|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$33.40 |
| Max. Negotiated Rate |
$351.10 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$118.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.08
|
| Rate for Payer: BCBS Complete |
$65.29
|
| Rate for Payer: BCBS MAPPO |
$113.66
|
| Rate for Payer: BCBS Trust/PPO |
$53.73
|
| Rate for Payer: BCN Medicare Advantage |
$113.66
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Cofinity Commercial |
$255.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.66
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$62.17
|
| Rate for Payer: Mclaren Medicare |
$113.66
|
| Rate for Payer: Meridian Medicaid |
$65.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$309.85
|
| Rate for Payer: PACE Medicare |
$107.98
|
| Rate for Payer: PACE SWMI |
$113.66
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$113.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$351.10
|
| Rate for Payer: Priority Health Medicare |
$113.66
|
| Rate for Payer: Priority Health Narrow Network |
$280.88
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Railroad Medicare Medicare |
$113.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.66
|
| Rate for Payer: UHC Exchange |
$33.40
|
| Rate for Payer: UHC Medicare Advantage |
$117.07
|
| Rate for Payer: VA VA |
$113.66
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
OP
|
$182.98
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$260.96 |
| Rate for Payer: Aetna Commercial |
$155.53
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.04
|
| Rate for Payer: BCBS Complete |
$31.26
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS Trust/PPO |
$260.96
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cofinity Commercial |
$128.09
|
| Rate for Payer: Cofinity Commercial |
$157.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$164.68
|
| Rate for Payer: Mclaren Medicaid |
$29.77
|
| Rate for Payer: Mclaren Medicare |
$54.43
|
| Rate for Payer: Meridian Medicaid |
$31.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.53
|
| Rate for Payer: PACE Medicare |
$51.71
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Commercial |
$155.53
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.33
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$138.66
|
| Rate for Payer: Priority Health SBD |
$115.28
|
| Rate for Payer: Railroad Medicare Medicare |
$54.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Exchange |
$26.52
|
| Rate for Payer: UHC Medicare Advantage |
$56.06
|
| Rate for Payer: VA VA |
$54.43
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
IP
|
$182.98
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$115.28 |
| Max. Negotiated Rate |
$164.68 |
| Rate for Payer: Aetna Commercial |
$155.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.94
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cofinity Commercial |
$128.09
|
| Rate for Payer: Cofinity Commercial |
$157.36
|
| Rate for Payer: Healthscope Commercial |
$164.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.53
|
| Rate for Payer: PHP Commercial |
$155.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.09
|
| Rate for Payer: Priority Health SBD |
$115.28
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
OP
|
$182.98
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$204.15 |
| Rate for Payer: Aetna Commercial |
$155.53
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.04
|
| Rate for Payer: BCBS Complete |
$31.26
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS Trust/PPO |
$204.15
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cofinity Commercial |
$157.36
|
| Rate for Payer: Cofinity Commercial |
$128.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$164.68
|
| Rate for Payer: Mclaren Medicaid |
$29.77
|
| Rate for Payer: Mclaren Medicare |
$54.43
|
| Rate for Payer: Meridian Medicaid |
$31.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.53
|
| Rate for Payer: PACE Medicare |
$51.71
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Commercial |
$155.53
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.33
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$138.66
|
| Rate for Payer: Priority Health SBD |
$115.28
|
| Rate for Payer: Railroad Medicare Medicare |
$54.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Exchange |
$18.01
|
| Rate for Payer: UHC Medicare Advantage |
$56.06
|
| Rate for Payer: VA VA |
$54.43
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
IP
|
$182.98
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$115.28 |
| Max. Negotiated Rate |
$164.68 |
| Rate for Payer: Aetna Commercial |
$155.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.94
|
| Rate for Payer: Cash Price |
$146.38
|
| Rate for Payer: Cofinity Commercial |
$128.09
|
