|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
IP
|
$33,420.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,054.60 |
| Max. Negotiated Rate |
$30,078.00 |
| Rate for Payer: Aetna Commercial |
$28,407.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21,723.00
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cofinity Commercial |
$23,394.00
|
| Rate for Payer: Cofinity Commercial |
$28,741.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$23,394.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26,736.00
|
| Rate for Payer: Healthscope Commercial |
$30,078.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,407.00
|
| Rate for Payer: PHP Commercial |
$28,407.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21,723.00
|
| Rate for Payer: Priority Health SBD |
$21,054.60
|
|
|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
OP
|
$33,420.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna Commercial |
$28,407.00
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21,723.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cofinity Commercial |
$28,741.20
|
| Rate for Payer: Cofinity Commercial |
$23,394.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$23,394.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26,736.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$30,078.00
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,407.00
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$28,407.00
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21,723.00
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$21,054.60
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,859.72
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC VASCULAR GRAFT
|
Facility
|
OP
|
$2,314.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$925.76 |
| Max. Negotiated Rate |
$2,082.96 |
| Rate for Payer: Aetna Commercial |
$1,967.24
|
| Rate for Payer: Aetna Medicare |
$1,157.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,504.36
|
| Rate for Payer: BCBS Complete |
$925.76
|
| Rate for Payer: Cash Price |
$1,851.52
|
| Rate for Payer: Cofinity Commercial |
$1,620.08
|
| Rate for Payer: Cofinity Commercial |
$1,990.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,620.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.52
|
| Rate for Payer: Healthscope Commercial |
$2,082.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,967.24
|
| Rate for Payer: PHP Commercial |
$1,967.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.36
|
| Rate for Payer: Priority Health SBD |
$1,458.07
|
|
|
HC VASCULAR GRAFT
|
Facility
|
IP
|
$2,314.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,458.07 |
| Max. Negotiated Rate |
$2,082.96 |
| Rate for Payer: Aetna Commercial |
$1,967.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,504.36
|
| Rate for Payer: Cash Price |
$1,851.52
|
| Rate for Payer: Cofinity Commercial |
$1,620.08
|
| Rate for Payer: Cofinity Commercial |
$1,990.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,620.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.52
|
| Rate for Payer: Healthscope Commercial |
$2,082.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,967.24
|
| Rate for Payer: PHP Commercial |
$1,967.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.36
|
| Rate for Payer: Priority Health SBD |
$1,458.07
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.94 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$36.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.16
|
| Rate for Payer: BCBS Complete |
$19.88
|
| Rate for Payer: BCBS MAPPO |
$35.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.33
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.33
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$18.94
|
| Rate for Payer: Mclaren Medicare |
$35.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.10
|
| Rate for Payer: Meridian Medicaid |
$19.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: PACE Medicare |
$33.56
|
| Rate for Payer: PACE SWMI |
$35.33
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: PHP Medicare Advantage |
$35.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health Medicare |
$35.33
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: Railroad Medicare Medicare |
$35.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.33
|
| Rate for Payer: UHC Medicare Advantage |
$35.33
|
| Rate for Payer: UHCCP Medicaid |
$19.89
|
| Rate for Payer: VA VA |
$35.33
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health SBD |
$53.09
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$29.96 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$37.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: BCBS Complete |
$29.96
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: UHC Core |
$55.43
|
| Rate for Payer: UHC Exchange |
$55.43
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.19 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health SBD |
$47.19
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.40
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health SBD |
$22.28
|
|
|
HC VDRL TITER CSF
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna Medicare |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.50
|
| Rate for Payer: BCBS Complete |
$2.48
|
| Rate for Payer: BCBS MAPPO |
$4.40
|
| Rate for Payer: BCN Medicare Advantage |
$4.40
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.40
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Mclaren Medicaid |
$2.36
|
| Rate for Payer: Mclaren Medicare |
$4.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.62
|
| Rate for Payer: Meridian Medicaid |
$2.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: PACE Medicare |
$4.18
|
| Rate for Payer: PACE SWMI |
$4.40
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: PHP Medicare Advantage |
$4.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health Medicare |
$4.40
|
| Rate for Payer: Priority Health SBD |
$47.55
|
| Rate for Payer: Railroad Medicare Medicare |
$4.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.40
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$4.40
|
|
|
HC VDRL TITER CSF
|
Facility
|
IP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.55 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.06
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health SBD |
$47.55
|
|
|
HC VEDOLIZUMAB
|
Facility
|
IP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.74 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$116.38
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health SBD |
$104.74
|
|
|
HC VEDOLIZUMAB
|
Facility
|
OP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| 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 |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Cofinity Commercial |
$116.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$104.74
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.72
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna Medicare |
$14.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.65
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS MAPPO |
$14.12
|
| Rate for Payer: BCN Medicare Advantage |
$14.12
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Mclaren Medicaid |
$7.57
|
| Rate for Payer: Mclaren Medicare |
$14.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.83
|
| Rate for Payer: Meridian Medicaid |
$7.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: PACE Medicare |
$13.41
|
| Rate for Payer: PACE SWMI |
$14.12
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health SBD |
$82.90
|
| Rate for Payer: Railroad Medicare Medicare |
$14.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$14.12
|
| Rate for Payer: UHCCP Medicaid |
$7.95
|
| Rate for Payer: VA VA |
$14.12
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.90 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health SBD |
$82.90
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$10.49
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.25 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health SBD |
$82.25
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
OP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.67 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: Aetna Medicare |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: BCBS Complete |
$21.71
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Cofinity Commercial |
$174.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Mclaren Medicaid |
$20.67
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$21.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health SBD |
$156.79
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.57
|
| Rate for Payer: UHC Medicare Advantage |
$38.57
|
| Rate for Payer: UHCCP Medicaid |
$21.71
|
| Rate for Payer: VA VA |
$38.57
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
IP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$156.79 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.77
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$174.22
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health SBD |
$156.79
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
IP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$643.39 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.82
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$714.88
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health SBD |
$643.39
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
OP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$1,456.65 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Cofinity Commercial |
$714.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$643.39
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$755.73
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$291.34
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
OP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Cofinity Commercial |
$1,709.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,709.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$1,538.43
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$1,807.05
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$291.34
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
IP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,538.43 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.27
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$1,709.37
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,709.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health SBD |
$1,538.43
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
IP
|
$1,072.90
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$675.93 |
| Max. Negotiated Rate |
$965.61 |
| Rate for Payer: Aetna Commercial |
$911.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.38
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cofinity Commercial |
$751.03
|
| Rate for Payer: Cofinity Commercial |
$922.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$751.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.32
|
| Rate for Payer: Healthscope Commercial |
$965.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.97
|
| Rate for Payer: PHP Commercial |
$911.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.38
|
| Rate for Payer: Priority Health SBD |
$675.93
|
|
