|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$661.13
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$416.51 |
| Max. Negotiated Rate |
$595.02 |
| Rate for Payer: Aetna Commercial |
$561.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.73
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cofinity Advantage |
$462.79
|
| Rate for Payer: Cofinity Commercial |
$568.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.90
|
| Rate for Payer: Healthscope Commercial |
$595.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$561.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$495.85
|
| Rate for Payer: PHP Commercial |
$561.96
|
| Rate for Payer: Priority Health SBD |
$416.51
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$420.24
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.94 |
| Max. Negotiated Rate |
$378.22 |
| Rate for Payer: Aetna Commercial |
$357.20
|
| Rate for Payer: Aetna Medicare |
$95.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.58
|
| Rate for Payer: BCBS Complete |
$50.34
|
| Rate for Payer: BCBS MAPPO |
$91.66
|
| Rate for Payer: BCBS Trust/PPO |
$97.73
|
| Rate for Payer: BCN Commercial |
$97.73
|
| Rate for Payer: BCN Medicare Advantage |
$91.66
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Advantage |
$294.17
|
| Rate for Payer: Cofinity Commercial |
$361.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.66
|
| Rate for Payer: Healthscope Commercial |
$378.22
|
| Rate for Payer: Mclaren Medicaid |
$47.94
|
| Rate for Payer: Mclaren Medicare |
$91.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.24
|
| Rate for Payer: Meridian Medicaid |
$96.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.20
|
| Rate for Payer: Nomi Health Commercial |
$274.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.18
|
| Rate for Payer: PACE Medicare |
$87.08
|
| Rate for Payer: PACE SWMI |
$91.66
|
| Rate for Payer: PHP Commercial |
$357.20
|
| Rate for Payer: PHP Medicare Advantage |
$91.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$91.66
|
| Rate for Payer: Priority Health Medicare |
$91.66
|
| Rate for Payer: Priority Health SBD |
$264.75
|
| Rate for Payer: Priority Health Tiered Network |
$73.33
|
| Rate for Payer: Railroad Medicare Medicare |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.49
|
| Rate for Payer: UHC Core |
$137.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.66
|
| Rate for Payer: UHC Exchange |
$137.49
|
| Rate for Payer: UHC Medicaid |
$47.94
|
| Rate for Payer: UHCCP Medicaid |
$47.94
|
| Rate for Payer: VA VA |
$91.66
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$420.24
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$264.75 |
| Max. Negotiated Rate |
$378.22 |
| Rate for Payer: Aetna Commercial |
$357.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.16
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Advantage |
$294.17
|
| Rate for Payer: Cofinity Commercial |
$361.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Healthscope Commercial |
$378.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.18
|
| Rate for Payer: PHP Commercial |
$357.20
|
| Rate for Payer: Priority Health SBD |
$264.75
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,412.01
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,519.57 |
| Max. Negotiated Rate |
$2,170.81 |
| Rate for Payer: Aetna Commercial |
$2,050.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,567.81
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cofinity Advantage |
$1,688.41
|
| Rate for Payer: Cofinity Commercial |
$2,074.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.61
|
| Rate for Payer: Healthscope Commercial |
$2,170.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.01
|
| Rate for Payer: PHP Commercial |
$2,050.21
|
| Rate for Payer: Priority Health SBD |
$1,519.57
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,412.01
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,170.81 |
| Rate for Payer: Aetna Commercial |
$2,050.21
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,567.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$511.83
|
| Rate for Payer: BCN Commercial |
$511.83
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cofinity Advantage |
$1,688.41
|
| Rate for Payer: Cofinity Commercial |
$2,074.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,170.81
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.21
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.01
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,050.21
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,519.57
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.81
|
| Rate for Payer: UHC Core |
$1,256.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$947.92
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,356.18 |
| Max. Negotiated Rate |
$1,937.39 |
| Rate for Payer: Aetna Commercial |
$1,829.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.23
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Advantage |
$1,506.86
|
| Rate for Payer: Cofinity Commercial |
$1,851.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Healthscope Commercial |
$1,937.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: PHP Commercial |
$1,829.76
|
| Rate for Payer: Priority Health SBD |
$1,356.18
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,937.39 |
| Rate for Payer: Aetna Commercial |
$1,829.76
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$295.28
|
| Rate for Payer: BCN Commercial |
$295.28
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Advantage |
$1,506.86
|
| Rate for Payer: Cofinity Commercial |
$1,851.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,937.39
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,829.76
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,356.18
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.23
|
| Rate for Payer: UHC Core |
$1,121.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$846.00
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,152.11
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,985.83 |
| Max. Negotiated Rate |
$2,836.90 |
| Rate for Payer: Aetna Commercial |
$2,679.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,048.87
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cofinity Advantage |
$2,206.48
|
| Rate for Payer: Cofinity Commercial |
$2,710.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,521.69
|
| Rate for Payer: Healthscope Commercial |
$2,836.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,679.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.08
|
| Rate for Payer: PHP Commercial |
$2,679.29
|
| Rate for Payer: Priority Health SBD |
$1,985.83
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,152.11
