|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$208.50
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$131.35 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.53
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Advantage |
$145.95
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: Priority Health SBD |
$131.35
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$9,259.56
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,833.52 |
| Max. Negotiated Rate |
$8,333.60 |
| Rate for Payer: Aetna Commercial |
$7,870.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,018.71
|
| Rate for Payer: Cash Price |
$7,407.65
|
| Rate for Payer: Cofinity Advantage |
$6,481.69
|
| Rate for Payer: Cofinity Commercial |
$7,963.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,407.65
|
| Rate for Payer: Healthscope Commercial |
$8,333.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,870.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,944.67
|
| Rate for Payer: PHP Commercial |
$7,870.63
|
| Rate for Payer: Priority Health SBD |
$5,833.52
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$9,259.56
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,210.53 |
| Max. Negotiated Rate |
$8,333.60 |
| Rate for Payer: Aetna Commercial |
$7,870.63
|
| Rate for Payer: Aetna Medicare |
$4,629.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,018.71
|
| Rate for Payer: BCBS Complete |
$3,703.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,210.53
|
| Rate for Payer: BCN Commercial |
$2,210.53
|
| Rate for Payer: Cash Price |
$7,407.65
|
| Rate for Payer: Cash Price |
$7,407.65
|
| Rate for Payer: Cofinity Advantage |
$6,481.69
|
| Rate for Payer: Cofinity Commercial |
$7,963.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,407.65
|
| Rate for Payer: Healthscope Commercial |
$8,333.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,407.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,870.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,944.67
|
| Rate for Payer: PHP Commercial |
$7,870.63
|
| Rate for Payer: Priority Health SBD |
$5,833.52
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$337.83
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.83 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$287.16
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.71
|
| Rate for Payer: BCN Commercial |
$1,633.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cofinity Advantage |
$236.48
|
| Rate for Payer: Cofinity Commercial |
$290.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$304.05
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.16
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.37
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$287.16
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$212.83
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$337.83
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.83 |
| Max. Negotiated Rate |
$304.05 |
| Rate for Payer: Aetna Commercial |
$287.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.59
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cofinity Advantage |
$236.48
|
| Rate for Payer: Cofinity Commercial |
$290.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.26
|
| Rate for Payer: Healthscope Commercial |
$304.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.37
|
| Rate for Payer: PHP Commercial |
$287.16
|
| Rate for Payer: Priority Health SBD |
$212.83
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,716.17
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,341.19 |
| Max. Negotiated Rate |
$3,344.55 |
| Rate for Payer: Aetna Commercial |
$3,158.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,415.51
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cofinity Advantage |
$2,601.32
|
| Rate for Payer: Cofinity Commercial |
$3,195.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,972.94
|
| Rate for Payer: Healthscope Commercial |
$3,344.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,158.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,787.13
|
| Rate for Payer: PHP Commercial |
$3,158.74
|
| Rate for Payer: Priority Health SBD |
$2,341.19
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,716.17
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,633.71 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$3,158.74
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,415.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.71
|
| Rate for Payer: BCN Commercial |
$1,633.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cofinity Advantage |
$2,601.32
|
| Rate for Payer: Cofinity Commercial |
$3,195.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,972.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$3,344.55
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,158.74
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,787.13
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,158.74
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$2,341.19
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,825.47
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,410.05 |
| Max. Negotiated Rate |
$3,442.92 |
| Rate for Payer: Aetna Commercial |
$3,251.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,486.56
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cofinity Advantage |
$2,677.83
|
| Rate for Payer: Cofinity Commercial |
$3,289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,060.38
|
| Rate for Payer: Healthscope Commercial |
$3,442.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,251.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,869.10
|
| Rate for Payer: PHP Commercial |
$3,251.65
|
| Rate for Payer: Priority Health SBD |
$2,410.05
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,825.47
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,633.71 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$3,251.65
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,486.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.71
|
| Rate for Payer: BCN Commercial |
$1,633.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cofinity Advantage |
$2,677.83
|
| Rate for Payer: Cofinity Commercial |
$3,289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,060.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$3,442.92
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,251.65
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,869.10
