|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health SBD |
$23.66
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health SBD |
$23.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
| Rate for Payer: UHCCP Medicaid |
$4.85
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.44 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health SBD |
$18.44
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health SBD |
$18.44
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.67
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$104.10 |
| Max. Negotiated Rate |
$148.72 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.41
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$115.67
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Healthscope Commercial |
$148.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: PHP Commercial |
$140.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health SBD |
$104.10
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$104.10 |
| Max. Negotiated Rate |
$2,242.66 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$828.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$115.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$148.72
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$140.45
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health SBD |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,242.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$448.55
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$6.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: Meridian Medicaid |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$3.26
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$29.18
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.35
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health SBD |
$19.73
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.35
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health SBD |
$19.73
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$173.70 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.21
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$193.00
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health SBD |
$173.70
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$110.28 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$137.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.21
|
| Rate for Payer: BCBS Complete |
$110.28
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$193.00
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health SBD |
$173.70
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$17,739.50
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,175.89 |
| Max. Negotiated Rate |
$67,348.90 |
| Rate for Payer: Aetna Commercial |
$15,078.58
|
| Rate for Payer: Aetna Medicare |
$24,882.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,530.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,907.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,907.33
|
| Rate for Payer: BCBS Complete |
$13,465.47
|
| Rate for Payer: BCBS MAPPO |
$23,925.86
|
| Rate for Payer: BCN Medicare Advantage |
$23,925.86
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$15,255.97
|
| Rate for Payer: Cofinity Commercial |
$12,417.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,417.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,925.86
|
| Rate for Payer: Healthscope Commercial |
$15,965.55
|
| Rate for Payer: Mclaren Medicaid |
$12,824.26
|
| Rate for Payer: Mclaren Medicare |
$23,925.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,122.15
|
| Rate for Payer: Meridian Medicaid |
$13,465.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,514.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: PACE Medicare |
$22,729.57
|
| Rate for Payer: PACE SWMI |
$23,925.86
|
| Rate for Payer: PHP Commercial |
$15,078.58
|
| Rate for Payer: PHP Medicare Advantage |
$23,925.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,824.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.67
|
| Rate for Payer: Priority Health Medicare |
$23,925.86
|
| Rate for Payer: Priority Health SBD |
$11,175.89
|
| Rate for Payer: Railroad Medicare Medicare |
$23,925.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67,348.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,925.86
|
| Rate for Payer: UHC Medicare Advantage |
$23,925.86
|
| Rate for Payer: UHCCP Medicaid |
$13,470.26
|
| Rate for Payer: VA VA |
$23,925.86
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$17,739.50
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,175.89 |
| Max. Negotiated Rate |
$15,965.55 |
| Rate for Payer: Aetna Commercial |
$15,078.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,530.67
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$12,417.65
|
| Rate for Payer: Cofinity Commercial |
$15,255.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,417.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Healthscope Commercial |
$15,965.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: PHP Commercial |
$15,078.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.67
|
| Rate for Payer: Priority Health SBD |
$11,175.89
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$17,739.50
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,175.89 |
| Max. Negotiated Rate |
$67,348.90 |
| Rate for Payer: Aetna Commercial |
$15,078.58
|
| Rate for Payer: Aetna Medicare |
$24,882.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,530.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,907.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,907.33
|
| Rate for Payer: BCBS Complete |
$13,465.47
|
| Rate for Payer: BCBS MAPPO |
$23,925.86
|
| Rate for Payer: BCN Medicare Advantage |
$23,925.86
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$15,255.97
|
| Rate for Payer: Cofinity Commercial |
$12,417.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,417.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,925.86
|
| Rate for Payer: Healthscope Commercial |
$15,965.55
|
| Rate for Payer: Mclaren Medicaid |
$12,824.26
|
| Rate for Payer: Mclaren Medicare |
$23,925.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,122.15
|
| Rate for Payer: Meridian Medicaid |
$13,465.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,514.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: PACE Medicare |
$22,729.57
|
| Rate for Payer: PACE SWMI |
$23,925.86
|
| Rate for Payer: PHP Commercial |
$15,078.58
|
| Rate for Payer: PHP Medicare Advantage |
$23,925.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,824.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.67
|
| Rate for Payer: Priority Health Medicare |
$23,925.86
|
| Rate for Payer: Priority Health SBD |
$11,175.89
|
| Rate for Payer: Railroad Medicare Medicare |
$23,925.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67,348.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,925.86
|
| Rate for Payer: UHC Medicare Advantage |
$23,925.86
|
| Rate for Payer: UHCCP Medicaid |
$13,470.26
|
| Rate for Payer: VA VA |
$23,925.86
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$17,739.50
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,175.89 |
| Max. Negotiated Rate |
$15,965.55 |
| Rate for Payer: Aetna Commercial |
$15,078.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,530.67
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$12,417.65
|
| Rate for Payer: Cofinity Commercial |
