|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,220.83 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Commercial |
$6,749.28
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,161.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.83
|
| Rate for Payer: BCN Commercial |
$1,220.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Advantage |
$5,558.23
|
| Rate for Payer: Cofinity Commercial |
$6,828.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,146.30
|
| Rate for Payer: Mclaren Medicaid |
$1,686.93
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$6,749.28
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$5,002.41
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,161.21
|
| Rate for Payer: UHC Core |
$4,136.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$3,120.55
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,002.41 |
| Max. Negotiated Rate |
$7,146.30 |
| Rate for Payer: Aetna Commercial |
$6,749.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,161.21
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Advantage |
$5,558.23
|
| Rate for Payer: Cofinity Commercial |
$6,828.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Healthscope Commercial |
$7,146.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: PHP Commercial |
$6,749.28
|
| Rate for Payer: Priority Health SBD |
$5,002.41
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.95 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health SBD |
$41.95
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.99
|
| Rate for Payer: BCN Commercial |
$19.99
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$18.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: Meridian Medicaid |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$28.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.75
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Priority Health Tiered Network |
$15.00
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.13
|
| Rate for Payer: UHC Core |
$28.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.75
|
| Rate for Payer: UHC Exchange |
$28.13
|
| Rate for Payer: UHC Medicaid |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$9.81
|
| Rate for Payer: VA VA |
$18.75
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
OP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.71
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.28
|
| Rate for Payer: UHC Core |
$7.44
|
| Rate for Payer: UHC Exchange |
$5.61
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
IP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.88 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Aetna Commercial |
$38.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.80
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Advantage |
$32.09
|
| Rate for Payer: Cofinity Commercial |
$39.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Healthscope Commercial |
$41.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: PHP Commercial |
$38.96
|
| Rate for Payer: Priority Health SBD |
$28.88
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Aetna Commercial |
$38.96
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.55
|
| Rate for Payer: BCN Commercial |
$4.55
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Advantage |
$32.09
|
| Rate for Payer: Cofinity Commercial |
$39.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$41.26
|
| Rate for Payer: Mclaren Medicaid |
$2.23
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Nomi Health Commercial |
$6.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$38.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.27
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$28.88
|
| Rate for Payer: Priority Health Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$6.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.39
|
| Rate for Payer: BCBS Complete |
$2.37
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.59
|
| Rate for Payer: BCN Commercial |
$4.59
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Mclaren Medicaid |
$2.25
|
| Rate for Payer: Mclaren Medicare |
$4.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Meridian Medicaid |
$4.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$6.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PACE Medicare |
$4.09
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.31
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health SBD |
$28.31
|
| Rate for Payer: Priority Health Tiered Network |
$3.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.47
|
| Rate for Payer: UHC Core |
$6.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.31
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$2.25
|
| Rate for Payer: VA VA |
$4.31
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.31 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: Priority Health SBD |
$28.31
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
IP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$626.76 |
| Max. Negotiated Rate |
$895.37 |
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Aetna Commercial |
$845.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.65
|
| Rate for Payer: Cofinity Advantage |
$696.39
|
| Rate for Payer: Cofinity Commercial |
$855.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$895.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: PHP Commercial |
$845.62
|
| Rate for Payer: Priority Health SBD |
$626.76
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
OP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$397.94 |
| Max. Negotiated Rate |
$1,308.90 |
| Rate for Payer: Aetna Commercial |
$845.62
|
| Rate for Payer: Aetna Medicare |
$497.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.65
|
| Rate for Payer: BCBS Complete |
$397.94
|
| Rate for Payer: BCBS Trust/PPO |
$635.74
|
| Rate for Payer: BCN Commercial |
$635.74
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cofinity Advantage |
$696.39
|
| Rate for Payer: Cofinity Commercial |
$855.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$895.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$795.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: PHP Commercial |
$845.62
|
| Rate for Payer: Priority Health SBD |
$626.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.90
|
| Rate for Payer: UHC Core |
$1,308.90
|
| Rate for Payer: UHC Exchange |
$1,308.90
|
|
|
HC MAGGOT THERAPY
|
Facility
|