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,836.90 |
| Rate for Payer: Aetna Commercial |
$2,679.29
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,048.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$542.87
|
| Rate for Payer: BCN Commercial |
$542.87
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cofinity Advantage |
$2,206.48
|
| Rate for Payer: Cofinity Commercial |
$2,710.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,521.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,836.90
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,679.29
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.08
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,679.29
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,985.83
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,048.87
|
| Rate for Payer: UHC Core |
$1,642.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,238.78
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,845.38
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,660.84 |
| Rate for Payer: Aetna Commercial |
$1,568.57
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$369.49
|
| Rate for Payer: BCN Commercial |
$369.49
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cofinity Advantage |
$1,291.77
|
| Rate for Payer: Cofinity Commercial |
$1,587.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,476.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,660.84
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,568.57
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.04
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,568.57
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,162.59
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,199.50
|
| Rate for Payer: UHC Core |
$961.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$725.23
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,845.38
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,162.59 |
| Max. Negotiated Rate |
$1,660.84 |
| Rate for Payer: Aetna Commercial |
$1,568.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.50
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cofinity Advantage |
$1,291.77
|
| Rate for Payer: Cofinity Commercial |
$1,587.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,476.30
|
| Rate for Payer: Healthscope Commercial |
$1,660.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,568.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.04
|
| Rate for Payer: PHP Commercial |
$1,568.57
|
| Rate for Payer: Priority Health SBD |
$1,162.59
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,113.86
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,961.73 |
| Max. Negotiated Rate |
$2,802.47 |
| Rate for Payer: Aetna Commercial |
$2,646.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,024.01
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Advantage |
$2,179.70
|
| Rate for Payer: Cofinity Commercial |
$2,677.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Healthscope Commercial |
$2,802.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: PHP Commercial |
$2,646.78
|
| Rate for Payer: Priority Health SBD |
$1,961.73
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,113.86
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,802.47 |
| Rate for Payer: Aetna Commercial |
$2,646.78
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,024.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$602.69
|
| Rate for Payer: BCN Commercial |
$602.69
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Advantage |
$2,179.70
|
| Rate for Payer: Cofinity Commercial |
$2,677.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,802.47
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,646.78
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,961.73
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,024.01
|
| Rate for Payer: UHC Core |
$1,622.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,223.75
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,440.80
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$907.70 |
| Max. Negotiated Rate |
$1,296.72 |
| Rate for Payer: Cofinity Commercial |
$1,239.09
|
| Rate for Payer: Aetna Commercial |
$1,224.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.52
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cofinity Advantage |
$1,008.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.64
|
| Rate for Payer: Healthscope Commercial |
$1,296.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.60
|
| Rate for Payer: PHP Commercial |
$1,224.68
|
| Rate for Payer: Priority Health SBD |
$907.70
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,440.80
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,296.72 |
| Rate for Payer: Aetna Commercial |
$1,224.68
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$555.75
|
| Rate for Payer: BCN Commercial |
$555.75
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cofinity Advantage |
$1,008.56
|
| Rate for Payer: Cofinity Commercial |
$1,239.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,296.72
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.68
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.60
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,224.68
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$907.70
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.52
|
| Rate for Payer: UHC Core |
$750.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$566.23
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,895.09
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$744.77 |
| Max. Negotiated Rate |
$1,705.58 |
| Rate for Payer: Aetna Commercial |
$1,610.83
|
| Rate for Payer: Aetna Medicare |
$947.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.81
|
| Rate for Payer: BCBS Complete |
$758.04
|
| Rate for Payer: BCBS Trust/PPO |
$785.16
|
| Rate for Payer: BCN Commercial |
$785.16
|
| Rate for Payer: Cash Price |
$1,516.07
|
| Rate for Payer: Cash Price |
$1,516.07
|
| Rate for Payer: Cofinity Advantage |
$1,326.56
|
| Rate for Payer: Cofinity Commercial |
$1,629.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,516.07
|
| Rate for Payer: Healthscope Commercial |
$1,705.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,516.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,610.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,421.32
|
| Rate for Payer: PHP Commercial |
$1,610.83
|
| Rate for Payer: Priority Health SBD |
$1,193.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,231.81
|
| Rate for Payer: UHC Core |
$987.34
|
| Rate for Payer: UHC Exchange |
$744.77
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,895.09
