|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
IP
|
$145.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.77 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna Commercial |
$123.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.68
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cofinity Advantage |
$101.96
|
| Rate for Payer: Cofinity Commercial |
$125.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.53
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.25
|
| Rate for Payer: PHP Commercial |
$123.81
|
| Rate for Payer: Priority Health SBD |
$91.77
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
OP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$35.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.27
|
| Rate for Payer: BCBS Complete |
$28.48
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Advantage |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: Priority Health SBD |
$44.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.27
|
| Rate for Payer: UHC Core |
$37.09
|
| Rate for Payer: UHC Exchange |
$27.98
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
IP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$44.85 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.27
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Advantage |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: Priority Health SBD |
$44.85
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
OP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$334.69
|
| Rate for Payer: BCN Commercial |
$334.69
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Advantage |
$1,337.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Mclaren Medicaid |
$326.90
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$1,203.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.50
|
| Rate for Payer: UHC Core |
$995.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$750.63
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
IP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,203.30 |
| Max. Negotiated Rate |
$1,719.00 |
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.50
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Advantage |
$1,337.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: Priority Health SBD |
$1,203.30
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$544.86 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.16
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Advantage |
$605.40
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: Priority Health SBD |
$544.86
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: Aetna Medicare |
$432.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.16
|
| Rate for Payer: BCBS Complete |
$345.94
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Advantage |
$605.40
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$691.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: Priority Health SBD |
$544.86
|
| Rate for Payer: UHCCP Medicaid |
$144.00
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$536.25
|
| Rate for Payer: BCN Commercial |
$536.25
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Advantage |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Mclaren Medicaid |
$326.90
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$839.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.77
|
| Rate for Payer: UHC Core |
$693.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$523.46
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$839.13 |
| Max. Negotiated Rate |
$1,198.76 |
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.77
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Advantage |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: Priority Health SBD |
$839.13
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$908.94 |
| Max. Negotiated Rate |
$1,298.48 |
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.79
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Advantage |
$1,009.93
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: Priority Health SBD |
$908.94
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.69 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$334.69
|
| Rate for Payer: BCN Commercial |
$334.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Advantage |
$1,009.93
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Mclaren Medicaid |
$820.32
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$908.94
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$708.75 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Advantage |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health SBD |
$708.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$442.12 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna Medicare |
$562.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Advantage |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$900.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health SBD |
$708.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.25
|
| Rate for Payer: UHC Core |
$586.12
|
| Rate for Payer: UHC Exchange |
$442.12
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
OP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$436.93 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: Aetna Medicare |
$555.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.66
|
| Rate for Payer: BCBS Complete |
$444.72
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Advantage |
$778.25
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$889.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: Priority Health SBD |
$700.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.66
|
| Rate for Payer: UHC Core |
$579.24
|
| Rate for Payer: UHC Exchange |
$436.93
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
IP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$700.43 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.66
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Advantage |
$778.25
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: Priority Health SBD |
$700.43
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$472.50 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.50
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Advantage |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: Priority Health SBD |
$472.50
