|
HC PARASITIC EXAMINATION, STOOL
|
Facility
|
OP
|
$17.34
|
|
|
Service Code
|
CPT 87177
|
| Hospital Charge Code |
30600283
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.74
|
| Rate for Payer: Aetna Medicare |
$9.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.12
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: BCBS MAPPO |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$6.97
|
| Rate for Payer: BCN Medicare Advantage |
$8.90
|
| Rate for Payer: Cash Price |
$13.87
|
| Rate for Payer: Cash Price |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$12.14
|
| Rate for Payer: Cofinity Commercial |
$14.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$4.87
|
| Rate for Payer: Mclaren Medicare |
$8.90
|
| Rate for Payer: Meridian Medicaid |
$5.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.74
|
| Rate for Payer: PACE Medicare |
$8.46
|
| Rate for Payer: PACE SWMI |
$8.90
|
| Rate for Payer: PHP Commercial |
$14.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.14
|
| Rate for Payer: Priority Health Medicare |
$8.90
|
| Rate for Payer: Priority Health SBD |
$10.92
|
| Rate for Payer: Railroad Medicare Medicare |
$8.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.68
|
| Rate for Payer: UHC Core |
$15.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.90
|
| Rate for Payer: UHC Exchange |
$8.90
|
| Rate for Payer: UHC Medicare Advantage |
$9.17
|
| Rate for Payer: VA VA |
$8.90
|
|
|
HC PARASITIC SPECIAL STAIN
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
30600284
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health SBD |
$22.49
|
|
|
HC PARASITIC SPECIAL STAIN
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
30600284
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: BCBS Complete |
$10.33
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$14.08
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$9.84
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$10.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.58
|
| Rate for Payer: UHC Core |
$30.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.98
|
| Rate for Payer: UHC Exchange |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: VA VA |
$17.98
|
|
|
HC PARATHYROID HORMONE INTACT
|
Facility
|
OP
|
$226.20
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
30100383
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$203.58 |
| Rate for Payer: Aetna Commercial |
$192.27
|
| Rate for Payer: Aetna Medicare |
$42.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.60
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$41.28
|
| Rate for Payer: BCBS Trust/PPO |
$32.33
|
| Rate for Payer: BCN Medicare Advantage |
$41.28
|
| Rate for Payer: Cash Price |
$180.96
|
| Rate for Payer: Cash Price |
$180.96
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$194.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.28
|
| Rate for Payer: Healthscope Commercial |
$203.58
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Mclaren Medicare |
$41.28
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$192.27
|
| Rate for Payer: PACE Medicare |
$39.22
|
| Rate for Payer: PACE SWMI |
$41.28
|
| Rate for Payer: PHP Commercial |
$192.27
|
| Rate for Payer: PHP Medicare Advantage |
$41.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.34
|
| Rate for Payer: Priority Health Medicare |
$41.28
|
| Rate for Payer: Priority Health SBD |
$142.51
|
| Rate for Payer: Railroad Medicare Medicare |
$41.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.54
|
| Rate for Payer: UHC Core |
$70.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.28
|
| Rate for Payer: UHC Exchange |
$41.28
|
| Rate for Payer: UHC Medicare Advantage |
$42.52
|
| Rate for Payer: VA VA |
$41.28
|
|
|
HC PARATHYROID HORMONE INTACT
|
Facility
|
IP
|
$226.20
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
30100383
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$142.51 |
| Max. Negotiated Rate |
$203.58 |
| Rate for Payer: Aetna Commercial |
$192.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.03
|
| Rate for Payer: Cash Price |
$180.96
|
| Rate for Payer: Cofinity Commercial |
$194.53
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Healthscope Commercial |
$203.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$192.27
|
| Rate for Payer: PHP Commercial |
$192.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.34
|
| Rate for Payer: Priority Health SBD |
$142.51
|
|
|
HC PARATHYROID RELATED PROTEIN
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100150
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna Medicare |
$14.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.65
|
| Rate for Payer: BCBS Complete |
$8.11
|
| Rate for Payer: BCBS MAPPO |
$14.12
|
| Rate for Payer: BCBS Trust/PPO |
$11.06
|
| Rate for Payer: BCN Medicare Advantage |
$14.12
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Mclaren Medicaid |
$7.72
|
| Rate for Payer: Mclaren Medicare |
$14.12
|
| Rate for Payer: Meridian Medicaid |
$8.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PACE Medicare |
$13.41
|
| Rate for Payer: PACE SWMI |
$14.12
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health SBD |
$37.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.94
|
| Rate for Payer: UHC Core |
$24.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.12
|
| Rate for Payer: UHC Exchange |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: VA VA |
$14.12
|
|
|
HC PARATHYROID RELATED PROTEIN
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100150
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.45
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health SBD |
$37.27
|
|
|
HC PARIETAL CELL AB
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200002
|
|
Hospital Revenue Code
|
302
|
| 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: Healthscope Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health SBD |
$34.06
|
|
|
HC PARIETAL CELL AB
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200002
