|
HC TRIGLYCERIDES
|
Facility
|
IP
|
$22.09
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$19.88 |
| Rate for Payer: Aetna Commercial |
$18.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.36
|
| Rate for Payer: Cash Price |
$17.67
|
| Rate for Payer: Cofinity Advantage |
$15.46
|
| Rate for Payer: Cofinity Commercial |
$19.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.67
|
| Rate for Payer: Healthscope Commercial |
$19.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.57
|
| Rate for Payer: PHP Commercial |
$18.78
|
| Rate for Payer: Priority Health SBD |
$13.92
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$17.22 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$5.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.17
|
| Rate for Payer: BCBS Complete |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$5.74
|
| Rate for Payer: BCN Medicare Advantage |
$5.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Mclaren Medicaid |
$3.00
|
| Rate for Payer: Mclaren Medicare |
$5.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.03
|
| Rate for Payer: Meridian Medicaid |
$6.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$17.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Medicare |
$5.45
|
| Rate for Payer: PACE SWMI |
$5.74
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$5.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.74
|
| Rate for Payer: Priority Health Medicare |
$5.74
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$4.59
|
| Rate for Payer: Railroad Medicare Medicare |
$5.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.61
|
| Rate for Payer: UHC Core |
$8.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.74
|
| Rate for Payer: UHC Exchange |
$8.61
|
| Rate for Payer: UHC Medicaid |
$3.00
|
| Rate for Payer: UHCCP Medicaid |
$3.00
|
| Rate for Payer: VA VA |
$5.74
|
|
|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
IP
|
$176.87
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.43 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.97
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Advantage |
$123.81
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: Priority Health SBD |
$111.43
|
|
|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
OP
|
$176.87
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.97
|
| 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 |
$37.45
|
| Rate for Payer: BCN Commercial |
$37.45
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Advantage |
$123.81
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| 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 |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$150.34
|
| 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 |
$111.43
|
| 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) |
$114.97
|
| Rate for Payer: UHC Core |
$92.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$69.51
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$78.37
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$70.53 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.94
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cofinity Advantage |
$54.86
|
| Rate for Payer: Cofinity Commercial |
$67.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.70
|
| Rate for Payer: Healthscope Commercial |
$70.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.78
|
| Rate for Payer: PHP Commercial |
$66.61
|
| Rate for Payer: Priority Health SBD |
$49.37
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$78.37
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.94
|
| 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 |
$35.15
|
| Rate for Payer: BCN Commercial |
$35.15
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cash Price |
$62.70
|
| Rate for Payer: Cofinity Advantage |
$54.86
|
| Rate for Payer: Cofinity Commercial |
$67.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$70.53
|
| 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 |
$66.61
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.78
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$66.61
|
| 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 |
$49.37
|
| 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) |
$50.94
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$30.80
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC TRIVISC FOR INTRA-ARTICULAR INJ, 1 MG
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS J7329
|
| Hospital Charge Code |
63600237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
|
|
HC TRIVISC FOR INTRA-ARTICULAR INJ, 1 MG
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS J7329
|
| Hospital Charge Code |
63600237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$14.79 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$3.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.09
|
| Rate for Payer: BCBS Complete |
$1.80
|
| Rate for Payer: BCBS MAPPO |
$3.27
|
| Rate for Payer: BCN Medicare Advantage |
$3.27
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.27
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$1.71
|
| Rate for Payer: Mclaren Medicare |
$3.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.43
|
| Rate for Payer: Meridian Medicaid |
$3.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$9.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Medicare |
$3.11
|
| Rate for Payer: PACE SWMI |
$3.27
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.79
|
| Rate for Payer: Priority Health Medicare |
$3.27
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: Priority Health Tiered Network |
$11.83
|
| Rate for Payer: Railroad Medicare Medicare |
$3.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.96
|
| Rate for Payer: UHC Core |
$5.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.27
|
| Rate for Payer: UHC Exchange |
$5.96
|
| Rate for Payer: UHC Medicaid |
$1.71
|
| Rate for Payer: UHCCP Medicaid |
$1.71
|
| Rate for Payer: VA VA |
$3.27
|
|
|
HC TRMT DEVICE - C
|
Facility
|
OP
|
$968.89
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
33300014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$194.18 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna Commercial |
$823.56
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$194.18
|
| Rate for Payer: BCN Commercial |
$194.18
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$775.11
|
| Rate for Payer: Cash Price |
$775.11
|
| Rate for Payer: Cofinity Advantage |
$678.22
|
| Rate for Payer: Cofinity Commercial |
$833.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$872.00
|
| Rate for Payer: Mclaren Medicaid |
$195.12
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.56
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$726.67
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$823.56
