|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,493.43
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,551.92 |
| Max. Negotiated Rate |
$5,844.09 |
| Rate for Payer: Aetna Commercial |
$5,519.42
|
| Rate for Payer: Aetna Medicare |
$3,246.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,220.73
|
| Rate for Payer: BCBS Complete |
$2,597.37
|
| 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: MI Amish Medical Board Commercial |
$5,194.74
|
| 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
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,220.73
|
| Rate for Payer: UHC Core |
$3,383.08
|
| Rate for Payer: UHC Exchange |
$2,551.92
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$224.17
|
| Rate for Payer: BCN Commercial |
$224.17
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Mclaren Medicaid |
$159.96
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.15
|
| Rate for Payer: UHC Core |
$232.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$175.43
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.22 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$706.55
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$445.13 |
| Max. Negotiated Rate |
$635.89 |
| Rate for Payer: Aetna Commercial |
$600.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.26
|
| Rate for Payer: Cash Price |
$565.24
|
| Rate for Payer: Cofinity Advantage |
$494.58
|
| Rate for Payer: Cofinity Commercial |
$607.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.24
|
| Rate for Payer: Healthscope Commercial |
$635.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.91
|
| Rate for Payer: PHP Commercial |
$600.57
|
| Rate for Payer: Priority Health SBD |
$445.13
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$706.55
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$635.89 |
| Rate for Payer: Aetna Commercial |
$600.57
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$565.24
|
| Rate for Payer: Cash Price |
$565.24
|
| Rate for Payer: Cofinity Advantage |
$494.58
|
| Rate for Payer: Cofinity Commercial |
$607.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$635.89
|
| Rate for Payer: Mclaren Medicaid |
$217.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.57
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.91
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$600.57
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$445.13
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.17
|
| Rate for Payer: UHC Core |
$625.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$625.17
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$635.14
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$400.14 |
| Max. Negotiated Rate |
$571.63 |
| Rate for Payer: Aetna Commercial |
$539.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.84
|
| Rate for Payer: Cash Price |
$508.11
|
| Rate for Payer: Cofinity Advantage |
$444.60
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.11
|
| Rate for Payer: Healthscope Commercial |
$571.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.36
|
| Rate for Payer: PHP Commercial |
$539.87
|
| Rate for Payer: Priority Health SBD |
$400.14
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$635.14
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$625.17 |
| Rate for Payer: Aetna Commercial |
$539.87
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$444.38
|
| Rate for Payer: BCN Commercial |
$444.38
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$508.11
|
| Rate for Payer: Cash Price |
$508.11
|
| Rate for Payer: Cofinity Advantage |
$444.60
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$571.63
|
| Rate for Payer: Mclaren Medicaid |
$217.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.87
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.36
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$539.87
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$400.14
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.17
|
| Rate for Payer: UHC Core |
$625.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$625.17
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.09 |
| Max. Negotiated Rate |
$105.84 |
| Rate for Payer: Aetna Commercial |
$99.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.44
|
| Rate for Payer: Cash Price |
$94.08
|
| Rate for Payer: Cofinity Advantage |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.08
|
| Rate for Payer: Healthscope Commercial |
$105.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.20
|
| Rate for Payer: PHP Commercial |
$99.96
|
| Rate for Payer: Priority Health SBD |
$74.09
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.36 |
| Max. Negotiated Rate |
$197.07 |
| Rate for Payer: Aetna Commercial |
$99.96
|
| Rate for Payer: Aetna Medicare |
$68.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.11
|
| Rate for Payer: BCBS Complete |
$36.08
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCBS Trust/PPO |
$70.04
|
| Rate for Payer: BCN Commercial |
$70.04
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$94.08
|
| Rate for Payer: Cash Price |
$94.08
|
| Rate for Payer: Cofinity Advantage |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$105.84
|
| Rate for Payer: Mclaren Medicaid |
$34.36
|
| Rate for Payer: Mclaren Medicare |
$65.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.97
|
| Rate for Payer: Meridian Medicaid |
$68.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.96
|
| Rate for Payer: Nomi Health Commercial |
$197.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.20
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$99.96
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.69
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health SBD |
$74.09
|
| Rate for Payer: Priority Health Tiered Network |
$52.55
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.54
|
| Rate for Payer: UHC Core |
$98.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.69
|
| Rate for Payer: UHC Exchange |
$98.54
|
| Rate for Payer: UHC Medicaid |
$34.36
|
| Rate for Payer: UHCCP Medicaid |
$34.36
|
| Rate for Payer: VA VA |
$65.69
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$131.35
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$220.11 |
| Rate for Payer: Aetna Commercial |
$111.65
|
| Rate for Payer: Aetna Medicare |
$76.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.71
|
| Rate for Payer: BCBS Complete |
