|
HC HEARING AID CHECK BINAURAL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$30.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UHC Core |
$45.29
|
| Rate for Payer: UHC Exchange |
$45.29
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health SBD |
$34.06
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$27.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: BCBS Complete |
$21.62
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UHC Core |
$40.00
|
| Rate for Payer: UHC Exchange |
$40.00
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Cofinity Commercial |
$84.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health SBD |
$76.47
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Medicare |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Cofinity Commercial |
$84.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health SBD |
$76.47
|
| Rate for Payer: UHC Core |
$89.82
|
| Rate for Payer: UHC Exchange |
$89.82
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$70.04 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health SBD |
$70.04
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$44.47 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$55.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: BCBS Complete |
$44.47
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health SBD |
$70.04
|
| Rate for Payer: UHC Core |
$82.27
|
| Rate for Payer: UHC Exchange |
$82.27
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,938.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$8,548.67
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,548.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$7,693.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,693.81 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,938.05
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Cofinity Commercial |
$8,548.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,548.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health SBD |
$7,693.81
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,343.05 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,512.67
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$5,936.72
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,936.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health SBD |
$5,343.05
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,512.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Cofinity Commercial |
$5,936.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,936.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$5,343.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,513.41 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,815.42
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$10,570.45
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,570.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health SBD |
$9,513.41
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,815.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Cofinity Commercial |
$10,570.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,570.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$9,513.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,041.69 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,296.98
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Cofinity Commercial |
$8,935.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,935.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health SBD |
$8,041.69
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,296.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$8,935.21
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,935.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$8,041.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,645.81 |
| Max. Negotiated Rate |
$8,065.45 |
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,825.05
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$6,273.13
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,273.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health SBD |
$5,645.81
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,825.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Cofinity Commercial |
$6,273.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,273.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$5,645.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,095.57 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,352.57
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Cofinity Commercial |
$8,995.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,995.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health SBD |
$8,095.57
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,352.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$8,995.08
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,995.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$8,095.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,766.07
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna Medicare |
$21.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: BCBS Complete |
$17.24
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$207.35 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: Aetna Medicare |
$259.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.95
|
| Rate for Payer: BCBS Complete |
$207.35
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$362.87
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health SBD |
$326.58
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$326.58 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.95
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$362.87
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health SBD |
$326.58
|
|