OP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$437.91 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$557.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: BCBS Complete |
$445.71
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.28
|
| Rate for Payer: UHC Core |
$580.53
|
| Rate for Payer: UHC Exchange |
$437.91
|
|
|
HC MAGGOT THERAPY
|
Facility
|
IP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$701.99 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$7.15
|
| Rate for Payer: BCN Commercial |
$7.15
|
| Rate for Payer: BCN Medicare Advantage |
$6.70
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.70
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$3.50
|
| Rate for Payer: Mclaren Medicare |
$6.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$7.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$10.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.70
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.70
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$5.36
|
| Rate for Payer: Railroad Medicare Medicare |
$6.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.05
|
| Rate for Payer: UHC Core |
$10.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.70
|
| Rate for Payer: UHC Exchange |
$10.05
|
| Rate for Payer: UHC Medicaid |
$3.50
|
| Rate for Payer: UHCCP Medicaid |
$3.50
|
| Rate for Payer: VA VA |
$6.70
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
|
HC MAKENA 10 MG
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$20.62 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna Medicare |
$1.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.62
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: Priority Health Tiered Network |
$16.50
|
|
|
HC MAKENA 10 MG
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
|
|
HC MALARIA SMEAR
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$6.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: BCBS Complete |
$3.29
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$4.79
|
| Rate for Payer: BCN Commercial |
$4.79
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$3.13
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: Meridian Medicaid |
$6.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$8.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.99
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$4.79
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.99
|
| Rate for Payer: UHC Core |
$8.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.99
|
| Rate for Payer: UHC Exchange |
$8.99
|
| Rate for Payer: UHC Medicaid |
$3.13
|
| Rate for Payer: UHCCP Medicaid |
$3.13
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC MALARIA SMEAR
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
|
|
HC MALLEABLE SS VE
|
Facility
|
OP
|
$186.00
|
|
| Hospital Charge Code |
27000716
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.10 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Aetna Commercial |
$158.10
|
| Rate for Payer: Aetna Medicare |
$93.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.90
|
| Rate for Payer: BCBS Complete |
$74.40
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Advantage |
$130.20
|
| Rate for Payer: Cofinity Commercial |
$159.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.80
|
| Rate for Payer: Healthscope Commercial |
$167.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: PHP Commercial |
$158.10
|
| Rate for Payer: Priority Health SBD |
$117.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.90
|
| Rate for Payer: UHC Core |
$96.91
|
| Rate for Payer: UHC Exchange |
$73.10
|
|
|
HC MALLEABLE SS VE
|
Facility
|
IP
|
$186.00
|
|
| Hospital Charge Code |
27000716
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$117.18 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Aetna Commercial |
$158.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.90
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Advantage |
$130.20
|
| Rate for Payer: Cofinity Commercial |
$159.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.80
|
| Rate for Payer: Healthscope Commercial |
$167.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: PHP Commercial |
$158.10
|
| Rate for Payer: Priority Health SBD |
$117.18
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
IP
|
$1,357.00
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$854.91 |
| Max. Negotiated Rate |
$1,221.30 |
| Rate for Payer: Aetna Commercial |
$1,153.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.05
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Advantage |
$949.90
|
| Rate for Payer: Cofinity Commercial |
$1,167.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,085.60
|
| Rate for Payer: Healthscope Commercial |
$1,221.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,153.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,017.75
|
| Rate for Payer: PHP Commercial |
$1,153.45
|
| Rate for Payer: Priority Health SBD |
$854.91
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
OP
|
$1,357.00
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.80 |
| Max. Negotiated Rate |
$1,221.30 |
| Rate for Payer: Aetna Commercial |
$1,153.45
|
| Rate for Payer: Aetna Medicare |
$678.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.05
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Advantage |
$949.90
|
| Rate for Payer: Cofinity Commercial |
$1,167.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,085.60
|
| Rate for Payer: Healthscope Commercial |
$1,221.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,085.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,153.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,017.75
|
| Rate for Payer: PHP Commercial |
$1,153.45
|
| Rate for Payer: Priority Health SBD |
$854.91
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
IP
|
$438.74
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$276.41 |
| Max. Negotiated Rate |
$394.87 |
| Rate for Payer: Aetna Commercial |
$372.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.18
|
| Rate for Payer: Cash Price |
$350.99
|
| Rate for Payer: Cofinity Advantage |
$307.12
|
| Rate for Payer: Cofinity Commercial |
$377.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.99
|
| Rate for Payer: Healthscope Commercial |
$394.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.06
|
| Rate for Payer: PHP Commercial |
$372.93
|
| Rate for Payer: Priority Health SBD |
$276.41
|
|