$40.29
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCBS Trust/PPO |
$78.23
|
| Rate for Payer: BCN Commercial |
$78.23
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cofinity Advantage |
$91.94
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$118.22
|
| Rate for Payer: Mclaren Medicaid |
$38.37
|
| Rate for Payer: Mclaren Medicare |
$73.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: Meridian Medicaid |
$77.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.65
|
| Rate for Payer: Nomi Health Commercial |
$220.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.51
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$111.65
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.37
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health SBD |
$82.75
|
| Rate for Payer: Priority Health Tiered Network |
$58.70
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.06
|
| Rate for Payer: UHC Core |
$110.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.37
|
| Rate for Payer: UHC Exchange |
$110.06
|
| Rate for Payer: UHC Medicaid |
$38.37
|
| Rate for Payer: UHCCP Medicaid |
$38.37
|
| Rate for Payer: VA VA |
$73.37
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$131.35
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.75 |
| Max. Negotiated Rate |
$118.22 |
| Rate for Payer: Aetna Commercial |
$111.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.38
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cofinity Advantage |
$91.94
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.08
|
| Rate for Payer: Healthscope Commercial |
$118.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.51
|
| Rate for Payer: PHP Commercial |
$111.65
|
| Rate for Payer: Priority Health SBD |
$82.75
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,179.85
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,642.68 |
| Max. Negotiated Rate |
$3,761.86 |
| Rate for Payer: Aetna Commercial |
$3,552.87
|
| Rate for Payer: Aetna Medicare |
$2,089.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,716.90
|
| Rate for Payer: BCBS Complete |
$1,671.94
|
| Rate for Payer: Cash Price |
$3,343.88
|
| Rate for Payer: Cofinity Advantage |
$2,925.89
|
| Rate for Payer: Cofinity Commercial |
$3,594.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.88
|
| Rate for Payer: Healthscope Commercial |
$3,761.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,343.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.89
|
| Rate for Payer: PHP Commercial |
$3,552.87
|
| Rate for Payer: Priority Health SBD |
$2,633.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,716.90
|
| Rate for Payer: UHC Core |
$2,177.70
|
| Rate for Payer: UHC Exchange |
$1,642.68
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,179.85
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,633.31 |
| Max. Negotiated Rate |
$3,761.86 |
| Rate for Payer: Aetna Commercial |
$3,552.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,716.90
|
| Rate for Payer: Cash Price |
$3,343.88
|
| Rate for Payer: Cofinity Advantage |
$2,925.89
|
| Rate for Payer: Cofinity Commercial |
$3,594.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.88
|
| Rate for Payer: Healthscope Commercial |
$3,761.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.89
|
| Rate for Payer: PHP Commercial |
$3,552.87
|
| Rate for Payer: Priority Health SBD |
$2,633.31
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,846.08
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,083.51 |
| Max. Negotiated Rate |
$7,061.47 |
| Rate for Payer: Aetna Commercial |
$6,669.17
|
| Rate for Payer: Aetna Medicare |
$3,923.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,099.95
|
| Rate for Payer: BCBS Complete |
$3,138.43
|
| Rate for Payer: Cash Price |
$6,276.86
|
| Rate for Payer: Cofinity Advantage |
$5,492.26
|
| Rate for Payer: Cofinity Commercial |
$6,747.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,276.86
|
| Rate for Payer: Healthscope Commercial |
$7,061.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,276.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,669.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,884.56
|
| Rate for Payer: PHP Commercial |
$6,669.17
|
| Rate for Payer: Priority Health SBD |
$4,943.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,099.95
|
| Rate for Payer: UHC Core |
$4,087.81
|
| Rate for Payer: UHC Exchange |
$3,083.51
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,846.08
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,943.03 |
| Max. Negotiated Rate |
$7,061.47 |
| Rate for Payer: Aetna Commercial |
$6,669.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,099.95
|
| Rate for Payer: Cash Price |
$6,276.86
|
| Rate for Payer: Cofinity Advantage |
$5,492.26
|
| Rate for Payer: Cofinity Commercial |
$6,747.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,276.86
|
| Rate for Payer: Healthscope Commercial |
$7,061.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,669.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,884.56
|
| Rate for Payer: PHP Commercial |
$6,669.17
|
| Rate for Payer: Priority Health SBD |
$4,943.03
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,432.43 |
| Max. Negotiated Rate |
$2,046.33 |
| Rate for Payer: Aetna Commercial |
$1,932.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.90
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Advantage |
$1,591.59
|
| Rate for Payer: Cofinity Commercial |
$1,955.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Healthscope Commercial |
$2,046.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: PHP Commercial |
$1,932.64
|
| Rate for Payer: Priority Health SBD |
$1,432.43
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$909.48 |
| Max. Negotiated Rate |
$6,782.57 |
| Rate for Payer: Aetna Commercial |
$1,932.64
|
| Rate for Payer: Aetna Medicare |
$1,136.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.90
|
| Rate for Payer: BCBS Complete |
$909.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.47
|
| Rate for Payer: BCN Commercial |
$1,134.47
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Advantage |
$1,591.59
|
| Rate for Payer: Cofinity Commercial |
$1,955.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Healthscope Commercial |
$2,046.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,818.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: PHP Commercial |
