|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$23.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Mclaren Medicare |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.12
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PACE Medicare |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health Medicare |
$22.97
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.97
|
| Rate for Payer: UHC Medicare Advantage |
$22.97
|
| Rate for Payer: UHCCP Medicaid |
$12.93
|
| Rate for Payer: VA VA |
$22.97
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.90 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.25
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health SBD |
$73.90
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Medicare Advantage |
$17.06
|
| Rate for Payer: UHCCP Medicaid |
$9.60
|
| Rate for Payer: VA VA |
$17.06
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$2,081.02 |
| Rate for Payer: Aetna Commercial |
$1,965.40
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$1,988.53
|
| Rate for Payer: Cofinity Commercial |
$1,618.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,618.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,081.02
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$1,965.40
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$1,456.71
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Core |
$1,711.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$1,711.06
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$291.34
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC PAP NAP
|
Facility
|
IP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,456.71 |
| Max. Negotiated Rate |
$2,081.02 |
| Rate for Payer: Aetna Commercial |
$1,965.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.96
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$1,618.57
|
| Rate for Payer: Cofinity Commercial |
$1,988.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,618.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Healthscope Commercial |
$2,081.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: PHP Commercial |
$1,965.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health SBD |
$1,456.71
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.34 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.47
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: PHP Commercial |
$47.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health SBD |
$35.34
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$51.20 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: Aetna Medicare |
$18.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.74
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.19
|
| Rate for Payer: BCN Medicare Advantage |
$18.19
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.19
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$9.75
|
| Rate for Payer: Mclaren Medicare |
$18.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.10
|
| Rate for Payer: Meridian Medicaid |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: PACE Medicare |
$17.28
|
| Rate for Payer: PACE SWMI |
$18.19
|
| Rate for Payer: PHP Commercial |
$47.69
|
| Rate for Payer: PHP Medicare Advantage |
$18.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$18.19
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: Railroad Medicare Medicare |
$18.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.19
|
| Rate for Payer: UHC Medicare Advantage |
$18.19
|
| Rate for Payer: UHCCP Medicaid |
$10.24
|
| Rate for Payer: VA VA |
$18.19
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$995.71
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$398.28 |
| Max. Negotiated Rate |
$896.14 |
| Rate for Payer: Aetna Commercial |
$846.35
|
| Rate for Payer: Aetna Medicare |
$497.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.21
|
| Rate for Payer: BCBS Complete |
$398.28
|
| Rate for Payer: Cash Price |
$796.57
|
| Rate for Payer: Cofinity Commercial |
$697.00
|
| Rate for Payer: Cofinity Commercial |
$856.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$697.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.57
|
| Rate for Payer: Healthscope Commercial |
$896.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.35
|
| Rate for Payer: PHP Commercial |
$846.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.21
|
| Rate for Payer: Priority Health SBD |
$627.30
|
|
|
HC PARACENTESIS
|
Facility
|
IP
|
$995.71
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$627.30 |
| Max. Negotiated Rate |
$896.14 |
| Rate for Payer: Aetna Commercial |
$846.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.21
|
| Rate for Payer: Cash Price |
$796.57
|
| Rate for Payer: Cofinity Commercial |
$697.00
|
| Rate for Payer: Cofinity Commercial |
$856.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$697.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.57
|
| Rate for Payer: Healthscope Commercial |
$896.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.35
|
| Rate for Payer: PHP Commercial |
$846.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.21
|
| Rate for Payer: Priority Health SBD |
$627.30
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
IP
|
$380.34
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$239.61 |
| Max. Negotiated Rate |
$342.31 |
| Rate for Payer: Aetna Commercial |
$323.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.22
|
| Rate for Payer: Cash Price |
$304.27
|
| Rate for Payer: Cofinity Commercial |
$266.24
|
| Rate for Payer: Cofinity Commercial |
$327.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.27
|
| Rate for Payer: Healthscope Commercial |
$342.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.29
|
| Rate for Payer: PHP Commercial |
$323.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.22
|
| Rate for Payer: Priority Health SBD |
$239.61
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
OP
|
$380.34
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$152.14 |
| Max. Negotiated Rate |
$342.31 |
| Rate for Payer: Aetna Commercial |
$323.29
|
| Rate for Payer: Aetna Medicare |
$190.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.22
|
| Rate for Payer: BCBS Complete |
$152.14
|
| Rate for Payer: Cash Price |
$304.27
|
| Rate for Payer: Cofinity Commercial |
$266.24
|
| Rate for Payer: Cofinity Commercial |
$327.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.27
|
| Rate for Payer: Healthscope Commercial |
$342.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.29
|
| Rate for Payer: PHP Commercial |
$323.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.22
|
| Rate for Payer: Priority Health SBD |
$239.61
|
|
|
HC PARAFFIN BATH
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.63 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health SBD |
$40.63
|
|
|
HC PARAFFIN BATH
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$32.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UHC Core |
$47.73
|
| Rate for Payer: UHC Exchange |
$47.73
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
IP
|
$106.08
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.83 |
| Max. Negotiated Rate |
$95.47 |
| Rate for Payer: Aetna Commercial |
$90.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.95
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$91.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.86
|
| Rate for Payer: Healthscope Commercial |
$95.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.17
|
| Rate for Payer: PHP Commercial |
$90.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.95
|
| Rate for Payer: Priority Health SBD |
$66.83
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
OP
|
$106.08
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$95.47 |
| Rate for Payer: Aetna Commercial |
$90.17
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Cofinity Commercial |
$91.23
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$95.47
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.17
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$90.17
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.95
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$66.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.78 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health SBD |
$51.78
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PARANEOPLASTIC AB CMPT
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
30200495
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$72.61 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
|
|
HC PARANEOPLASTIC AB CMPT
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
30200495
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PARANEOPLASTIC ANTIBODIES
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.32 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
|
|
HC PARANEOPLASTIC ANTIBODIES
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.72
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC PARANEOPLASTIC ANTIBODIES CMPT
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30200012
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| 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: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$56.35
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: VA VA |
$18.40
|
|