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$294.75 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: Aetna Medicare |
$375.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.50
|
| Rate for Payer: BCBS Complete |
$300.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Advantage |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$600.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: Priority Health SBD |
$472.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.50
|
| Rate for Payer: UHC Core |
$390.75
|
| Rate for Payer: UHC Exchange |
$294.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT INJ
|
Facility
|
OP
|
$741.19
|
|
|
Service Code
|
CPT 64466
|
| Hospital Charge Code |
37000021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$291.29 |
| Max. Negotiated Rate |
$667.07 |
| Rate for Payer: Aetna Commercial |
$630.01
|
| Rate for Payer: Aetna Medicare |
$370.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.77
|
| Rate for Payer: BCBS Complete |
$296.48
|
| Rate for Payer: Cash Price |
$592.95
|
| Rate for Payer: Cofinity Advantage |
$518.83
|
| Rate for Payer: Cofinity Commercial |
$637.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.95
|
| Rate for Payer: Healthscope Commercial |
$667.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$592.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.89
|
| Rate for Payer: PHP Commercial |
$630.01
|
| Rate for Payer: Priority Health SBD |
$466.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.77
|
| Rate for Payer: UHC Core |
$386.16
|
| Rate for Payer: UHC Exchange |
$291.29
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT INJ
|
Facility
|
IP
|
$741.19
|
|
|
Service Code
|
CPT 64466
|
| Hospital Charge Code |
37000021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$466.95 |
| Max. Negotiated Rate |
$667.07 |
| Rate for Payer: Aetna Commercial |
$630.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.77
|
| Rate for Payer: Cash Price |
$592.95
|
| Rate for Payer: Cofinity Advantage |
$518.83
|
| Rate for Payer: Cofinity Commercial |
$637.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.95
|
| Rate for Payer: Healthscope Commercial |
$667.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.89
|
| Rate for Payer: PHP Commercial |
$630.01
|
| Rate for Payer: Priority Health SBD |
$466.95
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$452.97 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.35
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Advantage |
$503.30
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: Priority Health SBD |
$452.97
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,202.41 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$199.86
|
| Rate for Payer: BCN Commercial |
$199.86
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Advantage |
$503.30
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$452.97
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.35
|
| Rate for Payer: UHC Core |
$374.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$282.57
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC THORACOTOMY
|
Facility
|
OP
|
$2,133.72
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$853.49 |
| Max. Negotiated Rate |
$1,920.35 |
| Rate for Payer: Aetna Commercial |
$1,813.66
|
| Rate for Payer: Aetna Medicare |
$1,066.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.92
|
| Rate for Payer: BCBS Complete |
$853.49
|
| Rate for Payer: Cash Price |
$1,706.98
|
| Rate for Payer: Cofinity Advantage |
$1,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.98
|
| Rate for Payer: Healthscope Commercial |
$1,920.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,706.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,813.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,600.29
|
| Rate for Payer: PHP Commercial |
$1,813.66
|
| Rate for Payer: Priority Health SBD |
$1,344.24
|
|
|
HC THORACOTOMY
|
Facility
|
IP
|
$2,133.72
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,344.24 |
| Max. Negotiated Rate |
$1,920.35 |
| Rate for Payer: Aetna Commercial |
$1,813.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.92
|
| Rate for Payer: Cash Price |
$1,706.98
|
| Rate for Payer: Cofinity Advantage |
$1,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.98
|
| Rate for Payer: Healthscope Commercial |
$1,920.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,813.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,600.29
|
| Rate for Payer: PHP Commercial |
$1,813.66
|
| Rate for Payer: Priority Health SBD |
$1,344.24
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
OP
|
$5,067.48
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,026.99 |
| Max. Negotiated Rate |
$4,560.73 |
| Rate for Payer: Aetna Commercial |
$4,307.36
|
| Rate for Payer: Aetna Medicare |
$2,533.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,293.86
|
| Rate for Payer: BCBS Complete |
$2,026.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,114.85
|
| Rate for Payer: BCN Commercial |
$2,114.85
|
| Rate for Payer: Cash Price |
$4,053.98
|
| Rate for Payer: Cash Price |
$4,053.98
|
| Rate for Payer: Cofinity Advantage |
$3,547.24
|
| Rate for Payer: Cofinity Commercial |
$4,358.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,053.98
|
| Rate for Payer: Healthscope Commercial |
$4,560.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,053.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,307.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,800.61
|
| Rate for Payer: PHP Commercial |
$4,307.36
|
| Rate for Payer: Priority Health SBD |
$3,192.51
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
IP
|
$5,067.48
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,192.51 |
| Max. Negotiated Rate |
$4,560.73 |
| Rate for Payer: Aetna Commercial |
$4,307.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,293.86
|
| Rate for Payer: Cash Price |
$4,053.98
|
| Rate for Payer: Cofinity Advantage |
$3,547.24
|
| Rate for Payer: Cofinity Commercial |
$4,358.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,053.98
|
| Rate for Payer: Healthscope Commercial |
$4,560.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,307.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,800.61
|
| Rate for Payer: PHP Commercial |
$4,307.36
|
| Rate for Payer: Priority Health SBD |
$3,192.51
|
|