$1,932.64
|
| Rate for Payer: Priority Health SBD |
$1,432.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,782.57
|
| Rate for Payer: UHC Core |
$6,782.57
|
| Rate for Payer: UHC Exchange |
$6,782.57
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$29,719.24 |
| Max. Negotiated Rate |
$179,222.83 |
| Rate for Payer: Aetna Commercial |
$53,722.26
|
| Rate for Payer: Aetna Medicare |
$59,097.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,081.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71,030.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71,030.69
|
| Rate for Payer: BCBS Complete |
$31,208.04
|
| Rate for Payer: BCBS MAPPO |
$56,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$80,781.78
|
| Rate for Payer: BCN Commercial |
$80,781.78
|
| Rate for Payer: BCN Medicare Advantage |
$56,824.55
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Advantage |
$44,241.86
|
| Rate for Payer: Cofinity Commercial |
$54,354.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,824.55
|
| Rate for Payer: Healthscope Commercial |
$56,882.39
|
| Rate for Payer: Mclaren Medicaid |
$29,719.24
|
| Rate for Payer: Mclaren Medicare |
$56,824.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,665.78
|
| Rate for Payer: Meridian Medicaid |
$59,665.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,348.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$62,507.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Nomi Health Commercial |
$170,473.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: PACE Medicare |
$53,983.32
|
| Rate for Payer: PACE SWMI |
$56,824.55
|
| Rate for Payer: PHP Commercial |
$53,722.26
|
| Rate for Payer: PHP Medicare Advantage |
$56,824.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,719.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$179,222.83
|
| Rate for Payer: Priority Health Medicare |
$56,824.55
|
| Rate for Payer: Priority Health SBD |
$39,817.68
|
| Rate for Payer: Priority Health Tiered Network |
$143,378.26
|
| Rate for Payer: Railroad Medicare Medicare |
$56,824.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93,760.51
|
| Rate for Payer: UHC Core |
$93,760.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56,824.55
|
| Rate for Payer: UHC Exchange |
$93,760.51
|
| Rate for Payer: UHC Medicaid |
$29,719.24
|
| Rate for Payer: UHCCP Medicaid |
$29,719.24
|
| Rate for Payer: VA VA |
$56,824.55
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$39,817.68 |
| Max. Negotiated Rate |
$56,882.39 |
| Rate for Payer: Aetna Commercial |
$53,722.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,081.73
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Advantage |
$44,241.86
|
| Rate for Payer: Cofinity Commercial |
$54,354.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Healthscope Commercial |
$56,882.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: PHP Commercial |
$53,722.26
|
| Rate for Payer: Priority Health SBD |
$39,817.68
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$983.75 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.98
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Advantage |
$1,093.06
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health SBD |
$983.75
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$613.67 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna Medicare |
$780.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.98
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Advantage |
$1,093.06
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,249.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health SBD |
$983.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.98
|
| Rate for Payer: UHC Core |
$813.55
|
| Rate for Payer: UHC Exchange |
$613.67
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$490.39 |
| Max. Negotiated Rate |
$1,123.03 |
| Rate for Payer: Aetna Commercial |
$1,060.64
|
| Rate for Payer: Aetna Medicare |
$623.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.08
|
| Rate for Payer: BCBS Complete |
$499.12
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Advantage |
$873.47
|
| Rate for Payer: Cofinity Commercial |
$1,073.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Healthscope Commercial |
$1,123.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: PHP Commercial |
$1,060.64
|
| Rate for Payer: Priority Health SBD |
$786.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.08
|
| Rate for Payer: UHC Core |
$650.11
|
| Rate for Payer: UHC Exchange |
$490.39
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$786.12 |
| Max. Negotiated Rate |
$1,123.03 |
| Rate for Payer: Aetna Commercial |
$1,060.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.08
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Advantage |
$873.47
|
| Rate for Payer: Cofinity Commercial |
$1,073.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Healthscope Commercial |
$1,123.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: PHP Commercial |
$1,060.64
|
| Rate for Payer: Priority Health SBD |
$786.12
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$634.61 |
| Max. Negotiated Rate |
$1,453.31 |
| Rate for Payer: Aetna Commercial |
$1,372.57
|
| Rate for Payer: Aetna Medicare |
$807.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.61
|
| Rate for Payer: BCBS Complete |
$645.92
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Advantage |
$1,130.35
|
| Rate for Payer: Cofinity Commercial |
$1,388.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Healthscope Commercial |
$1,453.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,291.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: PHP Commercial |
$1,372.57
|
| Rate for Payer: Priority Health SBD |
$1,017.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.61
|
| Rate for Payer: UHC Core |
$841.31
|
| Rate for Payer: UHC Exchange |
$634.61
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,017.32 |
| Max. Negotiated Rate |
$1,453.31 |
| Rate for Payer: Aetna Commercial |
$1,372.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.61
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Advantage |
$1,130.35
|
| Rate for Payer: Cofinity Commercial |
$1,388.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Healthscope Commercial |
$1,453.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: PHP Commercial |
$1,372.57
|
| Rate for Payer: Priority Health SBD |
$1,017.32
|
|
