|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Cofinity Commercial |
$1,331.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health SBD |
$1,198.64
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,198.64 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,331.82
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health SBD |
$1,198.64
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,331.82
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health SBD |
$1,198.64
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$416.68
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,310.97 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,310.97 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,310.97 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Cofinity Commercial |
$1,456.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health SBD |
$1,310.97
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$416.68
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,712.80 |
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cofinity Commercial |
$1,332.18
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,998.27
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health SBD |
$1,798.44
|
| Rate for Payer: Priority Health SBD |
$1,198.96
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$2,854.67
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,798.44 |
| Max. Negotiated Rate |
$2,569.20 |
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,998.27
|
| Rate for Payer: Cofinity Commercial |
$1,332.18
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health SBD |
$1,198.96
|
| Rate for Payer: Priority Health SBD |
$1,798.44
|
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
IP
|
$2,635.11
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,660.12 |
| Max. Negotiated Rate |
$2,371.60 |
| Rate for Payer: Aetna Commercial |
$2,239.84
|
| Rate for Payer: Aetna Commercial |
$1,493.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$1,844.58
|
| Rate for Payer: Cofinity Commercial |
$1,229.72
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Healthscope Commercial |
$1,581.07
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,493.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,239.84
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| Rate for Payer: PHP Commercial |
$1,493.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,229.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.58
|
| Rate for Payer: Priority Health SBD |
$1,660.12
|
| Rate for Payer: Priority Health SBD |
$1,106.75
|
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
OP
|
$2,635.11
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$2,371.60 |
| Rate for Payer: Aetna Commercial |
$2,239.84
|
| Rate for Payer: Aetna Commercial |
$1,493.23
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Cofinity Commercial |
$1,844.58
|
| Rate for Payer: Cofinity Commercial |
$1,229.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,581.07
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,239.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,493.23
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| Rate for Payer: PHP Commercial |
$1,493.23
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,229.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.58
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health SBD |
$1,660.12
|
| Rate for Payer: Priority Health SBD |
$1,106.75
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$416.68
|
| Rate for Payer: UHC Exchange |
$416.68
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
OP
|
$3,074.07
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$2,766.66 |
| Rate for Payer: Aetna Commercial |
$2,612.96
|
| Rate for Payer: Aetna Commercial |
$1,741.97
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cofinity Commercial |
$2,643.70
|
| Rate for Payer: Cofinity Commercial |
$1,434.57
|
| Rate for Payer: Cofinity Commercial |
$1,762.47
|
| Rate for Payer: Cofinity Commercial |
$2,151.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$2,766.66
|
| Rate for Payer: Healthscope Commercial |
$1,844.44
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,741.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,612.96
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$2,612.96
|
| Rate for Payer: PHP Commercial |
$1,741.97
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,434.57
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health SBD |
$1,936.66
|
| Rate for Payer: Priority Health SBD |
$1,291.11
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Exchange |
$653.96
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
IP
|
$2,049.38
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,291.11 |
| Max. Negotiated Rate |
$1,844.44 |
| Rate for Payer: Aetna Commercial |
$1,741.97
|
| Rate for Payer: Aetna Commercial |
$2,612.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.10
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cofinity Commercial |
$1,762.47
|
| Rate for Payer: Cofinity Commercial |
$2,151.85
|
| Rate for Payer: Cofinity Commercial |
$1,434.57
|
| Rate for Payer: Cofinity Commercial |
$2,643.70
|
| Rate for Payer: Healthscope Commercial |
$1,844.44
|
| Rate for Payer: Healthscope Commercial |
$2,766.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,612.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,741.97
|
| Rate for Payer: PHP Commercial |
$1,741.97
|
| Rate for Payer: PHP Commercial |
$2,612.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,434.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.85
|
| Rate for Payer: Priority Health SBD |
$1,291.11
|
| Rate for Payer: Priority Health SBD |
$1,936.66
|
|
|
HC MR MRCP
|
Facility
|
OP
|
$2,069.07
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$1,862.16 |
| Rate for Payer: Aetna Commercial |
$1,758.71
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCBS Trust/PPO |
$223.95
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,655.26
|
| Rate for Payer: Cash Price |
$1,655.26
|
| Rate for Payer: Cofinity Commercial |
$1,448.35
|
| Rate for Payer: Cofinity Commercial |
$1,779.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,862.16
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,758.71
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,758.71
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.35
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health SBD |
$1,303.51
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$197.77
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
|
HC MR MRCP
|
Facility
|
IP
|
$2,069.07
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,303.51 |
| Max. Negotiated Rate |
$1,862.16 |
| Rate for Payer: Aetna Commercial |
$1,758.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.90