$15,255.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,417.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Healthscope Commercial |
$15,965.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: PHP Commercial |
$15,078.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.67
|
| Rate for Payer: Priority Health SBD |
$11,175.89
|
|
|
HC EP AFTER DRUGS
|
Facility
|
OP
|
$7,423.93
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,969.57 |
| Max. Negotiated Rate |
$6,681.54 |
| Rate for Payer: Aetna Commercial |
$6,310.34
|
| Rate for Payer: Aetna Medicare |
$3,711.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,825.55
|
| Rate for Payer: BCBS Complete |
$2,969.57
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$5,196.75
|
| Rate for Payer: Cofinity Commercial |
$6,384.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,196.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$6,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: PHP Commercial |
$6,310.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health SBD |
$4,677.08
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,423.93
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,677.08 |
| Max. Negotiated Rate |
$6,681.54 |
| Rate for Payer: Aetna Commercial |
$6,310.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,825.55
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$5,196.75
|
| Rate for Payer: Cofinity Commercial |
$6,384.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,196.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$6,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: PHP Commercial |
$6,310.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health SBD |
$4,677.08
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
IP
|
$3,342.81
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,105.97 |
| Max. Negotiated Rate |
$3,008.53 |
| Rate for Payer: Aetna Commercial |
$2,841.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,172.83
|
| Rate for Payer: Cash Price |
$2,674.25
|
| Rate for Payer: Cofinity Commercial |
$2,339.97
|
| Rate for Payer: Cofinity Commercial |
$2,874.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,339.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,674.25
|
| Rate for Payer: Healthscope Commercial |
$3,008.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,841.39
|
| Rate for Payer: PHP Commercial |
$2,841.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.83
|
| Rate for Payer: Priority Health SBD |
$2,105.97
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
OP
|
$3,342.81
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,337.12 |
| Max. Negotiated Rate |
$3,008.53 |
| Rate for Payer: Aetna Commercial |
$2,841.39
|
| Rate for Payer: Aetna Medicare |
$1,671.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,172.83
|
| Rate for Payer: BCBS Complete |
$1,337.12
|
| Rate for Payer: Cash Price |
$2,674.25
|
| Rate for Payer: Cofinity Commercial |
$2,339.97
|
| Rate for Payer: Cofinity Commercial |
$2,874.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,339.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,674.25
|
| Rate for Payer: Healthscope Commercial |
$3,008.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,841.39
|
| Rate for Payer: PHP Commercial |
$2,841.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.83
|
| Rate for Payer: Priority Health SBD |
$2,105.97
|
| Rate for Payer: UHC Core |
$2,473.68
|
| Rate for Payer: UHC Exchange |
$2,473.68
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
OP
|
$2,388.64
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$955.46 |
| Max. Negotiated Rate |
$2,149.78 |
| Rate for Payer: Aetna Commercial |
$2,030.34
|
| Rate for Payer: Aetna Medicare |
$1,194.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.62
|
| Rate for Payer: BCBS Complete |
$955.46
|
| Rate for Payer: Cash Price |
$1,910.91
|
| Rate for Payer: Cofinity Commercial |
$1,672.05
|
| Rate for Payer: Cofinity Commercial |
$2,054.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,672.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,910.91
|
| Rate for Payer: Healthscope Commercial |
$2,149.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,030.34
|
| Rate for Payer: PHP Commercial |
$2,030.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.62
|
| Rate for Payer: Priority Health SBD |
$1,504.84
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
IP
|
$2,388.64
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,504.84 |
| Max. Negotiated Rate |
$2,149.78 |
| Rate for Payer: Aetna Commercial |
$2,030.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.62
|
| Rate for Payer: Cash Price |
$1,910.91
|
| Rate for Payer: Cofinity Commercial |
$1,672.05
|
| Rate for Payer: Cofinity Commercial |
$2,054.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,672.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,910.91
|
| Rate for Payer: Healthscope Commercial |
$2,149.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,030.34
|
| Rate for Payer: PHP Commercial |
$2,030.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.62
|
| Rate for Payer: Priority Health SBD |
$1,504.84
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
OP
|
$2,189.46
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$875.78 |
| Max. Negotiated Rate |
$1,970.51 |
| Rate for Payer: Aetna Commercial |
$1,861.04
|
| Rate for Payer: Aetna Medicare |
$1,094.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.15
|
| Rate for Payer: BCBS Complete |
$875.78
|
| Rate for Payer: Cash Price |
$1,751.57
|
| Rate for Payer: Cofinity Commercial |
$1,532.62
|
| Rate for Payer: Cofinity Commercial |
$1,882.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,532.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.57
|
| Rate for Payer: Healthscope Commercial |
$1,970.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.04
|
| Rate for Payer: PHP Commercial |
$1,861.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.15
|
| Rate for Payer: Priority Health SBD |
$1,379.36
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
IP
|
$2,189.46
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,379.36 |
| Max. Negotiated Rate |
$1,970.51 |
| Rate for Payer: Aetna Commercial |
$1,861.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.15
|
| Rate for Payer: Cash Price |
$1,751.57
|
| Rate for Payer: Cofinity Commercial |
$1,532.62
|
| Rate for Payer: Cofinity Commercial |
$1,882.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,532.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.57
|
| Rate for Payer: Healthscope Commercial |
$1,970.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.04
|
| Rate for Payer: PHP Commercial |
$1,861.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.15
|
| Rate for Payer: Priority Health SBD |
$1,379.36
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
OP
|
$675.00
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$337.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.75
|
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$472.50
|
| Rate for Payer: Cofinity Commercial |
$580.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$472.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.00
|
| Rate for Payer: Healthscope Commercial |
$607.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.75
|
| Rate for Payer: PHP Commercial |
$573.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.75
|
| Rate for Payer: Priority Health SBD |
$425.25
|
|
