|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
IP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$290.23 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.44
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Advantage |
$322.48
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: Priority Health SBD |
$290.23
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
OP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$74.96
|
| Rate for Payer: BCN Commercial |
$74.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Advantage |
$322.48
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$290.23
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.44
|
| Rate for Payer: UHC Core |
$240.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$181.05
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.31 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$74.96
|
| Rate for Payer: BCN Commercial |
$74.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.78
|
| Rate for Payer: UHC Core |
$8.64
|
| Rate for Payer: UHC Exchange |
$6.52
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: Priority Health SBD |
$10.45
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.43 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.52
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Advantage |
$38.26
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: Priority Health SBD |
$34.43
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.52
|
| Rate for Payer: BCBS Complete |
$21.86
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Advantage |
$38.26
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: Priority Health SBD |
$34.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$28.47
|
| Rate for Payer: UHC Exchange |
$21.48
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.92
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$38.63 |
| Rate for Payer: Aetna Commercial |
$36.48
|
| Rate for Payer: Aetna Medicare |
$21.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.90
|
| Rate for Payer: BCBS Complete |
$17.17
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cofinity Advantage |
$30.04
|
| Rate for Payer: Cofinity Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.34
|
| Rate for Payer: Healthscope Commercial |
$38.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.19
|
| Rate for Payer: PHP Commercial |
$36.48
|
| Rate for Payer: Priority Health SBD |
$27.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.90
|
| Rate for Payer: UHC Core |
$22.36
|
| Rate for Payer: UHC Exchange |
$16.87
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.92
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.04 |
| Max. Negotiated Rate |
$38.63 |
| Rate for Payer: Aetna Commercial |
$36.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.90
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cofinity Advantage |
$30.04
|
| Rate for Payer: Cofinity Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.34
|
| Rate for Payer: Healthscope Commercial |
$38.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.19
|
| Rate for Payer: PHP Commercial |
$36.48
|
| Rate for Payer: Priority Health SBD |
$27.04
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$51,795.10
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,064.48 |
| Max. Negotiated Rate |
$56,049.21 |
| Rate for Payer: Aetna Commercial |
$44,025.83
|
| Rate for Payer: Aetna Medicare |
$18,024.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,666.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,664.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,664.64
|
| Rate for Payer: BCBS Complete |
$9,518.58
|
| Rate for Payer: BCBS MAPPO |
$17,331.71
|
| Rate for Payer: BCN Medicare Advantage |
$17,331.71
|
| Rate for Payer: Cash Price |
$41,436.08
|
| Rate for Payer: Cash Price |
$41,436.08
|
| Rate for Payer: Cofinity Advantage |
$36,256.57
|
| Rate for Payer: Cofinity Commercial |
$44,543.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41,436.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,331.71
|
| Rate for Payer: Healthscope Commercial |
$46,615.59
|
| Rate for Payer: Mclaren Medicaid |
$9,064.48
|
| Rate for Payer: Mclaren Medicare |
$17,331.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,198.30
|
| Rate for Payer: Meridian Medicaid |
$18,198.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,931.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,064.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,025.83
|
| Rate for Payer: Nomi Health Commercial |
$51,995.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,846.32
|
| Rate for Payer: PACE Medicare |
$16,465.12
|
| Rate for Payer: PACE SWMI |
$17,331.71
|
| Rate for Payer: PHP Commercial |
$44,025.83
|
| Rate for Payer: PHP Medicare Advantage |
$17,331.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,064.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56,049.21
|
| Rate for Payer: Priority Health Medicare |
$17,331.71
|
| Rate for Payer: Priority Health SBD |
$32,630.91
|
| Rate for Payer: Priority Health Tiered Network |
$44,839.37
|
| Rate for Payer: Railroad Medicare Medicare |
$17,331.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,666.82
|
| Rate for Payer: UHC Core |
$26,985.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,331.71
|
| Rate for Payer: UHC Exchange |
$20,355.47
|
| Rate for Payer: UHC Medicaid |
$9,064.48
|
| Rate for Payer: UHCCP Medicaid |
$9,064.48
|
| Rate for Payer: VA VA |
$17,331.71
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$51,795.10
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32,630.91 |
| Max. Negotiated Rate |
$46,615.59 |
| Rate for Payer: Aetna Commercial |
$44,025.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,666.82
|
| Rate for Payer: Cash Price |
$41,436.08
|
| Rate for Payer: Cofinity Advantage |
$36,256.57
|
| Rate for Payer: Cofinity Commercial |
$44,543.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41,436.08
|
| Rate for Payer: Healthscope Commercial |
$46,615.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,025.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,846.32
|
| Rate for Payer: PHP Commercial |
$44,025.83
|
| Rate for Payer: Priority Health SBD |
$32,630.91
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$42.66
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.88 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Advantage |
$29.86
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.00
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health SBD |
$26.88
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$42.66
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.77 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$21.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: BCBS Complete |
$17.06
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Advantage |
$29.86
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.00
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health SBD |
$26.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.73
|
| Rate for Payer: UHC Core |
$22.23
|
| Rate for Payer: UHC Exchange |
$16.77
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$208.96
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.64 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$177.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.82
|
| Rate for Payer: Cash Price |
$167.17
|
| Rate for Payer: Cofinity Advantage |
$146.27
|
| Rate for Payer: Cofinity Commercial |
$179.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.17
|
| Rate for Payer: Healthscope Commercial |
$188.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.72
|
| Rate for Payer: PHP Commercial |
$177.62
|
| Rate for Payer: Priority Health SBD |
$131.64
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$208.96
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$82.12 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$177.62
|
| Rate for Payer: Aetna Medicare |
$104.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.82
|
| Rate for Payer: BCBS Complete |
$83.58
|
| Rate for Payer: Cash Price |
$167.17
|
| Rate for Payer: Cofinity Advantage |
$146.27
|
| Rate for Payer: Cofinity Commercial |
$179.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.17
|
| Rate for Payer: Healthscope Commercial |
$188.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.72
|
| Rate for Payer: PHP Commercial |
$177.62
|
| Rate for Payer: Priority Health SBD |
$131.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.82
|
| Rate for Payer: UHC Core |
$108.87
|
| Rate for Payer: UHC Exchange |
$82.12
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,493.43
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,090.86 |
| Max. Negotiated Rate |
$5,844.09 |
| Rate for Payer: Aetna Commercial |
$5,519.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,220.73
|
| Rate for Payer: Cash Price |
$5,194.74
|
| Rate for Payer: Cofinity Advantage |
$4,545.40
|
| Rate for Payer: Cofinity Commercial |
$5,584.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,194.74
|
| Rate for Payer: Healthscope Commercial |
$5,844.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,519.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,870.07
|
| Rate for Payer: PHP Commercial |
$5,519.42
|
| Rate for Payer: Priority Health SBD |
$4,090.86
|
|