| Rate for Payer: Cofinity Commercial |
$157.36
|
| Rate for Payer: Healthscope Commercial |
$164.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.53
|
| Rate for Payer: PHP Commercial |
$155.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.09
|
| Rate for Payer: Priority Health SBD |
$115.28
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
OP
|
$125.73
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$113.16 |
| Rate for Payer: Aetna Commercial |
$106.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.72
|
| Rate for Payer: BCBS Complete |
$50.29
|
| Rate for Payer: BCBS Trust/PPO |
$15.34
|
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Cofinity Commercial |
$88.01
|
| Rate for Payer: Cofinity Commercial |
$108.13
|
| Rate for Payer: Healthscope Commercial |
$113.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.87
|
| Rate for Payer: PHP Commercial |
$106.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.01
|
| Rate for Payer: Priority Health SBD |
$79.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.32
|
| Rate for Payer: UHC Exchange |
$3.93
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
IP
|
$125.73
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$79.21 |
| Max. Negotiated Rate |
$113.16 |
| Rate for Payer: Aetna Commercial |
$106.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.72
|
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Cofinity Commercial |
$108.13
|
| Rate for Payer: Cofinity Commercial |
$88.01
|
| Rate for Payer: Healthscope Commercial |
$113.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.87
|
| Rate for Payer: PHP Commercial |
$106.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.01
|
| Rate for Payer: Priority Health SBD |
$79.21
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
OP
|
$201.39
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$24.89 |
| Max. Negotiated Rate |
$436.07 |
| Rate for Payer: Aetna Commercial |
$171.18
|
| Rate for Payer: Aetna Medicare |
$144.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.74
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$138.99
|
| Rate for Payer: BCBS Trust/PPO |
$115.12
|
| Rate for Payer: BCN Medicare Advantage |
$138.99
|
| Rate for Payer: Cash Price |
$161.11
|
| Rate for Payer: Cash Price |
$161.11
|
| Rate for Payer: Cofinity Commercial |
$173.20
|
| Rate for Payer: Cofinity Commercial |
$140.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.99
|
| Rate for Payer: Healthscope Commercial |
$181.25
|
| Rate for Payer: Mclaren Medicaid |
$76.03
|
| Rate for Payer: Mclaren Medicare |
$138.99
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.18
|
| Rate for Payer: PACE Medicare |
$132.04
|
| Rate for Payer: PACE SWMI |
$138.99
|
| Rate for Payer: PHP Commercial |
$171.18
|
| Rate for Payer: PHP Medicare Advantage |
$138.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.07
|
| Rate for Payer: Priority Health Medicare |
$138.99
|
| Rate for Payer: Priority Health Narrow Network |
$348.85
|
| Rate for Payer: Priority Health SBD |
$126.88
|
| Rate for Payer: Railroad Medicare Medicare |
$138.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.99
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UHC Medicare Advantage |
$143.16
|
| Rate for Payer: VA VA |
$138.99
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
IP
|
$201.39
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$126.88 |
| Max. Negotiated Rate |
$181.25 |
| Rate for Payer: Aetna Commercial |
$171.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.90
|
| Rate for Payer: Cash Price |
$161.11
|
| Rate for Payer: Cofinity Commercial |
$140.97
|
| Rate for Payer: Cofinity Commercial |
$173.20
|
| Rate for Payer: Healthscope Commercial |
$181.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.18
|
| Rate for Payer: PHP Commercial |
$171.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.97
|
| Rate for Payer: Priority Health SBD |
$126.88
|
|
|
HC PULSE OX SINGLE
|
Facility
|
OP
|
$84.74
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$72.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.08
|
| Rate for Payer: BCBS Complete |
$33.90
|
| Rate for Payer: BCBS Trust/PPO |
$9.21
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Cofinity Commercial |
$72.88
|
| Rate for Payer: Healthscope Commercial |
$76.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.03
|
| Rate for Payer: PHP Commercial |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.32
|
| Rate for Payer: Priority Health SBD |
$53.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.88
|
| Rate for Payer: UHC Exchange |
$2.62
|
|
|
HC PULSE OX SINGLE
|
Facility
|
IP
|
$84.74
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$53.39 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$72.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.08
