|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
OP
|
$6,494.28
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$404.39 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,221.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,818.41
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$4,546.00
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Priority Health SBD |
$4,091.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.83
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Exchange |
$404.39
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
OP
|
$6,494.28
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$416.51 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,221.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,818.41
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Cofinity Commercial |
$4,546.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Priority Health SBD |
$4,091.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.16
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Exchange |
$416.51
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,494.28
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,091.40 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,221.28
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$4,546.00
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health SBD |
$4,091.40
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$200.40
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$126.25 |
| Max. Negotiated Rate |
$180.36 |
| Rate for Payer: Aetna Commercial |
$170.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.26
|
| Rate for Payer: Cash Price |
$160.32
|
| Rate for Payer: Cofinity Commercial |
$172.34
|
| Rate for Payer: Cofinity Commercial |
$140.28
|
| Rate for Payer: Healthscope Commercial |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.34
|
| Rate for Payer: PHP Commercial |
$170.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.28
|
| Rate for Payer: Priority Health SBD |
$126.25
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$200.40
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$5,340.42 |
| Rate for Payer: Aetna Commercial |
$170.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.26
|
| Rate for Payer: BCBS Complete |
$80.16
|
| Rate for Payer: BCBS Trust/PPO |
$5,340.42
|
| Rate for Payer: Cash Price |
$160.32
|
| Rate for Payer: Cash Price |
$160.32
|
| Rate for Payer: Cofinity Commercial |
$172.34
|
| Rate for Payer: Cofinity Commercial |
$140.28
|
| Rate for Payer: Healthscope Commercial |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.34
|
| Rate for Payer: PHP Commercial |
$170.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.28
|
| Rate for Payer: Priority Health SBD |
$126.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.20
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$197.45
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$8,900.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,607.00 |
| Max. Negotiated Rate |
$8,010.00 |
| Rate for Payer: Aetna Commercial |
$7,565.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,785.00
|
| Rate for Payer: Cash Price |
$7,120.00
|
| Rate for Payer: Cofinity Commercial |
$6,230.00
|
| Rate for Payer: Cofinity Commercial |
$7,654.00
|
| Rate for Payer: Healthscope Commercial |
$8,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,565.00
|
| Rate for Payer: PHP Commercial |
$7,565.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,230.00
|
| Rate for Payer: Priority Health SBD |
$5,607.00
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$8,900.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$795.68 |
| Max. Negotiated Rate |
$8,010.00 |
| Rate for Payer: Aetna Commercial |
$7,565.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,785.00
|
| Rate for Payer: BCBS Complete |
$3,560.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,675.92
|
| Rate for Payer: Cash Price |
$7,120.00
|
| Rate for Payer: Cash Price |
$7,120.00
|
| Rate for Payer: Cofinity Commercial |
$7,654.00
|
| Rate for Payer: Cofinity Commercial |
$6,230.00
|
| Rate for Payer: Healthscope Commercial |
$8,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,565.00
|
| Rate for Payer: PHP Commercial |
$7,565.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,230.00
|
| Rate for Payer: Priority Health SBD |
$5,607.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.25
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$795.68
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$324.72
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.57 |
| Max. Negotiated Rate |
$9,573.02 |
| Rate for Payer: Aetna Commercial |
$276.01
|
| Rate for Payer: Aetna Medicare |
$3,226.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,877.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,877.45
|
| Rate for Payer: BCBS Complete |
$1,781.77
|
| Rate for Payer: BCBS MAPPO |
$3,101.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,101.96
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cofinity Commercial |
$227.30
|
| Rate for Payer: Cofinity Commercial |
$279.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,101.96
|
| Rate for Payer: Healthscope Commercial |
$292.25
|
| Rate for Payer: Mclaren Medicaid |
$1,696.77
|
| Rate for Payer: Mclaren Medicare |
$3,101.96
|
| Rate for Payer: Meridian Medicaid |
$1,781.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,257.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,567.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.01
|
| Rate for Payer: PACE Medicare |
$2,946.86
|
| Rate for Payer: PACE SWMI |
$3,101.96
|
| Rate for Payer: PHP Commercial |
$276.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,573.02
|