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$9.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC PARTIAL EXC BONE; PHALANX OF TOE
|
Facility
|
IP
|
$2,791.74
|
|
|
Service Code
|
CPT 28124
|
| Hospital Charge Code |
76100285
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,758.80 |
| Max. Negotiated Rate |
$2,512.57 |
| Rate for Payer: Aetna Commercial |
$2,372.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.63
|
| Rate for Payer: Cash Price |
$2,233.39
|
| Rate for Payer: Cofinity Commercial |
$1,954.22
|
| Rate for Payer: Cofinity Commercial |
$2,400.90
|
| Rate for Payer: Healthscope Commercial |
$2,512.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,372.98
|
| Rate for Payer: PHP Commercial |
$2,372.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,954.22
|
| Rate for Payer: Priority Health SBD |
$1,758.80
|
|
|
HC PARTIAL EXC BONE; PHALANX OF TOE
|
Facility
|
OP
|
$2,791.74
|
|
|
Service Code
|
CPT 28124
|
| Hospital Charge Code |
76100285
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$222.05 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$2,372.98
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$222.05
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$2,233.39
|
| Rate for Payer: Cash Price |
$2,233.39
|
| Rate for Payer: Cofinity Commercial |
$2,400.90
|
| Rate for Payer: Cofinity Commercial |
$1,954.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$2,512.57
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,372.98
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$2,372.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,954.22
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$1,758.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$332.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
HC PARTIAL REMOVAL BONE TARSAL/METATARSAL
|
Facility
|
IP
|
$9,060.00
|
|
|
Service Code
|
CPT 28122
|
| Hospital Charge Code |
76100406
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,707.80 |
| Max. Negotiated Rate |
$8,154.00 |
| Rate for Payer: Aetna Commercial |
$7,701.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,889.00
|
| Rate for Payer: Cash Price |
$7,248.00
|
| Rate for Payer: Cofinity Commercial |
$6,342.00
|
| Rate for Payer: Cofinity Commercial |
$7,791.60
|
| Rate for Payer: Healthscope Commercial |
$8,154.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,701.00
|
| Rate for Payer: PHP Commercial |
$7,701.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,342.00
|
| Rate for Payer: Priority Health SBD |
$5,707.80
|
|
|
HC PARTIAL REMOVAL BONE TARSAL/METATARSAL
|
Facility
|
OP
|
$9,060.00
|
|
|
Service Code
|
CPT 28122
|
| Hospital Charge Code |
76100406
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$8,925.64 |
| Rate for Payer: Aetna Commercial |
$7,701.00
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,889.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,544.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$7,248.00
|
| Rate for Payer: Cash Price |
$7,248.00
|
| Rate for Payer: Cofinity Commercial |
$7,791.60
|
| Rate for Payer: Cofinity Commercial |
$6,342.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$8,154.00
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,701.00
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$7,701.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,342.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,925.64
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,140.51
|
| Rate for Payer: Priority Health SBD |
$5,707.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$435.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
HC PARTIAL REMOVAL OF HYMEN
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 56700
|
| Hospital Charge Code |
36100619
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,907.54 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
|
|
HC PARTIAL REMOVAL OF HYMEN
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 56700
|
| Hospital Charge Code |
36100619
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.38 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,893.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,477.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,477.26
|
| Rate for Payer: BCBS Complete |
$1,597.87
|
| Rate for Payer: BCBS MAPPO |
$2,781.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,781.81
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,781.81
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Mclaren Medicaid |
$1,521.65
|
| Rate for Payer: Mclaren Medicare |
$2,781.81
|
| Rate for Payer: Meridian Medicaid |
$1,597.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,920.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,199.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,642.72
|
| Rate for Payer: PACE SWMI |
$2,781.81
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,781.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,521.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health Medicare |
$2,781.81
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,781.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,781.81
|
| Rate for Payer: UHC Exchange |
$201.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,865.26
|
| Rate for Payer: VA VA |
$2,781.81
|
|
|
HC PARVOVIRUS B19 COMPONENT
|
Facility
|
OP
|
$23.10
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200314
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$25.56 |
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna Medicare |
$15.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.79
|
| Rate for Payer: BCBS Complete |
$8.63
|
| Rate for Payer: BCBS MAPPO |
$15.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.77
|
| Rate for Payer: BCN Medicare Advantage |
$15.03
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Mclaren Medicaid |
$8.22
|
| Rate for Payer: Mclaren Medicare |
$15.03
|
| Rate for Payer: Meridian Medicaid |