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Cofinity Commercial |
$72.88
|
| Rate for Payer: Healthscope Commercial |
$76.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.03
|
| Rate for Payer: PHP Commercial |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.32
|
| Rate for Payer: Priority Health SBD |
$53.39
|
|
|
HC PULSERIDER
|
Facility
|
OP
|
$16,734.38
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,693.75 |
| Max. Negotiated Rate |
$15,060.94 |
| Rate for Payer: Aetna Commercial |
$14,224.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,877.35
|
| Rate for Payer: BCBS Complete |
$6,693.75
|
| Rate for Payer: Cash Price |
$13,387.50
|
| Rate for Payer: Cofinity Commercial |
$11,714.07
|
| Rate for Payer: Cofinity Commercial |
$14,391.57
|
| Rate for Payer: Healthscope Commercial |
$15,060.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,224.22
|
| Rate for Payer: PHP Commercial |
$14,224.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,714.07
|
| Rate for Payer: Priority Health SBD |
$10,542.66
|
|
|
HC PULSERIDER
|
Facility
|
IP
|
$16,734.38
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,542.66 |
| Max. Negotiated Rate |
$15,060.94 |
| Rate for Payer: Aetna Commercial |
$14,224.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,877.35
|
| Rate for Payer: Cash Price |
$13,387.50
|
| Rate for Payer: Cofinity Commercial |
$11,714.07
|
| Rate for Payer: Cofinity Commercial |
$14,391.57
|
| Rate for Payer: Healthscope Commercial |
$15,060.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,224.22
|
| Rate for Payer: PHP Commercial |
$14,224.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,714.07
|
| Rate for Payer: Priority Health SBD |
$10,542.66
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
IP
|
$448.28
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$282.42 |
| Max. Negotiated Rate |
$403.45 |
| Rate for Payer: Aetna Commercial |
$381.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.38
|
| Rate for Payer: Cash Price |
$358.62
|
| Rate for Payer: Cofinity Commercial |
$313.80
|
| Rate for Payer: Cofinity Commercial |
$385.52
|
| Rate for Payer: Healthscope Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$381.04
|
| Rate for Payer: PHP Commercial |
$381.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.80
|
| Rate for Payer: Priority Health SBD |
$282.42
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
OP
|
$448.28
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$179.31 |
| Max. Negotiated Rate |
$403.45 |
| Rate for Payer: Aetna Commercial |
$381.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.38
|
| Rate for Payer: BCBS Complete |
$179.31
|
| Rate for Payer: Cash Price |
$358.62
|
| Rate for Payer: Cofinity Commercial |
$313.80
|
| Rate for Payer: Cofinity Commercial |
$385.52
|
| Rate for Payer: Healthscope Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$381.04
|
| Rate for Payer: PHP Commercial |
$381.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.80
|
| Rate for Payer: Priority Health SBD |
$282.42
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$81.91
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.89 |
| Max. Negotiated Rate |
$171.51 |
| Rate for Payer: Aetna Commercial |
$69.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.24
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS Trust/PPO |
$171.51
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Cofinity Commercial |
$70.44
|
| Rate for Payer: Healthscope Commercial |
$73.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.62
|
| Rate for Payer: PHP Commercial |
$69.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.34
|
| Rate for Payer: Priority Health SBD |
$51.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.38
|
| Rate for Payer: UHC Exchange |
$24.89
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$81.91
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$73.72 |
| Rate for Payer: Aetna Commercial |
$69.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.24
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Cofinity Commercial |
$70.44
|
| Rate for Payer: Healthscope Commercial |
$73.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.62
|
| Rate for Payer: PHP Commercial |
$69.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.34
|
| Rate for Payer: Priority Health SBD |
$51.60
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.51 |
| Max. Negotiated Rate |
$1,076.20 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$368.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.50
|
| Rate for Payer: BCBS Complete |
$203.80
|
| Rate for Payer: BCBS MAPPO |
$354.80
|
| Rate for Payer: BCBS Trust/PPO |
$152.77
|
| Rate for Payer: BCN Medicare Advantage |
$354.80
