|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.35
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health SBD |
$26.51
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna Medicare |
$21.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.35
|
| Rate for Payer: BCBS Complete |
$16.83
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health SBD |
$26.51
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31,991.09 |
| Max. Negotiated Rate |
$45,701.56 |
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,006.68
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$35,545.66
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,545.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health SBD |
$31,991.09
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,140.34 |
| Max. Negotiated Rate |
$48,002.12 |
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: Aetna Medicare |
$17,734.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,006.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,316.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,316.09
|
| Rate for Payer: BCBS Complete |
$9,597.36
|
| Rate for Payer: BCBS MAPPO |
$17,052.87
|
| Rate for Payer: BCN Medicare Advantage |
$17,052.87
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Cofinity Commercial |
$35,545.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,545.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,052.87
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Mclaren Medicaid |
$9,140.34
|
| Rate for Payer: Mclaren Medicare |
$17,052.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,905.51
|
| Rate for Payer: Meridian Medicaid |
$9,597.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,610.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: PACE Medicare |
$16,200.23
|
| Rate for Payer: PACE SWMI |
$17,052.87
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: PHP Medicare Advantage |
$17,052.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,140.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health Medicare |
$17,052.87
|
| Rate for Payer: Priority Health SBD |
$31,991.09
|
| Rate for Payer: Railroad Medicare Medicare |
$17,052.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48,002.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,052.87
|
| Rate for Payer: UHC Medicare Advantage |
$17,052.87
|
| Rate for Payer: UHCCP Medicaid |
$9,600.77
|
| Rate for Payer: VA VA |
$17,052.87
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health SBD |
$26.35
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.73 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$20.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: BCBS Complete |
$16.73
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health SBD |
$26.35
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$129.06 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.16
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$143.40
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health SBD |
$129.06
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.94 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna Medicare |
$102.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.16
|
| Rate for Payer: BCBS Complete |
$81.94
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$143.40
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health SBD |
$129.06
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,546.44 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna Medicare |
$3,183.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: BCBS Complete |
$2,546.44
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,010.65 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$810.38 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$299.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$162.08
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.71 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health SBD |
$275.71
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$1,173.19 |
| Rate for Payer: Aetna Commercial |
$588.79
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.25
|
| 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 |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$595.72
|
| Rate for Payer: Cofinity Commercial |
$484.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$623.43
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| 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 |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.79
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$588.79
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.25
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$436.40
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$234.65
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$436.40 |
| Max. Negotiated Rate |
$623.43 |
| Rate for Payer: Aetna Commercial |
$588.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.25
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$484.89
|
| Rate for Payer: Cofinity Commercial |
$595.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Healthscope Commercial |
$623.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.79
|
| Rate for Payer: PHP Commercial |
$588.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.25
|
| Rate for Payer: Priority Health SBD |
$436.40
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$392.29 |
| Max. Negotiated Rate |
$560.42 |
| Rate for Payer: Aetna Commercial |
$529.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.75
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$435.88
|
| Rate for Payer: Cofinity Commercial |
$535.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Healthscope Commercial |
$560.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: PHP Commercial |
$529.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: Priority Health SBD |
$392.29
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$1,173.19 |
| Rate for Payer: Aetna Commercial |
$529.29
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.75
|
| 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 |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$535.51
|
| Rate for Payer: Cofinity Commercial |
$435.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$560.42
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| 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 |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$529.29
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$392.29
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$234.65
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.48 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health SBD |
$69.48
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.21 |
| Max. Negotiated Rate |
$184.91 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$68.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| 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 |
$36.97
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Mclaren Medicaid |
$35.21
|
| 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 |
$36.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health SBD |
$69.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.69
|
| Rate for Payer: UHC Medicare Advantage |
$65.69
|
| Rate for Payer: UHCCP Medicaid |
$36.98
|
| Rate for Payer: VA VA |
$65.69
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.61 |
| Max. Negotiated Rate |
$108.02 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$84.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health SBD |
$75.61
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.33 |
| Max. Negotiated Rate |
$206.53 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Medicare |
$76.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| 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 |
$41.29
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$84.01
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Mclaren Medicaid |
$39.33
|
| 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 |
$41.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health SBD |
$75.61
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.37
|
| Rate for Payer: UHC Medicare Advantage |
$73.37
|
| Rate for Payer: UHCCP Medicaid |
$41.31
|
| Rate for Payer: VA VA |
$73.37
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,581.67 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,663.63
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$2,868.52
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,868.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health SBD |
$2,581.67
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,639.16 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: Aetna Medicare |
$2,048.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,663.63
|
| Rate for Payer: BCBS Complete |
$1,639.16
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$2,868.52
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,868.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health SBD |
$2,581.67
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,076.90 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: Aetna Medicare |
$3,846.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,999.96
|
| Rate for Payer: BCBS Complete |
$3,076.90
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$5,384.57
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,384.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health SBD |
$4,846.11
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,846.11 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,999.96
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$5,384.57
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,384.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health SBD |
$4,846.11
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$2,246.35 |
| Rate for Payer: Aetna Commercial |
$1,894.75
|
| Rate for Payer: Aetna Medicare |
$829.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$997.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$997.52
|
| Rate for Payer: BCBS Complete |
$449.13
|
| Rate for Payer: BCBS MAPPO |
$798.02
|
| Rate for Payer: BCN Medicare Advantage |
$798.02
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$1,917.04
|
| Rate for Payer: Cofinity Commercial |
$1,560.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,560.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.02
|
| Rate for Payer: Healthscope Commercial |
$2,006.21
|
| Rate for Payer: Mclaren Medicaid |
$427.74
|
| Rate for Payer: Mclaren Medicare |
$798.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.92
|
| Rate for Payer: Meridian Medicaid |
$449.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$917.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: PACE Medicare |
$758.12
|
| Rate for Payer: PACE SWMI |
$798.02
|
| Rate for Payer: PHP Commercial |
$1,894.75
|
| Rate for Payer: PHP Medicare Advantage |
$798.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health Medicare |
$798.02
|
| Rate for Payer: Priority Health SBD |
$1,404.35
|
| Rate for Payer: Railroad Medicare Medicare |
$798.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,246.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.02
|
| Rate for Payer: UHC Medicare Advantage |
$798.02
|
| Rate for Payer: UHCCP Medicaid |
$449.29
|
| Rate for Payer: VA VA |
$798.02
|
|