| Rate for Payer: Priority Health Medicare |
$3,101.96
|
| Rate for Payer: Priority Health Narrow Network |
$7,658.42
|
| Rate for Payer: Priority Health SBD |
$204.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.78
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,101.96
|
| Rate for Payer: UHC Exchange |
$253.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,195.02
|
| Rate for Payer: VA VA |
$3,101.96
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$324.72
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.57 |
| Max. Negotiated Rate |
$292.25 |
| Rate for Payer: Aetna Commercial |
$276.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.07
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cofinity Commercial |
$227.30
|
| Rate for Payer: Cofinity Commercial |
$279.26
|
| Rate for Payer: Healthscope Commercial |
$292.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.01
|
| Rate for Payer: PHP Commercial |
$276.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.30
|
| Rate for Payer: Priority Health SBD |
$204.57
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,571.86
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$325.15 |
| Max. Negotiated Rate |
$9,573.02 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna Medicare |
$3,226.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,877.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,877.45
|
| Rate for Payer: BCBS Complete |
$1,781.77
|
| Rate for Payer: BCBS MAPPO |
$3,101.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,101.96
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$2,500.30
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,101.96
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Mclaren Medicaid |
$1,696.77
|
| Rate for Payer: Mclaren Medicare |
$3,101.96
|
| Rate for Payer: Meridian Medicaid |
$1,781.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,257.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,567.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PACE Medicare |
$2,946.86
|
| Rate for Payer: PACE SWMI |
$3,101.96
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,573.02
|
| Rate for Payer: Priority Health Medicare |
$3,101.96
|
| Rate for Payer: Priority Health Narrow Network |
$7,658.42
|
| Rate for Payer: Priority Health SBD |
$2,250.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.66
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,101.96
|
| Rate for Payer: UHC Exchange |
$325.15
|
| Rate for Payer: UHC Medicare Advantage |
$3,195.02
|
| Rate for Payer: VA VA |
$3,101.96
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,571.86
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,250.27 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.71
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Cofinity Commercial |
$2,500.30
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health SBD |
$2,250.27
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,571.86
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,250.27 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.71
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$2,500.30
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health SBD |
$2,250.27
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,571.86
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.17 |
| Max. Negotiated Rate |
$9,573.02 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna Medicare |
$3,226.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,877.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,877.45
|
| Rate for Payer: BCBS Complete |
$1,781.77
|
| Rate for Payer: BCBS MAPPO |
$3,101.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,101.96
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Cofinity Commercial |
$2,500.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,101.96
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Mclaren Medicaid |
$1,696.77
|
| Rate for Payer: Mclaren Medicare |
$3,101.96
|
| Rate for Payer: Meridian Medicaid |
$1,781.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,257.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,567.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PACE Medicare |
$2,946.86
|
| Rate for Payer: PACE SWMI |
$3,101.96
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,573.02
|
| Rate for Payer: Priority Health Medicare |
$3,101.96
|
| Rate for Payer: Priority Health Narrow Network |
$7,658.42
|
| Rate for Payer: Priority Health SBD |
$2,250.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.59
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,101.96
|
| Rate for Payer: UHC Exchange |
$194.17
|
| Rate for Payer: UHC Medicare Advantage |
$3,195.02
|
| Rate for Payer: VA VA |
$3,101.96
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$165.69 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.95
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$184.10
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health SBD |
$165.69
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$16.78
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Cofinity Commercial |
$184.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$165.69
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$36.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$906.83 |
| Rate for Payer: Aetna Commercial |
$131.96
|
| Rate for Payer: Aetna Medicare |
$332.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.80
|
| Rate for Payer: BCBS Complete |
$183.72
|
| Rate for Payer: BCBS MAPPO |
$319.84
|
| Rate for Payer: BCBS Trust/PPO |
$91.84
|
| Rate for Payer: BCN Medicare Advantage |
$319.84
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$133.52
|
| Rate for Payer: Cofinity Commercial |
$108.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.84
