|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,294.70 |
| Max. Negotiated Rate |
$4,706.71 |
| Rate for Payer: Aetna Commercial |
$4,445.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,399.29
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Advantage |
$3,660.78
|
| Rate for Payer: Cofinity Commercial |
$4,497.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Healthscope Commercial |
$4,706.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,445.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: PHP Commercial |
$4,445.23
|
| Rate for Payer: Priority Health SBD |
$3,294.70
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$4,445.23
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,399.29
|
| 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 |
$2,015.63
|
| Rate for Payer: BCN Commercial |
$2,015.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Advantage |
$3,660.78
|
| Rate for Payer: Cofinity Commercial |
$4,497.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,706.71
|
| 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 |
$4,445.23
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,445.23
|
| 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 |
$3,294.70
|
| 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) |
$3,399.29
|
| Rate for Payer: UHC Core |
$2,724.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$2,055.26
|
| 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 VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,609.80 |
| Max. Negotiated Rate |
$2,299.72 |
| Rate for Payer: Aetna Commercial |
$2,171.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,660.91
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Advantage |
$1,788.67
|
| Rate for Payer: Cofinity Commercial |
$2,197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Healthscope Commercial |
$2,299.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: PHP Commercial |
$2,171.95
|
| Rate for Payer: Priority Health SBD |
$1,609.80
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$779.26 |
| Max. Negotiated Rate |
$2,299.72 |
| Rate for Payer: Aetna Commercial |
$2,171.95
|
| Rate for Payer: Aetna Medicare |
$1,277.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,660.91
|
| Rate for Payer: BCBS Complete |
$1,022.10
|
| Rate for Payer: BCBS Trust/PPO |
$779.26
|
| Rate for Payer: BCN Commercial |
$779.26
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Advantage |
$1,788.67
|
| Rate for Payer: Cofinity Commercial |
$2,197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Healthscope Commercial |
$2,299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,044.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: PHP Commercial |
$2,171.95
|
| Rate for Payer: Priority Health SBD |
$1,609.80
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$168.50 |
| Max. Negotiated Rate |
$240.71 |
| Rate for Payer: Aetna Commercial |
$227.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.85
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Advantage |
$187.22
|
| Rate for Payer: Cofinity Commercial |
$230.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$240.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: PHP Commercial |
$227.34
|
| Rate for Payer: Priority Health SBD |
$168.50
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$105.11 |
| Max. Negotiated Rate |
$634.72 |
| Rate for Payer: Aetna Commercial |
$227.34
|
| Rate for Payer: Aetna Medicare |
$133.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.85
|
| Rate for Payer: BCBS Complete |
$106.98
|
| Rate for Payer: BCBS Trust/PPO |
$634.72
|
| Rate for Payer: BCN Commercial |
$634.72
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Advantage |
$187.22
|
| Rate for Payer: Cofinity Commercial |
$230.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$240.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: PHP Commercial |
$227.34
|
| Rate for Payer: Priority Health SBD |
$168.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.85
|
| Rate for Payer: UHC Core |
$139.35
|
| Rate for Payer: UHC Exchange |
$105.11
|
|
|
HC VOLARA SUPPLY
|
Facility
|
IP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$179.29 |
| Max. Negotiated Rate |
$256.12 |
| Rate for Payer: Aetna Commercial |
$241.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.98
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Advantage |
$199.21
|
| Rate for Payer: Cofinity Commercial |
$244.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Healthscope Commercial |
$256.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: PHP Commercial |
$241.89
|
| Rate for Payer: Priority Health SBD |
$179.29
|
|
|
HC VOLARA SUPPLY
|
Facility
|
OP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$111.84 |
| Max. Negotiated Rate |
$256.12 |
| Rate for Payer: Aetna Commercial |
$241.89
|
| Rate for Payer: Aetna Medicare |
$142.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.98
|
| Rate for Payer: BCBS Complete |
$113.83
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Advantage |
$199.21
|
| Rate for Payer: Cofinity Commercial |
$244.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Healthscope Commercial |
$256.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: PHP Commercial |
$241.89
|
| Rate for Payer: Priority Health SBD |
$179.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.98
|
| Rate for Payer: UHC Core |
$148.27
|
| Rate for Payer: UHC Exchange |
$111.84
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.04
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Advantage |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: Priority Health SBD |
$12.64
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$3.88
|
| Rate for Payer: BCN Commercial |
$3.88
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Advantage |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Mclaren Medicaid |
$1.90
|
| Rate for Payer: Mclaren Medicare |
$3.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$5.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PACE Medicare |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.64
