|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,926.47
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,473.68 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,552.21
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Advantage |
$2,748.53
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: Priority Health SBD |
$2,473.68
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$4,061.71
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,558.88 |
| Max. Negotiated Rate |
$3,655.54 |
| Rate for Payer: Aetna Commercial |
$3,452.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,640.11
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cofinity Advantage |
$2,843.20
|
| Rate for Payer: Cofinity Commercial |
$3,493.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,249.37
|
| Rate for Payer: Healthscope Commercial |
$3,655.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,452.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,046.28
|
| Rate for Payer: PHP Commercial |
$3,452.45
|
| Rate for Payer: Priority Health SBD |
$2,558.88
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$4,061.71
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,620.74 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$3,452.45
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,640.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.74
|
| Rate for Payer: BCN Commercial |
$1,620.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cofinity Advantage |
$2,843.20
|
| Rate for Payer: Cofinity Commercial |
$3,493.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,249.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,655.54
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,452.45
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,046.28
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,452.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,558.88
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,331.45
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.62 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$144.62
|
| Rate for Payer: BCN Commercial |
$144.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,165.44
|
| Rate for Payer: UHC Core |
$1,735.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,309.26
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,331.45
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,098.81 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$157.06
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$98.95 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.09
|
| Rate for Payer: Cash Price |
$125.65
|
| Rate for Payer: Cofinity Advantage |
$109.94
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.65
|
| Rate for Payer: Healthscope Commercial |
$141.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.80
|
| Rate for Payer: PHP Commercial |
$133.50
|
| Rate for Payer: Priority Health SBD |
$98.95
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$157.06
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$43.91 |
| Max. Negotiated Rate |
$433.11 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: Aetna Medicare |
$139.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.41
|
| Rate for Payer: BCBS Complete |
$73.55
|
| Rate for Payer: BCBS MAPPO |
$133.93
|
| Rate for Payer: BCBS Trust/PPO |
$43.91
|
| Rate for Payer: BCN Commercial |
$43.91
|
| Rate for Payer: BCN Medicare Advantage |
$133.93
|
| Rate for Payer: Cash Price |
$125.65
|
| Rate for Payer: Cash Price |
$125.65
|
| Rate for Payer: Cofinity Advantage |
$109.94
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.93
|
| Rate for Payer: Healthscope Commercial |
$141.35
|
| Rate for Payer: Mclaren Medicaid |
$70.05
|
| Rate for Payer: Mclaren Medicare |
$133.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.63
|
| Rate for Payer: Meridian Medicaid |
$140.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.50
|
| Rate for Payer: Nomi Health Commercial |
$401.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.80
|
| Rate for Payer: PACE Medicare |
$127.23
|
| Rate for Payer: PACE SWMI |
$133.93
|
| Rate for Payer: PHP Commercial |
$133.50
|
| Rate for Payer: PHP Medicare Advantage |
$133.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$433.11
|
| Rate for Payer: Priority Health Medicare |
$133.93
|
| Rate for Payer: Priority Health SBD |
$98.95
|
| Rate for Payer: Priority Health Tiered Network |
$346.49
|
| Rate for Payer: Railroad Medicare Medicare |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.09
|
| Rate for Payer: UHC Core |
$81.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.93
|
| Rate for Payer: UHC Exchange |
$61.72
|
| Rate for Payer: UHC Medicaid |
$70.05
|
| Rate for Payer: UHCCP Medicaid |
$70.05
|
| Rate for Payer: VA VA |
$133.93
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$245.98
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.97 |
| Max. Negotiated Rate |
$221.38 |
| Rate for Payer: Aetna Commercial |