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$610.40
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.78
|
| Rate for Payer: UHC Core |
$504.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$380.77
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: VA VA |
$373.08
|
|
|
HC TRMT DEVICE - C
|
Facility
|
IP
|
$968.89
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
33300014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$610.40 |
| Max. Negotiated Rate |
$872.00 |
| Rate for Payer: Aetna Commercial |
$823.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.78
|
| Rate for Payer: Cash Price |
$775.11
|
| Rate for Payer: Cofinity Advantage |
$678.22
|
| Rate for Payer: Cofinity Commercial |
$833.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.11
|
| Rate for Payer: Healthscope Commercial |
$872.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$726.67
|
| Rate for Payer: PHP Commercial |
$823.56
|
| Rate for Payer: Priority Health SBD |
$610.40
|
|
|
HC TROFILE
|
Facility
|
OP
|
$2,091.20
|
|
|
Service Code
|
CPT 87999
|
| Hospital Charge Code |
30600179
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$1,882.08 |
| Rate for Payer: Aetna Commercial |
$1,777.52
|
| Rate for Payer: Aetna Medicare |
$1,045.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.28
|
| Rate for Payer: BCBS Complete |
$836.48
|
| Rate for Payer: BCBS Trust/PPO |
$10.46
|
| Rate for Payer: BCN Commercial |
$10.46
|
| Rate for Payer: Cash Price |
$1,672.96
|
| Rate for Payer: Cash Price |
$1,672.96
|
| Rate for Payer: Cofinity Advantage |
$1,463.84
|
| Rate for Payer: Cofinity Commercial |
$1,798.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.96
|
| Rate for Payer: Healthscope Commercial |
$1,882.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,672.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.40
|
| Rate for Payer: PHP Commercial |
$1,777.52
|
| Rate for Payer: Priority Health SBD |
$1,317.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,045.60
|
| Rate for Payer: UHC Core |
$1,045.60
|
| Rate for Payer: UHC Exchange |
$1,045.60
|
|
|
HC TROFILE
|
Facility
|
IP
|
$2,091.20
|
|
|
Service Code
|
CPT 87999
|
| Hospital Charge Code |
30600179
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1,317.46 |
| Max. Negotiated Rate |
$1,882.08 |
| Rate for Payer: Aetna Commercial |
$1,777.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.28
|
| Rate for Payer: Cash Price |
$1,672.96
|
| Rate for Payer: Cofinity Advantage |
$1,463.84
|
| Rate for Payer: Cofinity Commercial |
$1,798.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.96
|
| Rate for Payer: Healthscope Commercial |
$1,882.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.40
|
| Rate for Payer: PHP Commercial |
$1,777.52
|
| Rate for Payer: Priority Health SBD |
$1,317.46
|
|
|
HC TROPONIN QUANTITATIVE
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
30100449
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.09 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: Priority Health SBD |
$69.09
|
|
|
HC TROPONIN QUANTITATIVE
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
30100449
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$6.85
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$13.29
|
| Rate for Payer: BCN Commercial |
$13.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$6.52
|
| Rate for Payer: Mclaren Medicare |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$13.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$18.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PACE Medicare |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.47
|
| Rate for Payer: Priority Health Medicare |
$12.47
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$9.98
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.71
|
| Rate for Payer: UHC Core |
$18.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.47
|
| Rate for Payer: UHC Exchange |
$18.71
|
| Rate for Payer: UHC Medicaid |
$6.52
|
| Rate for Payer: UHCCP Medicaid |
$6.52
|
| Rate for Payer: VA VA |
$12.47
|
|
|
HC TROUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200064
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC TROUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200064
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC TRYPTASE, S
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$42.79
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC TRYPTASE, S
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.79 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health SBD |
$42.79
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.46 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health SBD |
$43.46
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$17.91
|
| Rate for Payer: BCN Commercial |
$17.91
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: Meridian Medicaid |
$17.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$25.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.80
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$13.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.20
|
| Rate for Payer: UHC Core |
$25.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.80
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$16.80
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$409.92
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna Commercial |
$348.43
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$177.16
|
| Rate for Payer: BCN Commercial |
$177.16
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cofinity Advantage |
$286.94
|
| Rate for Payer: Cofinity Commercial |
$352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$368.93
|
| Rate for Payer: Mclaren Medicaid |
$130.20
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.43
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.44
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$348.43
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$258.25
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.45
|
| Rate for Payer: UHC Core |
$213.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$161.10
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$409.92
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$258.25 |
| Max. Negotiated Rate |
$368.93 |
| Rate for Payer: Aetna Commercial |
$348.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.45
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cofinity Advantage |
$286.94
|
| Rate for Payer: Cofinity Commercial |
$352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.94
|
| Rate for Payer: Healthscope Commercial |
$368.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.44
|
| Rate for Payer: PHP Commercial |
$348.43
|
| Rate for Payer: Priority Health SBD |
$258.25
|
|
