
|
| Rate for Payer: BCBS Complete |
$48.42
|
| Rate for Payer: Cash Price |
$96.85
|
| Rate for Payer: Cofinity Advantage |
$84.74
|
| Rate for Payer: Cofinity Commercial |
$104.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.85
|
| Rate for Payer: Healthscope Commercial |
$108.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.80
|
| Rate for Payer: PHP Commercial |
$102.90
|
| Rate for Payer: Priority Health SBD |
$76.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.69
|
| Rate for Payer: UHC Core |
$63.07
|
| Rate for Payer: UHC Exchange |
$47.58
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$92.30 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$50.45
|
| Rate for Payer: BCN Commercial |
$50.45
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.30
|
| Rate for Payer: UHC Core |
$92.30
|
| Rate for Payer: UHC Exchange |
$92.30
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.30 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$284.30
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$284.30
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$583.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.66 |
| Max. Negotiated Rate |
$833.80 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: Priority Health SBD |
$583.66
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.08 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$209.08
|
| Rate for Payer: BCCCP Commercial |
$284.96
|
| Rate for Payer: BCN Commercial |
$209.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$583.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.66 |
| Max. Negotiated Rate |
$833.80 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: Priority Health SBD |
$583.66
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.66 |
| Max. Negotiated Rate |
$833.80 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: Priority Health SBD |
$583.66
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.30 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$787.47
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$284.30
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$284.30
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Advantage |
$648.51
|
| Rate for Payer: Cofinity Commercial |
$796.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$583.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$1,089.92
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$686.65 |
| Max. Negotiated Rate |
$980.93 |
| Rate for Payer: Aetna Commercial |
$926.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.45
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cofinity Advantage |
$762.94
|
| Rate for Payer: Cofinity Commercial |
$937.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.94
|
| Rate for Payer: Healthscope Commercial |
$980.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.44
|
| Rate for Payer: PHP Commercial |
$926.43
|
| Rate for Payer: Priority Health SBD |
$686.65
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$1,089.92
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.90 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$926.43
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCCCP Commercial |
$126.90
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cofinity Advantage |
$762.94
|
| Rate for Payer: Cofinity Commercial |
$937.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$980.93
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.43
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.44
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$926.43
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$686.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.45
|
| Rate for Payer: UHC Core |
$567.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$428.34
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$153.88
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.94 |
| Max. Negotiated Rate |
$138.49 |
| Rate for Payer: Aetna Commercial |
$130.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.02
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Advantage |
$107.72
|
| Rate for Payer: Cofinity Commercial |
$132.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Healthscope Commercial |
$138.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: PHP Commercial |
$130.80
|
| Rate for Payer: Priority Health SBD |
$96.94
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$153.88
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$61.55 |
| Max. Negotiated Rate |
$740.53 |
| Rate for Payer: Aetna Commercial |
$130.80
|
| Rate for Payer: Aetna Medicare |
$76.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.02
|
| Rate for Payer: BCBS Complete |
$61.55
|
| Rate for Payer: BCBS Trust/PPO |
$740.53
|
| Rate for Payer: BCCCP Commercial |
$221.53
|
| Rate for Payer: BCN Commercial |
$740.53
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Advantage |
$107.72
|
| Rate for Payer: Cofinity Commercial |
$132.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Healthscope Commercial |
$138.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: PHP Commercial |
$130.80
|
| Rate for Payer: Priority Health SBD |
$96.94
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$169.26
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$106.63 |
| Max. Negotiated Rate |
$152.33 |
| Rate for Payer: Aetna Commercial |
$143.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.02
|
| Rate for Payer: Cash Price |
$135.41
|
| Rate for Payer: Cofinity Advantage |
$118.48
|
| Rate for Payer: Cofinity Commercial |
$145.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.41
|
| Rate for Payer: Healthscope Commercial |
$152.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.94
|
| Rate for Payer: PHP Commercial |
$143.87
|
| Rate for Payer: Priority Health SBD |
$106.63
|
|