$209.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.89
|
| Rate for Payer: Cash Price |
$196.78
|
| Rate for Payer: Cofinity Advantage |
$172.19
|
| Rate for Payer: Cofinity Commercial |
$211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.78
|
| Rate for Payer: Healthscope Commercial |
$221.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.49
|
| Rate for Payer: PHP Commercial |
$209.08
|
| Rate for Payer: Priority Health SBD |
$154.97
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$245.98
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$221.38 |
| Rate for Payer: Aetna Commercial |
$209.08
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$146.51
|
| Rate for Payer: BCN Commercial |
$146.51
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$196.78
|
| Rate for Payer: Cash Price |
$196.78
|
| Rate for Payer: Cofinity Advantage |
$172.19
|
| Rate for Payer: Cofinity Commercial |
$211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$221.38
|
| Rate for Payer: Mclaren Medicaid |
$27.15
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$54.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.08
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.49
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$209.08
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.92
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health SBD |
$154.97
|
| Rate for Payer: Priority Health Tiered Network |
$134.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.15
|
| Rate for Payer: UHC Core |
$80.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$201.18
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$119.83
|
| Rate for Payer: BCN Commercial |
$119.83
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$160.94
|
| Rate for Payer: Cash Price |
$160.94
|
| Rate for Payer: Cofinity Advantage |
$140.83
|
| Rate for Payer: Cofinity Commercial |
$173.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$181.06
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.00
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.88
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$171.00
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$126.74
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.35
|
| Rate for Payer: UHC Core |
$193.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$193.35
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$201.18
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$126.74 |
| Max. Negotiated Rate |
$181.06 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.77
|
| Rate for Payer: Cash Price |
$160.94
|
| Rate for Payer: Cofinity Advantage |
$140.83
|
| Rate for Payer: Cofinity Commercial |
$173.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.94
|
| Rate for Payer: Healthscope Commercial |
$181.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.88
|
| Rate for Payer: PHP Commercial |
$171.00
|
| Rate for Payer: Priority Health SBD |
$126.74
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.59
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$11.33 |
| Rate for Payer: Aetna Commercial |
$10.70
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: BCBS Complete |
$1.80
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$3.50
|
| Rate for Payer: BCN Commercial |
$3.50
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cofinity Advantage |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$10.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Healthscope Commercial |
$11.33
|
| Rate for Payer: Mclaren Medicaid |
$1.72
|
| Rate for Payer: Mclaren Medicare |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: Meridian Medicaid |
$3.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.70
|
| Rate for Payer: Nomi Health Commercial |
$4.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.44
|
| Rate for Payer: PACE Medicare |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$10.70
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.28
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health SBD |
$7.93
|
| Rate for Payer: Priority Health Tiered Network |
$2.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.92
|
| Rate for Payer: UHC Core |
$4.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.28
|
| Rate for Payer: UHC Exchange |
$4.92
|
| Rate for Payer: UHC Medicaid |
$1.72
|
| Rate for Payer: UHCCP Medicaid |
$1.72
|
| Rate for Payer: VA VA |
$3.28
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.59
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$11.33 |
| Rate for Payer: Aetna Commercial |
$10.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.18
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cofinity Advantage |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$10.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.07
|
| Rate for Payer: Healthscope Commercial |
$11.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.70
|
| Rate for Payer: Priority Health SBD |
$7.93
