|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,295.28 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,368.14
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$2,550.31
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,550.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health SBD |
$2,295.28
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$9,468.51 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna Medicare |
$3,498.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,368.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Cofinity Commercial |
$2,550.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,550.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health SBD |
$2,295.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,468.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,893.77
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$169.00 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.37
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$187.78
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health SBD |
$169.00
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.37
|
| 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 |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Cofinity Commercial |
$187.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| 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 |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$169.00
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$12.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.77 |
| Max. Negotiated Rate |
$142.52 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.93
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$110.85
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health SBD |
$99.77
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.77 |
| Max. Negotiated Rate |
$987.55 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna Medicare |
$364.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Cofinity Commercial |
$110.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health SBD |
$99.77
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$197.52
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.91 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.81 |
| Max. Negotiated Rate |
$104.01 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.12
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$80.90
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health SBD |
$72.81
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$80.90
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$72.81
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$404.39 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$149.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.57
|
| Rate for Payer: BCBS Complete |
$80.85
|
| Rate for Payer: BCBS MAPPO |
$143.66
|
| Rate for Payer: BCN Medicare Advantage |
$143.66
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$137.70
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.66
|
| Rate for Payer: Healthscope Commercial |
$144.11
|
| Rate for Payer: Mclaren Medicaid |
$77.00
|
| Rate for Payer: Mclaren Medicare |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.84
|
| Rate for Payer: Meridian Medicaid |
$80.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: PACE Medicare |
$136.48
|
| Rate for Payer: PACE SWMI |
$143.66
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: PHP Medicare Advantage |
$143.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health Medicare |
$143.66
|
| Rate for Payer: Priority Health SBD |
$100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$143.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.39
|
| Rate for Payer: UHC Core |
$118.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.66
|
| Rate for Payer: UHC Exchange |
$118.49
|
| Rate for Payer: UHC Medicare Advantage |
$143.66
|
| Rate for Payer: UHCCP Medicaid |
$80.88
|
| Rate for Payer: VA VA |
$143.66
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$100.88 |
| Max. Negotiated Rate |
$144.11 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Cofinity Commercial |
$137.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Healthscope Commercial |
$144.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health SBD |
$100.88
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| 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 |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$3.50
|
| 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 |
$3.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.53
|
| Rate for Payer: UHC Medicare Advantage |
$6.53
|
| Rate for Payer: UHCCP Medicaid |
$3.68
|
| Rate for Payer: VA VA |
$6.53
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health SBD |
$54.40
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| 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 |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| 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 |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$14.02
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.29 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health SBD |
$61.29
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.92
|
| 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 |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Cofinity Commercial |
$69.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| 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 |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.92 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.92
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$69.92
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health SBD |
$62.92
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.75 |
| Max. Negotiated Rate |
$345.28 |
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: Aetna Medicare |
$127.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.32
|
| Rate for Payer: BCBS Complete |
$69.03
|
| Rate for Payer: BCBS MAPPO |
$122.66
|
| Rate for Payer: BCN Medicare Advantage |
$122.66
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Cofinity Commercial |
$195.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.66
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Mclaren Medicaid |
$65.75
|
| Rate for Payer: Mclaren Medicare |
$122.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.79
|
| Rate for Payer: Meridian Medicaid |
$69.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: PACE Medicare |
$116.53
|
| Rate for Payer: PACE SWMI |
$122.66
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: PHP Medicare Advantage |
$122.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health Medicare |
$122.66
|
| Rate for Payer: Priority Health SBD |
$175.86
|
| Rate for Payer: Railroad Medicare Medicare |
$122.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.28
|
| Rate for Payer: UHC Core |
$206.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.66
|
| Rate for Payer: UHC Exchange |
$206.56
|
| Rate for Payer: UHC Medicare Advantage |
$122.66
|
| Rate for Payer: UHCCP Medicaid |
$69.06
|
| Rate for Payer: VA VA |
$122.66
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$175.86 |
| Max. Negotiated Rate |
$251.23 |
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.44
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$195.40
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health SBD |
$175.86
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: BCBS Complete |
$2.52
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$2.40
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: Meridian Medicaid |
$2.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.48
|
| Rate for Payer: UHC Medicare Advantage |
$4.48
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$4.48
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| 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 |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$86.81
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| 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 |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$78.13
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$14.02
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$78.13 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Cofinity Commercial |
$86.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health SBD |
$78.13
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$402.53
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$253.59 |
| Max. Negotiated Rate |
$362.28 |
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.64
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cofinity Commercial |
$281.77
|
| Rate for Payer: Cofinity Commercial |
$346.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.02
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health SBD |
$253.59
|
|