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,251.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$2,410.05
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$22.85
|
| Rate for Payer: BCN Commercial |
$22.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Advantage |
$191.54
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$172.39
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$172.39 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.86
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Advantage |
$191.54
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: Priority Health SBD |
$172.39
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$145.38 |
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Advantage |
$113.07
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: Priority Health SBD |
$101.76
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$132.88
|
| Rate for Payer: BCN Commercial |
$132.88
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Advantage |
$113.07
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Mclaren Medicaid |
$186.79
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$101.76
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| 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 PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| 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 PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$210.67 |
| Rate for Payer: Aetna Commercial |
$100.20
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$210.67
|
| Rate for Payer: BCN Commercial |
$210.67
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Advantage |
$82.52
|
| Rate for Payer: Cofinity Commercial |
$101.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$106.09
|
| Rate for Payer: Mclaren Medicaid |
$27.15
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$54.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$100.20
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.92
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health SBD |
$74.26
|
| Rate for Payer: Priority Health Tiered Network |
$134.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.15
|
| Rate for Payer: UHC Core |
$80.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$74.26 |
| Max. Negotiated Rate |
$106.09 |
| Rate for Payer: Aetna Commercial |
$100.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.62
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Advantage |
$82.52
|
| Rate for Payer: Cofinity Commercial |
$101.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Healthscope Commercial |
$106.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: PHP Commercial |
$100.20
|
| Rate for Payer: Priority Health SBD |
$74.26
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$102.89 |
| Max. Negotiated Rate |
$146.99 |
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.16
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Advantage |
$114.32
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: Priority Health SBD |
$102.89
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$64.18 |
| Max. Negotiated Rate |
$416.48 |
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: Aetna Medicare |
$133.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.99
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$128.79
|
| Rate for Payer: BCBS Trust/PPO |
$409.45
|
| Rate for Payer: BCN Commercial |
$409.45
|
| Rate for Payer: BCN Medicare Advantage |
$128.79
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Advantage |
$114.32
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.79
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$128.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.23
|
| Rate for Payer: Meridian Medicaid |
$135.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$386.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PACE Medicare |
$122.35
|
| Rate for Payer: PACE SWMI |
$128.79
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: PHP Medicare Advantage |
$128.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.48
|
| Rate for Payer: Priority Health Medicare |
$128.79
|
| Rate for Payer: Priority Health SBD |
$102.89
|
| Rate for Payer: Priority Health Tiered Network |
$333.18
|
| Rate for Payer: Railroad Medicare Medicare |
$128.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.16
|
| Rate for Payer: UHC Core |
$85.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.79
|
| Rate for Payer: UHC Exchange |
$64.18
|
| Rate for Payer: UHC Medicaid |
$67.36
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$128.79
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.49 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: Priority Health SBD |
$55.49
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: BCBS Complete |
$3.59
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$6.97
|
| Rate for Payer: BCN Commercial |
$6.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Mclaren Medicaid |
$3.42
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$6.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$9.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.53
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health SBD |
$55.49
|
| Rate for Payer: Priority Health Tiered Network |
$5.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.80
|
| Rate for Payer: UHC Core |
$9.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.53
|
| Rate for Payer: UHC Exchange |
$9.80
|
| Rate for Payer: UHC Medicaid |
$3.42
|
| Rate for Payer: UHCCP Medicaid |
$3.42
|
| Rate for Payer: VA VA |
$6.53
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$62.51 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: Priority Health SBD |
$62.51
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$19.92
|
| Rate for Payer: BCN Commercial |
$19.92
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Mclaren Medicaid |
$13.03
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$62.51
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Advantage |
$71.32
|
| Rate for Payer: Cofinity Commercial |
$87.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$64.18
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.18 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.22
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Advantage |
$71.32
|
| Rate for Payer: Cofinity Commercial |
$87.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: Priority Health SBD |
$64.18
|
|