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$6.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$7.12
|
| Rate for Payer: BCN Commercial |
$7.12
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Mclaren Medicaid |
$3.49
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$10.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.68
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health SBD |
$28.31
|
| Rate for Payer: Priority Health Tiered Network |
$5.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.02
|
| Rate for Payer: UHC Core |
$10.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.68
|
| Rate for Payer: UHC Exchange |
$10.02
|
| Rate for Payer: UHC Medicaid |
$3.49
|
| Rate for Payer: UHCCP Medicaid |
$3.49
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.31 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: Priority Health SBD |
$28.31
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$567.74
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$510.97 |
| Rate for Payer: Aetna Commercial |
$482.58
|
| Rate for Payer: Aetna Medicare |
$139.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.41
|
| Rate for Payer: BCBS Complete |
$73.55
|
| Rate for Payer: BCBS MAPPO |
$133.93
|
| Rate for Payer: BCBS Trust/PPO |
$340.71
|
| Rate for Payer: BCN Commercial |
$340.71
|
| Rate for Payer: BCN Medicare Advantage |
$133.93
|
| Rate for Payer: Cash Price |
$454.19
|
| Rate for Payer: Cash Price |
$454.19
|
| Rate for Payer: Cofinity Advantage |
$397.42
|
| Rate for Payer: Cofinity Commercial |
$488.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.93
|
| Rate for Payer: Healthscope Commercial |
$510.97
|
| Rate for Payer: Mclaren Medicaid |
$70.05
|
| Rate for Payer: Mclaren Medicare |
$133.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.63
|
| Rate for Payer: Meridian Medicaid |
$140.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$482.58
|
| Rate for Payer: Nomi Health Commercial |
$401.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.81
|
| Rate for Payer: PACE Medicare |
$127.23
|
| Rate for Payer: PACE SWMI |
$133.93
|
| Rate for Payer: PHP Commercial |
$482.58
|
| Rate for Payer: PHP Medicare Advantage |
$133.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$433.11
|
| Rate for Payer: Priority Health Medicare |
$133.93
|
| Rate for Payer: Priority Health SBD |
$357.68
|
| Rate for Payer: Priority Health Tiered Network |
$346.49
|
| Rate for Payer: Railroad Medicare Medicare |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.03
|
| Rate for Payer: UHC Core |
$295.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.93
|
| Rate for Payer: UHC Exchange |
$223.12
|
| Rate for Payer: UHC Medicaid |
$70.05
|
| Rate for Payer: UHCCP Medicaid |
$70.05
|
| Rate for Payer: VA VA |
$133.93
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$567.74
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$357.68 |
| Max. Negotiated Rate |
$510.97 |
| Rate for Payer: Aetna Commercial |
$482.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.03
|
| Rate for Payer: Cash Price |
$454.19
|
| Rate for Payer: Cofinity Advantage |
$397.42
|
| Rate for Payer: Cofinity Commercial |
$488.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.19
|
| Rate for Payer: Healthscope Commercial |
$510.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$482.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.81
|
| Rate for Payer: PHP Commercial |
$482.58
|
| Rate for Payer: Priority Health SBD |
$357.68
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
OP
|
$503.46
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$145.07 |
| Max. Negotiated Rate |
$453.11 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: Aetna Medicare |
$251.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.25
|
| Rate for Payer: BCBS Complete |
$201.38
|
| Rate for Payer: BCBS Trust/PPO |
$145.07
|
| Rate for Payer: BCN Commercial |
$145.07
|
| Rate for Payer: Cash Price |
$402.77
|
| Rate for Payer: Cash Price |
$402.77
|
| Rate for Payer: Cofinity Advantage |
$352.42
|
| Rate for Payer: Cofinity Commercial |
$432.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.77
|
| Rate for Payer: Healthscope Commercial |
$453.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$377.60
|
| Rate for Payer: PHP Commercial |
$427.94
|
| Rate for Payer: Priority Health SBD |
$317.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.25
|
| Rate for Payer: UHC Core |
$262.30
|
| Rate for Payer: UHC Exchange |
$197.86
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$503.46
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$317.18 |
| Max. Negotiated Rate |
$453.11 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.25
|
| Rate for Payer: Cash Price |
$402.77
|
| Rate for Payer: Cofinity Advantage |
$352.42
|
| Rate for Payer: Cofinity Commercial |
$432.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.77
|
| Rate for Payer: Healthscope Commercial |
$453.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$377.60
|
| Rate for Payer: PHP Commercial |
