|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$178.29
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$160.46 |
| Rate for Payer: Aetna Commercial |
$151.55
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$54.58
|
| Rate for Payer: BCN Commercial |
$54.58
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Advantage |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$160.46
|
| Rate for Payer: Mclaren Medicaid |
$26.77
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$151.55
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$112.32
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.31 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$26.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$21.31
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.00
|
| Rate for Payer: UHC Core |
$33.00
|
| Rate for Payer: UHC Exchange |
$33.00
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.57 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.31 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$26.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$21.31
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.00
|
| Rate for Payer: UHC Core |
$33.00
|
| Rate for Payer: UHC Exchange |
$33.00
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.57 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.30 |
| Max. Negotiated Rate |
$31.85 |
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: Priority Health SBD |
$22.30
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$41.92 |
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: Aetna Medicare |
$13.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.60
|
| Rate for Payer: BCBS Complete |
$7.29
|
| Rate for Payer: BCBS MAPPO |
$13.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.32
|
| Rate for Payer: BCN Commercial |
$33.32
|
| Rate for Payer: BCN Medicare Advantage |
$13.28
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.28
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Mclaren Medicare |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.94
|
| Rate for Payer: Meridian Medicaid |
$13.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Nomi Health Commercial |
$39.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PACE Medicare |
$12.62
|
| Rate for Payer: PACE SWMI |
$13.28
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.92
|
| Rate for Payer: Priority Health Medicare |
$13.28
|
| Rate for Payer: Priority Health SBD |
$22.30
|
| Rate for Payer: Priority Health Tiered Network |
$33.54
|
| Rate for Payer: Railroad Medicare Medicare |
$13.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.62
|
| Rate for Payer: UHC Core |
$14.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.28
|
| Rate for Payer: UHC Exchange |
$14.62
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$13.28
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.79 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.77
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Advantage |
$104.22
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: Priority Health SBD |
$93.79
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Advantage |
$104.22
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Mclaren Medicaid |
$6.76
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$93.79
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health SBD |
$34.76
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Mclaren Medicaid |
$6.76
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Mclaren Medicaid |
$6.76
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$19.12
|
| Rate for Payer: BCN Commercial |
$19.12
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Advantage |
$22.31
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Mclaren Medicaid |
$9.38
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.08
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.08 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.72
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Advantage |
$22.31
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: Priority Health SBD |
$20.08
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Advantage |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: Priority Health SBD |
$13.01
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Advantage |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,694.38 |
| Max. Negotiated Rate |
$12,420.54 |
| Rate for Payer: Aetna Commercial |
$11,730.51
|
| Rate for Payer: Aetna Commercial |
$7,820.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,970.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,980.26
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cofinity Advantage |
$9,660.42
|
| Rate for Payer: Cofinity Advantage |
$6,440.28
|
| Rate for Payer: Cofinity Commercial |
$11,868.52
|
| Rate for Payer: Cofinity Commercial |
$7,912.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Healthscope Commercial |
$8,280.36
|
| Rate for Payer: Healthscope Commercial |
$12,420.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: PHP Commercial |
$11,730.51
|
| Rate for Payer: PHP Commercial |
$7,820.34
|
| Rate for Payer: Priority Health SBD |
$8,694.38
|
| Rate for Payer: Priority Health SBD |
$5,796.25
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$12,420.54 |
| Rate for Payer: Aetna Commercial |
$11,730.51
|
| Rate for Payer: Aetna Commercial |
$7,820.34
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,980.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,970.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.24
|
| Rate for Payer: BCN Commercial |
$2,017.24
|
| Rate for Payer: BCN Commercial |
$2,017.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cofinity Advantage |
$6,440.28
|
| Rate for Payer: Cofinity Advantage |
$9,660.42
|
| Rate for Payer: Cofinity Commercial |
$11,868.52
|
| Rate for Payer: Cofinity Commercial |
$7,912.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$12,420.54
|
| Rate for Payer: Healthscope Commercial |
$8,280.36
|
| Rate for Payer: Mclaren Medicaid |
$1,727.75
|
| Rate for Payer: Mclaren Medicaid |
$1,727.75
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$11,730.51
|
| Rate for Payer: PHP Commercial |
$7,820.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,796.25
|
| Rate for Payer: Priority Health SBD |
$8,694.38
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,970.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,980.26
|
| Rate for Payer: UHC Core |
$4,793.41
|
| Rate for Payer: UHC Core |
$7,190.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,615.76
|
| Rate for Payer: UHC Exchange |
$5,423.64
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.14 |
| Max. Negotiated Rate |
$763.21 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Commercial |
$817.13
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$93.14
|
| Rate for Payer: BCBS Trust/PPO |
$93.14
|
| Rate for Payer: BCN Commercial |
$93.14
|
| Rate for Payer: BCN Commercial |
$93.14
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Advantage |
$672.93
|
| Rate for Payer: Cofinity Advantage |
$448.62
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Cofinity Commercial |
$826.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$865.20
|
| Rate for Payer: Mclaren Medicaid |
$123.43
|
| Rate for Payer: Mclaren Medicaid |
$123.43
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: PHP Commercial |
$817.13
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$605.64
|
| Rate for Payer: Priority Health SBD |
$403.76
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.86
|
| Rate for Payer: UHC Core |
$500.85
|
| Rate for Payer: UHC Core |
$333.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$377.80
|
| Rate for Payer: UHC Exchange |
$251.87
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$403.76 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Commercial |
$817.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.86
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cofinity Advantage |
$448.62
|
| Rate for Payer: Cofinity Advantage |
$672.93
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Cofinity Commercial |
$826.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Healthscope Commercial |
$865.20
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: PHP Commercial |
$817.13
|
| Rate for Payer: Priority Health SBD |
$403.76
|
| Rate for Payer: Priority Health SBD |
$605.64
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$772.78
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$289.13 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna Commercial |
$656.86
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$289.13
|
| Rate for Payer: BCN Commercial |
$289.13
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cofinity Advantage |
$540.95
|
| Rate for Payer: Cofinity Commercial |
$664.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$695.50
|
| Rate for Payer: Mclaren Medicaid |
$385.14
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.86
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.59
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$656.86
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$486.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.31
|
| Rate for Payer: UHC Core |
$402.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$303.70
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$772.78
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$486.85 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna Commercial |
$656.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.31
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cofinity Advantage |
$540.95
|
| Rate for Payer: Cofinity Commercial |
$664.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.22
|
| Rate for Payer: Healthscope Commercial |
$695.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.59
|
| Rate for Payer: PHP Commercial |
$656.86
|
| Rate for Payer: Priority Health SBD |
$486.85
|
|