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health SBD |
$12.64
|
| Rate for Payer: Priority Health Tiered Network |
$2.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.46
|
| Rate for Payer: UHC Core |
$5.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.64
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicaid |
$1.90
|
| Rate for Payer: UHCCP Medicaid |
$1.90
|
| Rate for Payer: VA VA |
$3.64
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| 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 VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$24.47
|
| Rate for Payer: BCN Commercial |
$24.47
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| 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 |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$12.00
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.91
|
| Rate for Payer: BCN Commercial |
$32.91
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Advantage |
$147.08
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Mclaren Medicaid |
$16.14
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$132.38
|
| Rate for Payer: Priority Health Tiered Network |
$24.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.29
|
| Rate for Payer: UHC Core |
$46.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$46.29
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$132.38 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Advantage |
$147.08
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: Priority Health SBD |
$132.38
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.61 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Advantage |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: Priority Health SBD |
$61.61
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$24.47
|
| Rate for Payer: BCN Commercial |
$24.47
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Advantage |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Mclaren Medicaid |
$12.00
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$61.61
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$118.43 |
| Rate for Payer: Aetna Commercial |
$111.85
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.91
|
| Rate for Payer: BCN Commercial |
$32.91
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Advantage |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$113.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$118.43
|
| Rate for Payer: Mclaren Medicaid |
$16.14
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$111.85
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$82.90
|
| Rate for Payer: Priority Health Tiered Network |
$24.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.29
|
| Rate for Payer: UHC Core |
$46.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$46.29
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$82.90 |
| Max. Negotiated Rate |
$118.43 |
| Rate for Payer: Aetna Commercial |
$111.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Advantage |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$113.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Healthscope Commercial |
$118.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PHP Commercial |
$111.85
|
| Rate for Payer: Priority Health SBD |
$82.90
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$19.09
|
| Rate for Payer: BCN Commercial |
$19.09
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Advantage |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$18.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$26.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.90
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$62.85
|
| Rate for Payer: Priority Health Tiered Network |
$14.32
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.85
|
| Rate for Payer: UHC Core |
$26.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.90
|
| Rate for Payer: UHC Exchange |
$26.85
|
| Rate for Payer: UHC Medicaid |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$62.85 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Advantage |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: Priority Health SBD |
$62.85
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$83.57 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: Priority Health SBD |
$83.57
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$24.47
|
| Rate for Payer: BCN Commercial |
$24.47
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Mclaren Medicaid |
$12.00
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$83.57
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$24.47
|
| Rate for Payer: BCN Commercial |
$24.47
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Advantage |
$90.31
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Mclaren Medicaid |
$12.00
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$81.28
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$81.28 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Advantage |
$90.31
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: Priority Health SBD |
$81.28
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$28.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.89
|
| Rate for Payer: BCBS Complete |
$14.89
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.90
|
| Rate for Payer: BCN Commercial |
$28.90
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Mclaren Medicaid |
$14.18
|
| Rate for Payer: Mclaren Medicare |
$27.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Meridian Medicaid |
$28.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$40.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.11
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: Priority Health Tiered Network |
$21.69
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.67
|
| Rate for Payer: UHC Core |
$40.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.11
|
| Rate for Payer: UHC Exchange |
$40.67
|
| Rate for Payer: UHC Medicaid |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$14.18
|
| Rate for Payer: VA VA |
$27.11
|
|