$8.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.64
|
| Rate for Payer: PACE Medicare |
$14.28
|
| Rate for Payer: PACE SWMI |
$15.03
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: PHP Medicare Advantage |
$15.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Medicare |
$15.03
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: Railroad Medicare Medicare |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.04
|
| Rate for Payer: UHC Core |
$25.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.03
|
| Rate for Payer: UHC Exchange |
$15.03
|
| Rate for Payer: UHC Medicare Advantage |
$15.48
|
| Rate for Payer: VA VA |
$15.03
|
|
|
HC PARVOVIRUS B19 COMPONENT
|
Facility
|
IP
|
$23.10
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200314
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$20.79 |
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.64
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health SBD |
$14.55
|
|
|
HC PARVOVIRUS B19 IGG
|
Facility
|
IP
|
$23.10
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$20.79 |
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.64
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health SBD |
$14.55
|
|
|
HC PARVOVIRUS B19 IGG
|
Facility
|
OP
|
$23.10
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$25.56 |
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna Medicare |
$15.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.79
|
| Rate for Payer: BCBS Complete |
$8.63
|
| Rate for Payer: BCBS MAPPO |
$15.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.77
|
| Rate for Payer: BCN Medicare Advantage |
$15.03
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Mclaren Medicaid |
$8.22
|
| Rate for Payer: Mclaren Medicare |
$15.03
|
| Rate for Payer: Meridian Medicaid |
$8.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.64
|
| Rate for Payer: PACE Medicare |
$14.28
|
| Rate for Payer: PACE SWMI |
$15.03
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: PHP Medicare Advantage |
$15.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Medicare |
$15.03
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: Railroad Medicare Medicare |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.04
|
| Rate for Payer: UHC Core |
$25.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.03
|
| Rate for Payer: UHC Exchange |
$15.03
|
| Rate for Payer: UHC Medicare Advantage |
$15.48
|
| Rate for Payer: VA VA |
$15.03
|
|
|
HC PASTE
|
Facility
|
IP
|
$30.48
|
|
| Hospital Charge Code |
27000131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$27.43 |
| Rate for Payer: Aetna Commercial |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.81
|
| Rate for Payer: Cash Price |
$24.38
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Healthscope Commercial |
$27.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.91
|
| Rate for Payer: PHP Commercial |
$25.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.34
|
| Rate for Payer: Priority Health SBD |
$19.20
|
|
|
HC PASTE
|
Facility
|
OP
|
$30.48
|
|
| Hospital Charge Code |
27000131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$27.43 |
| Rate for Payer: Aetna Commercial |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.81
|
| Rate for Payer: BCBS Complete |
$12.19
|
| Rate for Payer: Cash Price |
$24.38
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Healthscope Commercial |
$27.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.91
|
| Rate for Payer: PHP Commercial |
$25.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.34
|
| Rate for Payer: Priority Health SBD |
$19.20
|
|
|
HC PASTE NO STING
|
Facility
|
IP
|
$41.90
|
|
|
Service Code
|
HCPCS A4406
|
| Hospital Charge Code |
27000627
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$37.71 |
| Rate for Payer: Aetna Commercial |
$35.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.24
|
| Rate for Payer: Cash Price |
$33.52
|
| Rate for Payer: Cofinity Commercial |
$29.33
|
| Rate for Payer: Cofinity Commercial |
$36.03
|
| Rate for Payer: Healthscope Commercial |
$37.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.62
|
| Rate for Payer: PHP Commercial |
$35.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.33
|
| Rate for Payer: Priority Health SBD |
$26.40
|
|
|
HC PASTE NO STING
|
Facility
|
OP
|
$41.90
|
|
|
Service Code
|
HCPCS A4406
|
| Hospital Charge Code |
27000627
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$37.71 |
| Rate for Payer: Aetna Commercial |
$35.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.24
|
| Rate for Payer: BCBS Complete |
$16.76
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: Cash Price |
$33.52
|
| Rate for Payer: Cash Price |
$33.52
|
| Rate for Payer: Cofinity Commercial |
$36.03
|
| Rate for Payer: Cofinity Commercial |
$29.33
|
| Rate for Payer: Healthscope Commercial |
$37.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.62
|
| Rate for Payer: PHP Commercial |
$35.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.33
|
| Rate for Payer: Priority Health SBD |
$26.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.37
|
| Rate for Payer: UHC Exchange |
$7.81
|
|
|
HC PATH CONSULT ON REFERRAL WITH SLIDE PREP
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
31000113
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.12 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health SBD |
$68.12
|
|
|
HC PATH CONSULT ON REFERRAL WITH SLIDE PREP
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
31000113
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.28
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.76
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Mclaren Medicare |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.72
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health Narrow Network |
$123.78
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.27
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$112.97
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
