|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
OP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$62.15 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.71
|
| Rate for Payer: BCBS Complete |
$21.01
|
| Rate for Payer: BCBS MAPPO |
$36.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.57
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.57
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Mclaren Medicaid |
$20.00
|
| Rate for Payer: Mclaren Medicare |
$36.57
|
| Rate for Payer: Meridian Medicaid |
$21.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PACE Medicare |
$34.74
|
| Rate for Payer: PACE SWMI |
$36.57
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$36.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health Medicare |
$36.57
|
| Rate for Payer: Priority Health SBD |
$35.72
|
| Rate for Payer: Railroad Medicare Medicare |
$36.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.88
|
| Rate for Payer: UHC Core |
$62.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.57
|
| Rate for Payer: UHC Exchange |
$36.57
|
| Rate for Payer: UHC Medicare Advantage |
$37.67
|
| Rate for Payer: VA VA |
$36.57
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.86
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health SBD |
$35.72
|
|
|
HC SOMATOMEDIN
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.58
|
| Rate for Payer: BCBS Complete |
$12.21
|
| Rate for Payer: BCBS MAPPO |
$21.26
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.26
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Mclaren Medicaid |
$11.63
|
| Rate for Payer: Mclaren Medicare |
$21.26
|
| Rate for Payer: Meridian Medicaid |
$12.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Medicare |
$20.20
|
| Rate for Payer: PACE SWMI |
$21.26
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$21.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health Medicare |
$21.26
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: Railroad Medicare Medicare |
$21.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.51
|
| Rate for Payer: UHC Core |
$36.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.26
|
| Rate for Payer: UHC Exchange |
$21.26
|
| Rate for Payer: UHC Medicare Advantage |
$21.90
|
| Rate for Payer: VA VA |
$21.26
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health SBD |
$34.06
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
|
|
HC SOYBEAN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,735.90 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,854.50
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$4,151.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health SBD |
$3,735.90
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
OP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,854.50
|
| Rate for Payer: BCBS Complete |
$2,372.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$4,151.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health SBD |
$3,735.90
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.52 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.67
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$341.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,377.62 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.27 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,537.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$2,732.79
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$2,459.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.70
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$244.27
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,459.51 |
| Max. Negotiated Rate |
$3,513.59 |
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,537.59
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$2,732.79
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health SBD |
$2,459.51
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.46 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$106.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$153.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,017.32 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$81.27 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.85
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health SBD |
$81.27
|
| Rate for Payer: Priority Health SBD |
$95.10
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$31.44 |
| Max. Negotiated Rate |
$150.91 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: Aetna Medicare |
$125.56
|
| Rate for Payer: Aetna Medicare |
$125.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.91
|
| Rate for Payer: BCBS Complete |
$69.35
|
| Rate for Payer: BCBS Complete |
$69.35
|
| Rate for Payer: BCBS MAPPO |
$120.73
|
| Rate for Payer: BCBS MAPPO |
$120.73
|
| Rate for Payer: BCBS Trust/PPO |
$31.44
|
| Rate for Payer: BCBS Trust/PPO |
$31.44
|
| Rate for Payer: BCN Medicare Advantage |
$120.73
|
| Rate for Payer: BCN Medicare Advantage |
$120.73
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.73
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Mclaren Medicaid |
$66.04
|
| Rate for Payer: Mclaren Medicaid |
$66.04
|
| Rate for Payer: Mclaren Medicare |
$120.73
|
| Rate for Payer: Mclaren Medicare |
$120.73
|
| Rate for Payer: Meridian Medicaid |
$69.35
|
| Rate for Payer: Meridian Medicaid |
$69.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: PACE Medicare |
$114.69
|
| Rate for Payer: PACE Medicare |
$114.69
|
| Rate for Payer: PACE SWMI |
$120.73
|
| Rate for Payer: PACE SWMI |
$120.73
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: PHP Medicare Advantage |
$120.73
|
| Rate for Payer: PHP Medicare Advantage |
$120.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health Medicare |
$120.73
|
| Rate for Payer: Priority Health Medicare |
$120.73
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: Priority Health SBD |
$81.27
|
| Rate for Payer: Railroad Medicare Medicare |
$120.73
|
| Rate for Payer: Railroad Medicare Medicare |
$120.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.73
|
| Rate for Payer: UHC Exchange |
$63.85
|
| Rate for Payer: UHC Exchange |
$63.85
|
| Rate for Payer: UHC Medicare Advantage |
$124.35
|
| Rate for Payer: UHC Medicare Advantage |
$124.35
|
| Rate for Payer: VA VA |
$120.73
|
| Rate for Payer: VA VA |
$120.73
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.41 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.17
