|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.47 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Advantage |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health SBD |
$45.47
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
IP
|
$1,526.66
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$961.80 |
| Max. Negotiated Rate |
$1,373.99 |
| Rate for Payer: Aetna Commercial |
$1,297.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.33
|
| Rate for Payer: Cash Price |
$1,221.33
|
| Rate for Payer: Cofinity Advantage |
$1,068.66
|
| Rate for Payer: Cofinity Commercial |
$1,312.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,221.33
|
| Rate for Payer: Healthscope Commercial |
$1,373.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,297.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.99
|
| Rate for Payer: PHP Commercial |
$1,297.66
|
| Rate for Payer: Priority Health SBD |
$961.80
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
OP
|
$1,526.66
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,373.99 |
| Rate for Payer: Aetna Commercial |
$1,297.66
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$925.31
|
| Rate for Payer: BCN Commercial |
$925.31
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,221.33
|
| Rate for Payer: Cash Price |
$1,221.33
|
| Rate for Payer: Cofinity Advantage |
$1,068.66
|
| Rate for Payer: Cofinity Commercial |
$1,312.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,221.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,373.99
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,297.66
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.99
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,297.66
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$961.80
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.33
|
| Rate for Payer: UHC Core |
$795.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$599.98
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$557.54 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health SBD |
$557.54
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$540.37
|
| Rate for Payer: BCN Commercial |
$540.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$557.54
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.24
|
| Rate for Payer: UHC Core |
$461.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$347.80
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
OP
|
$1,040.40
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$280.32
|
| Rate for Payer: BCN Commercial |
$280.32
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Advantage |
$728.28
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$655.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.26
|
| Rate for Payer: UHC Core |
$542.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$408.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
IP
|
$1,040.40
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$655.45 |
| Max. Negotiated Rate |
$936.36 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.26
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Advantage |
$728.28
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: Priority Health SBD |
$655.45
|
|
|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,245.28
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,414.53 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$1,908.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,459.43
|
| Rate for Payer: Cash Price |
$1,796.22
|
| Rate for Payer: Cofinity Advantage |
$1,571.70
|
| Rate for Payer: Cofinity Commercial |
$1,930.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,796.22
|
| Rate for Payer: Healthscope Commercial |
$2,020.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,908.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.96
|
| Rate for Payer: PHP Commercial |
$1,908.49
|
| Rate for Payer: Priority Health SBD |
$1,414.53
|
|
|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,245.28
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$882.40 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$1,908.49
|
| Rate for Payer: Aetna Medicare |
$1,122.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,459.43
|
| Rate for Payer: BCBS Complete |
$898.11
|
| Rate for Payer: Cash Price |
$1,796.22
|
| Rate for Payer: Cofinity Advantage |
$1,571.70
|
| Rate for Payer: Cofinity Commercial |
$1,930.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,796.22
|
| Rate for Payer: Healthscope Commercial |
$2,020.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,796.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,908.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.96
|
| Rate for Payer: PHP Commercial |
$1,908.49
|
| Rate for Payer: Priority Health SBD |
$1,414.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,459.43
|
| Rate for Payer: UHC Core |
$1,169.79
|
| Rate for Payer: UHC Exchange |
$882.40
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health SBD |
$66.86
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$66.26
|
| Rate for Payer: BCN Commercial |
$66.26
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$32.50
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$52.53
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$47.28 |
| Rate for Payer: Aetna Commercial |
$44.65
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$13.43
|
| Rate for Payer: BCN Commercial |
$13.43
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Advantage |
$36.77
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$47.28
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.65
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.40
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$44.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$33.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$52.53
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.09 |
| Max. Negotiated Rate |
$47.28 |
| Rate for Payer: Aetna Commercial |
$44.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.14
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Advantage |
$36.77
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Healthscope Commercial |
$47.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.40
|
| Rate for Payer: PHP Commercial |
$44.65
|
| Rate for Payer: Priority Health SBD |
$33.09
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$215.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$193.82 |
| Rate for Payer: Aetna Commercial |
$183.06
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.98
|
| 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 |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$172.29
|
| Rate for Payer: Cash Price |
$172.29
|
| Rate for Payer: Cofinity Advantage |
$150.75
|
| Rate for Payer: Cofinity Commercial |
$185.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$193.82
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| 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 |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.06
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.52
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$183.06
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$135.68
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$215.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.68 |
| Max. Negotiated Rate |
$193.82 |
| Rate for Payer: Cash Price |
$172.29
|
| Rate for Payer: Aetna Commercial |
$183.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.98
|
| Rate for Payer: Cofinity Advantage |
$150.75
|
| Rate for Payer: Cofinity Commercial |
$185.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.29
|
| Rate for Payer: Healthscope Commercial |
$193.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.52
|
| Rate for Payer: PHP Commercial |
$183.06
|
| Rate for Payer: Priority Health SBD |
$135.68
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$27.59
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCN Commercial |
$16.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Advantage |
$19.31
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Mclaren Medicaid |
$8.00
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$16.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$22.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.30
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health SBD |
$17.38
|
| Rate for Payer: Priority Health Tiered Network |
$12.24
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.95
|
| Rate for Payer: UHC Core |
$22.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.30
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicaid |
$8.00
|
| Rate for Payer: UHCCP Medicaid |
$8.00
|
| Rate for Payer: VA VA |
$15.30
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$27.59
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.93
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Advantage |
$19.31
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: Priority Health SBD |
$17.38
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$17.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.74
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS MAPPO |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.68
|
| Rate for Payer: BCN Commercial |
$17.68
|
| Rate for Payer: BCN Medicare Advantage |
$16.59
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Advantage |
$27.48
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Mclaren Medicaid |
$8.68
|
| Rate for Payer: Mclaren Medicare |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.42
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$24.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Medicare |
$15.76
|
| Rate for Payer: PACE SWMI |
$16.59
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$16.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.59
|
| Rate for Payer: Priority Health Medicare |
$16.59
|
| Rate for Payer: Priority Health SBD |
$24.73
|
| Rate for Payer: Priority Health Tiered Network |
$13.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.89
|
| Rate for Payer: UHC Core |
$24.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.59
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UHC Medicaid |
$8.68
|
| Rate for Payer: UHCCP Medicaid |
$8.68
|
| Rate for Payer: VA VA |
$16.59
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.73 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.52
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Advantage |
$27.48
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health SBD |
$24.73
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$162.55 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.71
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Advantage |
$180.61
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: Priority Health SBD |
$162.55
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Advantage |
$180.61
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Mclaren Medicaid |
$52.94
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$162.55
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.71
|
| Rate for Payer: UHC Core |
$134.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$101.40
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$124.54 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.49
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Advantage |
$138.38
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health SBD |
$124.54
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.69 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna Medicare |
$98.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.49
|
| Rate for Payer: BCBS Complete |
$79.07
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Advantage |
$138.38
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health SBD |
$124.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.49
|
| Rate for Payer: UHC Core |
$102.99
|
| Rate for Payer: UHC Exchange |
$77.69
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$21.56
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$41.87
|
| Rate for Payer: BCN Commercial |
$41.87
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$20.53
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$58.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.26
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: Priority Health Tiered Network |
$31.41
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$58.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.26
|
| Rate for Payer: UHC Exchange |
$58.89
|
| Rate for Payer: UHC Medicaid |
$20.53
|
| Rate for Payer: UHCCP Medicaid |
$20.53
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$99.10 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health SBD |
$99.10
|
|