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.80
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Mclaren Medicaid |
$194.08
|
| Rate for Payer: Mclaren Medicare |
$354.80
|
| Rate for Payer: Meridian Medicaid |
$203.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PACE Medicare |
$337.06
|
| Rate for Payer: PACE SWMI |
$354.80
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: PHP Medicare Advantage |
$354.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.20
|
| Rate for Payer: Priority Health Medicare |
$354.80
|
| Rate for Payer: Priority Health Narrow Network |
$860.96
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: Railroad Medicare Medicare |
$354.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.80
|
| Rate for Payer: UHC Exchange |
$45.51
|
| Rate for Payer: UHC Medicare Advantage |
$365.44
|
| Rate for Payer: VA VA |
$354.80
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$170.29 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health SBD |
$170.29
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
OP
|
$933.32
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.33 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$46.33
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Cofinity Commercial |
$653.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$587.99
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$82.84
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
IP
|
$933.32
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$587.99 |
| Max. Negotiated Rate |
$839.99 |
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$653.32
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health SBD |
$587.99
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
OP
|
$269.89
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.29 |
| Max. Negotiated Rate |
$1,076.20 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: Aetna Medicare |
$368.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.50
|
| Rate for Payer: BCBS Complete |
$203.80
|
| Rate for Payer: BCBS MAPPO |
$354.80
|
| Rate for Payer: BCBS Trust/PPO |
$162.28
|
| Rate for Payer: BCN Medicare Advantage |
$354.80
|
| Rate for Payer: Cash Price |
$215.91
|
| Rate for Payer: Cash Price |
$215.91
|
| Rate for Payer: Cofinity Commercial |
$188.92
|
| Rate for Payer: Cofinity Commercial |
$232.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.80
|
| Rate for Payer: Healthscope Commercial |
$242.90
|
| Rate for Payer: Mclaren Medicaid |
$194.08
|
| Rate for Payer: Mclaren Medicare |
$354.80
|
| Rate for Payer: Meridian Medicaid |
$203.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.41
|
| Rate for Payer: PACE Medicare |
$337.06
|
| Rate for Payer: PACE SWMI |
$354.80
|
| Rate for Payer: PHP Commercial |
$229.41
|
| Rate for Payer: PHP Medicare Advantage |
$354.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.20
|
| Rate for Payer: Priority Health Medicare |
$354.80
|
| Rate for Payer: Priority Health Narrow Network |
$860.96
|
| Rate for Payer: Priority Health SBD |
$170.03
|
| Rate for Payer: Railroad Medicare Medicare |
$354.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.80
|
| Rate for Payer: UHC Exchange |
$95.29
|
| Rate for Payer: UHC Medicare Advantage |
$365.44
|
| Rate for Payer: VA VA |
$354.80
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
IP
|
$269.89
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$170.03 |
| Max. Negotiated Rate |
$242.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.43
|
| Rate for Payer: Cash Price |
$215.91
|
| Rate for Payer: Cofinity Commercial |
$188.92
|
| Rate for Payer: Cofinity Commercial |
$232.11
|
| Rate for Payer: Healthscope Commercial |
$242.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.41
|
| Rate for Payer: PHP Commercial |
$229.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.92
|
| Rate for Payer: Priority Health SBD |
$170.03
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
OP
|
$762.46
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.60 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$383.24
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Cofinity Commercial |
$533.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.29
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$652.23
|
| Rate for Payer: Priority Health SBD |
$480.35
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.36
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$77.60
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
IP
|
$762.46
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$480.35 |
| Max. Negotiated Rate |
$686.21 |
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.60
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$533.72
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health SBD |
$480.35
|
|
