|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
OP
|
$298.86
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$119.54 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$149.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.26
|
| Rate for Payer: BCBS Complete |
$119.54
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Cofinity Commercial |
$209.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.03
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.26
|
| Rate for Payer: Priority Health SBD |
$188.28
|
| Rate for Payer: UHC Core |
$221.16
|
| Rate for Payer: UHC Exchange |
$221.16
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
IP
|
$2,225.11
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,401.82 |
| Max. Negotiated Rate |
$2,002.60 |
| Rate for Payer: Aetna Commercial |
$1,891.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.32
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cofinity Commercial |
$1,557.58
|
| Rate for Payer: Cofinity Commercial |
$1,913.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,557.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.09
|
| Rate for Payer: Healthscope Commercial |
$2,002.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.34
|
| Rate for Payer: PHP Commercial |
$1,891.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.32
|
| Rate for Payer: Priority Health SBD |
$1,401.82
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
OP
|
$2,225.11
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,401.82 |
| Max. Negotiated Rate |
$10,512.58 |
| Rate for Payer: Aetna Commercial |
$1,891.34
|
| Rate for Payer: Aetna Medicare |
$3,884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,668.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,668.27
|
| Rate for Payer: BCBS Complete |
$2,101.84
|
| Rate for Payer: BCBS MAPPO |
$3,734.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,734.62
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cofinity Commercial |
$1,913.59
|
| Rate for Payer: Cofinity Commercial |
$1,557.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,557.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,734.62
|
| Rate for Payer: Healthscope Commercial |
$2,002.60
|
| Rate for Payer: Mclaren Medicaid |
$2,001.76
|
| Rate for Payer: Mclaren Medicare |
$3,734.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,921.35
|
| Rate for Payer: Meridian Medicaid |
$2,101.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,294.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.34
|
| Rate for Payer: PACE Medicare |
$3,547.89
|
| Rate for Payer: PACE SWMI |
$3,734.62
|
| Rate for Payer: PHP Commercial |
$1,891.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,734.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,001.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.32
|
| Rate for Payer: Priority Health Medicare |
$3,734.62
|
| Rate for Payer: Priority Health SBD |
$1,401.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,734.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,512.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,734.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,734.62
|
| Rate for Payer: UHCCP Medicaid |
$2,102.59
|
| Rate for Payer: VA VA |
$3,734.62
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
OP
|
$575.70
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$489.35
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$495.10
|
| Rate for Payer: Cofinity Commercial |
$402.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$402.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$518.13
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.35
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$489.35
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.20
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$362.69
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
IP
|
$575.70
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.69 |
| Max. Negotiated Rate |
$518.13 |
| Rate for Payer: Aetna Commercial |
$489.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.20
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$402.99
|
| Rate for Payer: Cofinity Commercial |
$495.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$402.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.56
|
| Rate for Payer: Healthscope Commercial |
$518.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.35
|
| Rate for Payer: PHP Commercial |
$489.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.20
|
| Rate for Payer: Priority Health SBD |
$362.69
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health SBD |
$20.32
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$47.43 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Cofinity Commercial |
$22.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.49
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC WEST NILE VIRUS AB IGG & IGM CSF
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$47.43 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$28.19
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.49
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC WEST NILE VIRUS AB IGG & IGM CSF
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health SBD |
$28.19
|
|
|
HC WEST NILE VIRUS CMPT
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health SBD |
$20.32
|
|
|
HC WEST NILE VIRUS CMPT
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$40.51 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Cofinity Commercial |
$22.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$8.10
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC WEST NILE VIRUS CSF CMPT
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$40.51 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health SBD |
$28.19
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$8.10
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC WEST NILE VIRUS CSF CMPT
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health SBD |
$28.19
|
|
|
HC WET PREP
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health SBD |
$32.33
|
|
|
HC WET PREP
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$6.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.28
|
| Rate for Payer: BCBS Complete |
$3.28
|
| Rate for Payer: BCBS MAPPO |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.82
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.82
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Mclaren Medicaid |
$3.12
|
| Rate for Payer: Mclaren Medicare |
$5.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.11
|
| Rate for Payer: Meridian Medicaid |
$3.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: PACE Medicare |
$5.53
|
| Rate for Payer: PACE SWMI |
$5.82
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: Railroad Medicare Medicare |
$5.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.82
|
| Rate for Payer: UHCCP Medicaid |
$3.28
|
| Rate for Payer: VA VA |
$5.82
|
|
|
HC WHEAT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC WHEAT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC WHEELCHAIR MANAGEMENT EA 15 MIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 97542
|
| Hospital Charge Code |
42000032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health SBD |
$62.27
|
|
|
HC WHEELCHAIR MANAGEMENT EA 15 MIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 97542
|
| Hospital Charge Code |
42000032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.54 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$49.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: BCBS Complete |
$39.54
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: UHC Core |
$73.14
|
| Rate for Payer: UHC Exchange |
$73.14
|
|
|
HC WHIRLPOOL
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.04 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$46.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: BCBS Complete |
$37.04
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: UHC Core |
$68.52
|
| Rate for Payer: UHC Exchange |
$68.52
|
|
|
HC WHIRLPOOL
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health SBD |
$58.34
|
|
|
HC WHITE ASH IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200106
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC WHITE ASH IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200106
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC WHITE FACED HORNET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200107
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC WHITE FACED HORNET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200107
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