|
| Rate for Payer: Healthscope Commercial |
$139.72
|
| Rate for Payer: Mclaren Medicaid |
$174.95
|
| Rate for Payer: Mclaren Medicare |
$319.84
|
| Rate for Payer: Meridian Medicaid |
$183.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: PACE Medicare |
$303.85
|
| Rate for Payer: PACE SWMI |
$319.84
|
| Rate for Payer: PHP Commercial |
$131.96
|
| Rate for Payer: PHP Medicare Advantage |
$319.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$906.83
|
| Rate for Payer: Priority Health Medicare |
$319.84
|
| Rate for Payer: Priority Health Narrow Network |
$725.46
|
| Rate for Payer: Priority Health SBD |
$97.81
|
| Rate for Payer: Railroad Medicare Medicare |
$319.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.28
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.84
|
| Rate for Payer: UHC Exchange |
$76.62
|
| Rate for Payer: UHC Medicare Advantage |
$329.44
|
| Rate for Payer: VA VA |
$319.84
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$97.81 |
| Max. Negotiated Rate |
$139.72 |
| Rate for Payer: Aetna Commercial |
$131.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.91
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$108.68
|
| Rate for Payer: Cofinity Commercial |
$133.52
|
| Rate for Payer: Healthscope Commercial |
$139.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: PHP Commercial |
$131.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: Priority Health SBD |
$97.81
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.29
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.37
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Cofinity Commercial |
$35.85
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health SBD |
$32.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.58
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Exchange |
$23.25
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.27 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.29
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Cofinity Commercial |
$35.85
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health SBD |
$32.27
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$180.46 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.64
|
| 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 |
$151.00
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$97.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$101.97
|
| 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 |
$96.30
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$96.30
|
| 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 |
$79.31
|
| 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 |
$71.38
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.46
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$164.05
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$71.38 |
| Max. Negotiated Rate |
$101.97 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.64
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$97.44
|
| Rate for Payer: Healthscope Commercial |
$101.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.30
|
| Rate for Payer: PHP Commercial |
$96.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.31
|
| Rate for Payer: Priority Health SBD |
$71.38
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$98.90 |
| Max. Negotiated Rate |
$141.28 |
| Rate for Payer: Aetna Commercial |
$133.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.04
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$109.89
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Healthscope Commercial |
$141.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PHP Commercial |
$133.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health SBD |
$98.90
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.33 |
| Max. Negotiated Rate |
$206.59 |
| Rate for Payer: Aetna Commercial |
$133.43
|
| Rate for Payer: Aetna Medicare |
$67.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.72
|
| Rate for Payer: BCBS Complete |
$37.09
|
| Rate for Payer: BCBS MAPPO |
$64.58
|
| Rate for Payer: BCBS Trust/PPO |
$200.20
|
| Rate for Payer: BCN Medicare Advantage |
$64.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Cofinity Commercial |
$109.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.58
|
| Rate for Payer: Healthscope Commercial |
$141.28
|
| Rate for Payer: Mclaren Medicaid |
$35.33
|
| Rate for Payer: Mclaren Medicare |
$64.58
|
| Rate for Payer: Meridian Medicaid |
$37.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PACE Medicare |
$61.35
|
| Rate for Payer: PACE SWMI |
$64.58
|
| Rate for Payer: PHP Commercial |
$133.43
|
| Rate for Payer: PHP Medicare Advantage |
$64.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.59
|
| Rate for Payer: Priority Health Medicare |
$64.58
|
| Rate for Payer: Priority Health Narrow Network |
$165.27
|
| Rate for Payer: Priority Health SBD |
$98.90
|
| Rate for Payer: Railroad Medicare Medicare |
$64.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.58
|
| Rate for Payer: UHC Medicare Advantage |
$66.52
|
| Rate for Payer: VA VA |
$64.58
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: BCBS Complete |
$3.75
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$3.57
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Medicaid |
$3.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health SBD |
$53.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.84
|
| Rate for Payer: UHC Core |
$11.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.53
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicare Advantage |
$6.73
|
| Rate for Payer: VA VA |
$6.53
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$53.34 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health SBD |
$53.34
|
|