$427.94
|
| Rate for Payer: Priority Health SBD |
$317.18
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,619.40
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,020.22 |
| Max. Negotiated Rate |
$1,457.46 |
| Rate for Payer: Aetna Commercial |
$1,376.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.61
|
| Rate for Payer: Cash Price |
$1,295.52
|
| Rate for Payer: Cofinity Advantage |
$1,133.58
|
| Rate for Payer: Cofinity Commercial |
$1,392.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.52
|
| Rate for Payer: Healthscope Commercial |
$1,457.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.55
|
| Rate for Payer: PHP Commercial |
$1,376.49
|
| Rate for Payer: Priority Health SBD |
$1,020.22
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$1,619.40
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$88.58 |
| Max. Negotiated Rate |
$1,780.43 |
| Rate for Payer: Aetna Commercial |
$1,376.49
|
| Rate for Payer: Aetna Medicare |
$572.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$688.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$688.20
|
| Rate for Payer: BCBS Complete |
$302.37
|
| Rate for Payer: BCBS MAPPO |
$550.56
|
| Rate for Payer: BCBS Trust/PPO |
$88.58
|
| Rate for Payer: BCN Commercial |
$88.58
|
| Rate for Payer: BCN Medicare Advantage |
$550.56
|
| Rate for Payer: Cash Price |
$1,295.52
|
| Rate for Payer: Cash Price |
$1,295.52
|
| Rate for Payer: Cofinity Advantage |
$1,133.58
|
| Rate for Payer: Cofinity Commercial |
$1,392.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.56
|
| Rate for Payer: Healthscope Commercial |
$1,457.46
|
| Rate for Payer: Mclaren Medicaid |
$287.94
|
| Rate for Payer: Mclaren Medicare |
$550.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.09
|
| Rate for Payer: Meridian Medicaid |
$578.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.49
|
| Rate for Payer: Nomi Health Commercial |
$1,651.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.55
|
| Rate for Payer: PACE Medicare |
$523.03
|
| Rate for Payer: PACE SWMI |
$550.56
|
| Rate for Payer: PHP Commercial |
$1,376.49
|
| Rate for Payer: PHP Medicare Advantage |
$550.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,780.43
|
| Rate for Payer: Priority Health Medicare |
$550.56
|
| Rate for Payer: Priority Health SBD |
$1,020.22
|
| Rate for Payer: Priority Health Tiered Network |
$1,424.34
|
| Rate for Payer: Railroad Medicare Medicare |
$550.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,052.61
|
| Rate for Payer: UHC Core |
$843.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.56
|
| Rate for Payer: UHC Exchange |
$636.42
|
| Rate for Payer: UHC Medicaid |
$287.94
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: VA VA |
$550.56
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.58 |
| Max. Negotiated Rate |
$207.25 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$207.25
|
| Rate for Payer: BCN Commercial |
$207.25
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$30.74
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.96
|
| Rate for Payer: UHC Core |
$35.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$26.58
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health SBD |
$42.61
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$667.13
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$600.42 |
| Rate for Payer: Aetna Commercial |
$567.06
|
| Rate for Payer: Aetna Medicare |
$333.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.63
|
| Rate for Payer: BCBS Complete |
$266.85
|
| Rate for Payer: BCBS Trust/PPO |
$314.00
|
| Rate for Payer: BCN Commercial |
$314.00
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cofinity Advantage |
$466.99
|
| Rate for Payer: Cofinity Commercial |
$573.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.70
|
| Rate for Payer: Healthscope Commercial |
$600.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$533.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.06
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.35
|
| Rate for Payer: PHP Commercial |
$567.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$183.04
|
| Rate for Payer: Priority Health SBD |
$420.29
|
| Rate for Payer: Priority Health Tiered Network |
$146.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.63
|
| Rate for Payer: UHC Core |
$347.57
|
| Rate for Payer: UHC Exchange |
$262.18
|
|
|
HC SPEECH EVAL
|
Facility
|
IP
|
$667.13
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$420.29 |
| Max. Negotiated Rate |
$600.42 |
| Rate for Payer: Aetna Commercial |
$567.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.63
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cofinity Advantage |
$466.99
|
| Rate for Payer: Cofinity Commercial |
$573.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.70
|
| Rate for Payer: Healthscope Commercial |
$600.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.35
|
| Rate for Payer: PHP Commercial |
$567.06
|
| Rate for Payer: Priority Health SBD |
$420.29
|
|