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$131.57
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.77
|
| Rate for Payer: PHP Commercial |
$159.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.57
|
| Rate for Payer: Priority Health SBD |
$118.41
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.17
|
| 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 |
$106.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$131.57
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| 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 |
$159.77
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$159.77
|
| 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 |
$131.57
|
| 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 |
$118.41
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.75
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$110.68
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$162.52 |
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.38
|
| 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 |
$86.46
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$126.41
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| 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 |
$153.49
|
| Rate for Payer: PACE Medicare |
$51.71
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Commercial |
$153.49
|
| 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 |
$126.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.40
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$84.32
|
| Rate for Payer: Priority Health SBD |
$113.77
|
| Rate for Payer: Railroad Medicare Medicare |
$54.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.68
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Exchange |
$81.53
|
| Rate for Payer: UHC Medicare Advantage |
$56.06
|
| Rate for Payer: VA VA |
$54.43
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$113.77 |
| Max. Negotiated Rate |
$162.52 |
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.38
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$126.41
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.49
|
| Rate for Payer: PHP Commercial |
$153.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.41
|
| Rate for Payer: Priority Health SBD |
$113.77
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: BCBS Complete |
$1.88
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.57
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Mclaren Medicaid |
$1.79
|
| Rate for Payer: Mclaren Medicare |
$3.28
|
| Rate for Payer: Meridian Medicaid |
$1.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PACE Medicare |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.94
|
| Rate for Payer: UHC Core |
$4.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.38
|
| Rate for Payer: VA VA |
$3.28
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.86
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health SBD |
$7.62
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$43.20
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$6.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$5.23
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Cofinity Commercial |
$30.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health SBD |
$27.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.02
|
| Rate for Payer: UHC Core |
$11.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Exchange |
$6.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.88
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$43.20
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.22 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.08
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$30.24
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health SBD |
$27.22
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$545.70
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$66.04 |
| Max. Negotiated Rate |
$491.13 |
| Rate for Payer: Aetna Commercial |
$463.84
|
| Rate for Payer: Aetna Commercial |
$702.10
|
| Rate for Payer: Aetna Medicare |
$125.56
|
| Rate for Payer: Aetna Medicare |
$125.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.91
|
| Rate for Payer: BCBS Complete |
$69.35
|
| Rate for Payer: BCBS Complete |
$69.35
|
| Rate for Payer: BCBS MAPPO |
$120.73
|
| Rate for Payer: BCBS MAPPO |
$120.73
|
| Rate for Payer: BCBS Trust/PPO |
$228.91
|
| Rate for Payer: BCBS Trust/PPO |
$228.91
|
| Rate for Payer: BCN Medicare Advantage |
$120.73
|
| Rate for Payer: BCN Medicare Advantage |
$120.73
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$436.56
|
| Rate for Payer: Cash Price |
$436.56
|
| Rate for Payer: Cofinity Commercial |
$381.99
|
| Rate for Payer: Cofinity Commercial |
$578.20
|
| Rate for Payer: Cofinity Commercial |
$469.30
|
| Rate for Payer: Cofinity Commercial |
$710.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.73
|
| Rate for Payer: Healthscope Commercial |
$491.13
|
| Rate for Payer: Healthscope Commercial |
$743.40
|
| Rate for Payer: Mclaren Medicaid |
$66.04
|
| Rate for Payer: Mclaren Medicaid |
$66.04
|
| Rate for Payer: Mclaren Medicare |
$120.73
|
| Rate for Payer: Mclaren Medicare |
$120.73
|
| Rate for Payer: Meridian Medicaid |
$69.35
|
| Rate for Payer: Meridian Medicaid |
$69.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.84
|
| Rate for Payer: PACE Medicare |
$114.69
|
| Rate for Payer: PACE Medicare |
$114.69
|
| Rate for Payer: PACE SWMI |
$120.73
|
| Rate for Payer: PACE SWMI |
$120.73
|
| Rate for Payer: PHP Commercial |
$463.84
|
| Rate for Payer: PHP Commercial |
$702.10
|
| Rate for Payer: PHP Medicare Advantage |
$120.73
|
| Rate for Payer: PHP Medicare Advantage |
$120.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.99
|
| Rate for Payer: Priority Health Medicare |
$120.73
|
| Rate for Payer: Priority Health Medicare |
$120.73
|
| Rate for Payer: Priority Health SBD |
$343.79
|
| Rate for Payer: Priority Health SBD |
$520.38
|
| Rate for Payer: Railroad Medicare Medicare |
$120.73
|
| Rate for Payer: Railroad Medicare Medicare |
$120.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.73
|
| Rate for Payer: UHC Exchange |
$142.11
|
| Rate for Payer: UHC Exchange |
$142.11
|
| Rate for Payer: UHC Medicare Advantage |
$124.35
|
| Rate for Payer: UHC Medicare Advantage |
$124.35
|
| Rate for Payer: VA VA |
$120.73
|
| Rate for Payer: VA VA |
$120.73
|
|
