|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.56
|
| 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 |
$7,641.30
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Cofinity Commercial |
$6,686.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,686.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| 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 |
$8,118.89
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| 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 |
$6,208.56
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$6,017.53
|
| 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 RT ONLY
|
Facility
|
IP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,017.53 |
| Max. Negotiated Rate |
$8,596.47 |
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.56
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$6,686.14
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,686.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.89
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,208.56
|
| Rate for Payer: Priority Health SBD |
$6,017.53
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.63
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$23.29
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$20.96
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.63
|
| Rate for Payer: BCBS Complete |
$13.31
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$23.29
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$20.96
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$53.40 |
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$19.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.68
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.56 |
| Max. Negotiated Rate |
$27.94 |
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.18
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health SBD |
$19.56
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$26.61
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$45.77 |
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$23.95
|
| Rate for Payer: Mclaren Medicaid |
$8.72
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.62
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$22.62
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.30
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health SBD |
$16.76
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHCCP Medicaid |
$9.15
|
| Rate for Payer: VA VA |
$16.26
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$26.61
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.76 |
| Max. Negotiated Rate |
$23.95 |
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.30
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.29
|
| Rate for Payer: Healthscope Commercial |
$23.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.62
|
| Rate for Payer: PHP Commercial |
$22.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.30
|
| Rate for Payer: Priority Health SBD |
$16.76
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$38.67
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$34.80 |
| Rate for Payer: Aetna Commercial |
$32.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.14
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cofinity Commercial |
$27.07
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.94
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.87
|
| Rate for Payer: PHP Commercial |
$32.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.14
|
| Rate for Payer: Priority Health SBD |
$24.36
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$38.67
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$66.54 |
| Rate for Payer: Aetna Commercial |
$32.87
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$13.30
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Commercial |
$27.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$13.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.87
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$32.87
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.14
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$23.64
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$19.80
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$34.09 |
| Rate for Payer: Aetna Commercial |
$16.83
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Commercial |
$13.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$17.82
|
| Rate for Payer: Mclaren Medicaid |
$6.49
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.83
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.87
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health SBD |
$12.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.11
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$19.80
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$17.82 |
| Rate for Payer: Aetna Commercial |
$16.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.87
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$13.86
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.84
|
| Rate for Payer: Healthscope Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.83
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.87
|
| Rate for Payer: Priority Health SBD |
$12.47
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$53.40 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.68
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health SBD |
$19.66
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$27.95
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$25.16 |
| Rate for Payer: Aetna Commercial |
$23.76
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.25
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.20
|
| Rate for Payer: Cash Price |
$22.36
|
| Rate for Payer: Cash Price |
$22.36
|
| Rate for Payer: Cofinity Commercial |
$24.04
|
| Rate for Payer: Cofinity Commercial |
$19.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$25.16
|
| Rate for Payer: Mclaren Medicaid |
$2.25
|
| Rate for Payer: Mclaren Medicare |
$4.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.41
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.76
|
| Rate for Payer: PACE Medicare |
$3.99
|
| Rate for Payer: PACE SWMI |
$4.20
|
| Rate for Payer: PHP Commercial |
$23.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.17
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health SBD |
$17.61
|
| Rate for Payer: Railroad Medicare Medicare |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.20
|
| Rate for Payer: UHCCP Medicaid |
$2.36
|
| Rate for Payer: VA VA |
$4.20
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$27.95
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$25.16 |
| Rate for Payer: Aetna Commercial |
$23.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.17
|
| Rate for Payer: Cash Price |
$22.36
|
| Rate for Payer: Cofinity Commercial |
$19.57
|
| Rate for Payer: Cofinity Commercial |
$24.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$25.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.76
|
| Rate for Payer: PHP Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.17
|
| Rate for Payer: Priority Health SBD |
$17.61
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$8.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.82
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.86
|
| Rate for Payer: BCN Medicare Advantage |
$7.86
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.86
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.25
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$7.47
|
| Rate for Payer: PACE SWMI |
$7.86
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$7.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$7.86
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.86
|
| Rate for Payer: UHC Medicare Advantage |
$7.86
|
| Rate for Payer: UHCCP Medicaid |
$4.43
|
| Rate for Payer: VA VA |
$7.86
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.14 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.34
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$76.83
|
| Rate for Payer: Cofinity Commercial |
$94.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health SBD |
$69.14
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.39
|
| Rate for Payer: Cofinity Commercial |
$76.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$69.14
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.49
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$98.32 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health SBD |
$98.32
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.10 |
| Max. Negotiated Rate |
$189.61 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$70.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.20
|
| Rate for Payer: BCBS Complete |
$37.91
|
| Rate for Payer: BCBS MAPPO |
$67.36
|
| Rate for Payer: BCN Medicare Advantage |
$67.36
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Cofinity Commercial |
$109.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.36
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$36.10
|
| Rate for Payer: Mclaren Medicare |
$67.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.73
|
| Rate for Payer: Meridian Medicaid |
$37.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: PACE Medicare |
$63.99
|
| Rate for Payer: PACE SWMI |
$67.36
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$67.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health Medicare |
$67.36
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: Railroad Medicare Medicare |
$67.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.36
|
| Rate for Payer: UHC Medicare Advantage |
$67.36
|
| Rate for Payer: UHCCP Medicaid |
$37.92
|
| Rate for Payer: VA VA |
$67.36
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC HEMATOCRIT
|
Facility
|
IP
|
$23.87
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$21.48 |
| Rate for Payer: Aetna Commercial |
$20.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.52
|
| Rate for Payer: Cash Price |
$19.10
|
| Rate for Payer: Cofinity Commercial |
$16.71
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.10
|
| Rate for Payer: Healthscope Commercial |
$21.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.29
|
| Rate for Payer: PHP Commercial |
$20.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.52
|
| Rate for Payer: Priority Health SBD |
$15.04
|
|
