|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.44 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna Commercial |
$74.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.20
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Healthscope Commercial |
$79.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PHP Commercial |
$74.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health SBD |
$55.44
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$23.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: BCBS Complete |
$12.87
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$17.55
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$12.26
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Medicaid |
$12.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.89
|
| Rate for Payer: UHC Core |
$32.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.41
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$23.08
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health SBD |
$31.49
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.55
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health SBD |
$29.61
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Mclaren Medicaid |
$8.48
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health SBD |
$29.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.60
|
| Rate for Payer: UHC Core |
$26.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Mclaren Medicaid |
$8.48
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health SBD |
$29.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.60
|
| Rate for Payer: UHC Core |
$26.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.55
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health SBD |
$29.61
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.87 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$3,631.73
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,777.20
|
| 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 |
$1,528.16
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$2,990.83
|
| Rate for Payer: Cofinity Commercial |
$3,674.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$3,845.36
|
| 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 |
$3,631.73
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$3,631.73
|
| 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 |
$2,990.83
|
| 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 |
$2,691.75
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$266.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,691.75 |
| Max. Negotiated Rate |
$3,845.36 |
| Rate for Payer: Aetna Commercial |
$3,631.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,777.20
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$2,990.83
|
| Rate for Payer: Cofinity Commercial |
$3,674.45
|
| Rate for Payer: Healthscope Commercial |
$3,845.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,631.73
|
| Rate for Payer: PHP Commercial |
$3,631.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.83
|
| Rate for Payer: Priority Health SBD |
$2,691.75
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.70 |
| Max. Negotiated Rate |
$2,210.42 |
| Rate for Payer: Aetna Commercial |
$2,087.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,596.41
|
| Rate for Payer: BCBS Complete |
$982.41
|
| Rate for Payer: BCBS Trust/PPO |
$590.80
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$2,112.18
|
| Rate for Payer: Cofinity Commercial |
$1,719.21
|
| Rate for Payer: Healthscope Commercial |
$2,210.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: PHP Commercial |
$2,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: Priority Health SBD |
$1,547.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.47
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$127.70
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,547.29 |
| Max. Negotiated Rate |
$2,210.42 |
| Rate for Payer: Aetna Commercial |
$2,087.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,596.41
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$1,719.21
|
| Rate for Payer: Cofinity Commercial |
$2,112.18
|
| Rate for Payer: Healthscope Commercial |
$2,210.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: PHP Commercial |
$2,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: Priority Health SBD |
$1,547.29
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$257.08
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$481.22 |
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.10
|
| Rate for Payer: BCBS Complete |
$102.83
|
| Rate for Payer: BCBS Trust/PPO |
$481.22
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cofinity Commercial |
$179.96
|
| Rate for Payer: Cofinity Commercial |
$221.09
|
| Rate for Payer: Healthscope Commercial |
$231.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.52
|
| Rate for Payer: PHP Commercial |
$218.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.96
|
| Rate for Payer: Priority Health SBD |
$161.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.23
|
| Rate for Payer: UHC Exchange |
$185.66
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$257.08
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$161.96 |
| Max. Negotiated Rate |
$231.37 |
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.10
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cofinity Commercial |
$179.96
|
| Rate for Payer: Cofinity Commercial |
$221.09
|
| Rate for Payer: Healthscope Commercial |
$231.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.52
|
| Rate for Payer: PHP Commercial |
$218.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.96
|
| Rate for Payer: Priority Health SBD |
$161.96
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$19.28
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$17.35 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.53
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cofinity Commercial |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.39
|
| Rate for Payer: PHP Commercial |
$16.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.50
|
| Rate for Payer: Priority Health SBD |
$12.15
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$19.28
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$17.35 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: BCBS Complete |
$2.09
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$2.85
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Cofinity Commercial |
$13.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$17.35
|
| Rate for Payer: Mclaren Medicaid |
$1.99
|
| Rate for Payer: Mclaren Medicare |
$3.64
|
| Rate for Payer: Meridian Medicaid |
$2.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.39
|
| Rate for Payer: PACE Medicare |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$16.39
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.50
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health SBD |
$12.15
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.37
|
| Rate for Payer: UHC Core |
$5.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.64
|
| Rate for Payer: UHC Exchange |
$3.64
|
| Rate for Payer: UHC Medicare Advantage |
$3.75
|
| Rate for Payer: VA VA |
$3.64
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$13.18
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$17.97
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Medicaid |
$13.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Core |
$39.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$201.96
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$17.73
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$24.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Mclaren Medicaid |
$16.88
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$17.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.67
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.37
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$127.23
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Core |
$39.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$30.86
|
| Rate for Payer: UHC Medicare Advantage |
$31.79
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$201.96
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$127.23 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.67
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.37
|
| Rate for Payer: Priority Health SBD |
$127.23
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Aetna Commercial |
$79.90
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$13.18
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$17.97
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$80.84
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$84.60
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Medicaid |
$13.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.90
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$79.90
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$59.22
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Core |
$39.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.22 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Aetna Commercial |
$79.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.10
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$80.84
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Healthscope Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.90
|
| Rate for Payer: PHP Commercial |
$79.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health SBD |
$59.22
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$17.73
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$24.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$88.54
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Mclaren Medicaid |
$16.88
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$17.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.51
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$79.68
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Core |
$39.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$30.86
|
| Rate for Payer: UHC Medicare Advantage |
$31.79
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$126.48
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$79.68 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.21
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Cofinity Commercial |
$88.54
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.51
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health SBD |
$79.68
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$95.88
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.28
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$14.02
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Mclaren Medicaid |
$9.79
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Medicaid |
$10.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.50
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.12
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$60.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.48
|
| Rate for Payer: UHC Core |
$30.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$17.90
|
| Rate for Payer: UHC Medicare Advantage |
$18.44
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$95.88
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.50
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.12
|
| Rate for Payer: Priority Health SBD |
$60.40
|
|