|
| Rate for Payer: Cash Price |
$1,655.26
|
| Rate for Payer: Cofinity Commercial |
$1,448.35
|
| Rate for Payer: Cofinity Commercial |
$1,779.40
|
| Rate for Payer: Healthscope Commercial |
$1,862.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,758.71
|
| Rate for Payer: PHP Commercial |
$1,758.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.35
|
| Rate for Payer: Priority Health SBD |
$1,303.51
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
OP
|
$985.70
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$394.28 |
| Max. Negotiated Rate |
$887.13 |
| Rate for Payer: Aetna Commercial |
$837.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.70
|
| Rate for Payer: BCBS Complete |
$394.28
|
| Rate for Payer: BCBS Trust/PPO |
$594.07
|
| Rate for Payer: Cash Price |
$788.56
|
| Rate for Payer: Cash Price |
$788.56
|
| Rate for Payer: Cofinity Commercial |
$689.99
|
| Rate for Payer: Cofinity Commercial |
$847.70
|
| Rate for Payer: Healthscope Commercial |
$887.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.84
|
| Rate for Payer: PHP Commercial |
$837.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.99
|
| Rate for Payer: Priority Health SBD |
$620.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.60
|
| Rate for Payer: UHC Exchange |
$417.82
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
IP
|
$985.70
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$620.99 |
| Max. Negotiated Rate |
$887.13 |
| Rate for Payer: Aetna Commercial |
$837.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.70
|
| Rate for Payer: Cash Price |
$788.56
|
| Rate for Payer: Cofinity Commercial |
$689.99
|
| Rate for Payer: Cofinity Commercial |
$847.70
|
| Rate for Payer: Healthscope Commercial |
$887.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.84
|
| Rate for Payer: PHP Commercial |
$837.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.99
|
| Rate for Payer: Priority Health SBD |
$620.99
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
OP
|
$2,173.50
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,956.15 |
| Rate for Payer: Aetna Commercial |
$1,847.48
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCBS Trust/PPO |
$298.41
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$1,738.80
|
| Rate for Payer: Cash Price |
$1,738.80
|
| Rate for Payer: Cofinity Commercial |
$1,869.21
|
| Rate for Payer: Cofinity Commercial |
$1,521.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,956.15
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,847.48
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,847.48
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.57
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health Narrow Network |
$917.26
|
| Rate for Payer: Priority Health SBD |
$1,369.30
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$229.54
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
IP
|
$2,173.50
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,369.30 |
| Max. Negotiated Rate |
$1,956.15 |
| Rate for Payer: Aetna Commercial |
$1,847.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.78
|
| Rate for Payer: Cash Price |
$1,738.80
|
| Rate for Payer: Cofinity Commercial |
$1,869.21
|
| Rate for Payer: Cofinity Commercial |
$1,521.45
|
| Rate for Payer: Healthscope Commercial |
$1,956.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,847.48
|
| Rate for Payer: PHP Commercial |
$1,847.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.45
|
| Rate for Payer: Priority Health SBD |
$1,369.30
|
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
IP
|
$2,104.40
|
|
|
Service Code
|
CPT 70542
|
| Hospital Charge Code |
61000003
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,325.77 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$1,788.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.86
|
| Rate for Payer: Cash Price |
$1,683.52
|
| Rate for Payer: Cofinity Commercial |
$1,473.08
|
| Rate for Payer: Cofinity Commercial |
$1,809.78
|
| Rate for Payer: Healthscope Commercial |
$1,893.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.74
|
| Rate for Payer: PHP Commercial |
$1,788.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.08
|
| Rate for Payer: Priority Health SBD |
$1,325.77
|
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
OP
|
$2,104.40
|
|
|
Service Code
|
CPT 70542
|
| Hospital Charge Code |
61000003
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.18 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$1,788.74
|
| Rate for Payer: Aetna Medicare |
$355.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.74
|
| Rate for Payer: BCBS Complete |
$196.55
|
| Rate for Payer: BCBS MAPPO |
$342.19
|
| Rate for Payer: BCBS Trust/PPO |
$337.58
|
| Rate for Payer: BCN Medicare Advantage |
$342.19
|
| Rate for Payer: Cash Price |
$1,683.52
|
| Rate for Payer: Cash Price |
$1,683.52
|
| Rate for Payer: Cofinity Commercial |
$1,473.08
|
| Rate for Payer: Cofinity Commercial |
$1,809.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.19
|
| Rate for Payer: Healthscope Commercial |
$1,893.96
|
| Rate for Payer: Mclaren Medicaid |
$187.18
|
| Rate for Payer: Mclaren Medicare |
$342.19
|
| Rate for Payer: Meridian Medicaid |
$196.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.74
|
| Rate for Payer: PACE Medicare |
$325.08
|
| Rate for Payer: PACE SWMI |
$342.19
|
| Rate for Payer: PHP Commercial |
$1,788.74
|
| Rate for Payer: PHP Medicare Advantage |
$342.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.57
|
| Rate for Payer: Priority Health Medicare |
$342.19
|
| Rate for Payer: Priority Health Narrow Network |
$917.26
|
| Rate for Payer: Priority Health SBD |
$1,325.77
|
| Rate for Payer: Railroad Medicare Medicare |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.19
|
| Rate for Payer: UHC Exchange |
$271.12
|
| Rate for Payer: UHC Medicare Advantage |
$352.46
|
| Rate for Payer: VA VA |
$342.19
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,256.99 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
OP
|
$1,995.22
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.26 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Medicare |
$226.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCBS Trust/PPO |
$285.73
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Medicaid |
$119.26
|
| Rate for Payer: Mclaren Medicare |
$218.03
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: PACE Medicare |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.43
|
| Rate for Payer: Priority Health Medicare |
$218.03
|
| Rate for Payer: Priority Health Narrow Network |
$573.14
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.03
|
| Rate for Payer: UHC Exchange |
$228.55
|
| Rate for Payer: UHC Medicare Advantage |
$224.57
|
| Rate for Payer: VA VA |
$218.03
|
|