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,193.91 |
| Max. Negotiated Rate |
$1,705.58 |
| Rate for Payer: Aetna Commercial |
$1,610.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.81
|
| Rate for Payer: Cash Price |
$1,516.07
|
| Rate for Payer: Cofinity Advantage |
$1,326.56
|
| Rate for Payer: Cofinity Commercial |
$1,629.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,516.07
|
| Rate for Payer: Healthscope Commercial |
$1,705.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,610.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,421.32
|
| Rate for Payer: PHP Commercial |
$1,610.83
|
| Rate for Payer: Priority Health SBD |
$1,193.91
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,579.23
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$994.91 |
| Max. Negotiated Rate |
$1,421.31 |
| Rate for Payer: Aetna Commercial |
$1,342.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.50
|
| Rate for Payer: Cash Price |
$1,263.38
|
| Rate for Payer: Cofinity Advantage |
$1,105.46
|
| Rate for Payer: Cofinity Commercial |
$1,358.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.38
|
| Rate for Payer: Healthscope Commercial |
$1,421.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,184.42
|
| Rate for Payer: PHP Commercial |
$1,342.35
|
| Rate for Payer: Priority Health SBD |
$994.91
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,579.23
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$620.64 |
| Max. Negotiated Rate |
$1,421.31 |
| Rate for Payer: Aetna Commercial |
$1,342.35
|
| Rate for Payer: Aetna Medicare |
$789.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.50
|
| Rate for Payer: BCBS Complete |
$631.69
|
| Rate for Payer: BCBS Trust/PPO |
$785.16
|
| Rate for Payer: BCN Commercial |
$785.16
|
| Rate for Payer: Cash Price |
$1,263.38
|
| Rate for Payer: Cash Price |
$1,263.38
|
| Rate for Payer: Cofinity Advantage |
$1,105.46
|
| Rate for Payer: Cofinity Commercial |
$1,358.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.38
|
| Rate for Payer: Healthscope Commercial |
$1,421.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,263.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,184.42
|
| Rate for Payer: PHP Commercial |
$1,342.35
|
| Rate for Payer: Priority Health SBD |
$994.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,026.50
|
| Rate for Payer: UHC Core |
$822.78
|
| Rate for Payer: UHC Exchange |
$620.64
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
OP
|
$2,413.21
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$785.16 |
| Max. Negotiated Rate |
$2,171.89 |
| Rate for Payer: Aetna Commercial |
$2,051.23
|
| Rate for Payer: Aetna Medicare |
$1,206.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.59
|
| Rate for Payer: BCBS Complete |
$965.28
|
| Rate for Payer: BCBS Trust/PPO |
$785.16
|
| Rate for Payer: BCN Commercial |
$785.16
|
| Rate for Payer: Cash Price |
$1,930.57
|
| Rate for Payer: Cash Price |
$1,930.57
|
| Rate for Payer: Cofinity Advantage |
$1,689.25
|
| Rate for Payer: Cofinity Commercial |
$2,075.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.57
|
| Rate for Payer: Healthscope Commercial |
$2,171.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,930.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.91
|
| Rate for Payer: PHP Commercial |
$2,051.23
|
| Rate for Payer: Priority Health SBD |
$1,520.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,568.59
|
| Rate for Payer: UHC Core |
$1,257.28
|
| Rate for Payer: UHC Exchange |
$948.39
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
IP
|
$2,413.21
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,520.32 |
| Max. Negotiated Rate |
$2,171.89 |
| Rate for Payer: Aetna Commercial |
$2,051.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.59
|
| Rate for Payer: Cash Price |
$1,930.57
|
| Rate for Payer: Cofinity Advantage |
$1,689.25
|
| Rate for Payer: Cofinity Commercial |
$2,075.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.57
|
| Rate for Payer: Healthscope Commercial |
$2,171.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.91
|
| Rate for Payer: PHP Commercial |
$2,051.23
|
| Rate for Payer: Priority Health SBD |
$1,520.32
|
|
|
HC MR BRAIN W CON
|
Facility
|
IP
|
$2,537.03
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,598.33 |
| Max. Negotiated Rate |
$2,283.33 |
| Rate for Payer: Aetna Commercial |
$2,156.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,649.07
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cofinity Advantage |
$1,775.92
|
| Rate for Payer: Cofinity Commercial |
$2,181.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.62
|
| Rate for Payer: Healthscope Commercial |
$2,283.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,156.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,902.77
|
| Rate for Payer: PHP Commercial |
$2,156.48
|
| Rate for Payer: Priority Health SBD |
$1,598.33
|
|
|
HC MR BRAIN W CON
|
Facility
|
OP
|
$2,537.03
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,283.33 |
| Rate for Payer: Aetna Commercial |
$2,156.48
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,649.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$433.84
|
| Rate for Payer: BCN Commercial |
$433.84
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cofinity Advantage |
$1,775.92
|
| Rate for Payer: Cofinity Commercial |
$2,181.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,283.33
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,156.48
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,902.77
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,156.48
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,598.33
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.07
|
| Rate for Payer: UHC Core |
$1,321.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$997.05
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BRAIN WO CON
|
Facility
|
OP
|
$2,114.36
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,902.92 |
| Rate for Payer: Aetna Commercial |
$1,797.21
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$295.28
|
| Rate for Payer: BCN Commercial |
$295.28
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Advantage |
$1,480.05
|
| Rate for Payer: Cofinity Commercial |
$1,818.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,902.92
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,797.21
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,332.05
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.33
|
| Rate for Payer: UHC Core |
$1,101.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$830.94
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,114.36
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,332.05 |
| Max. Negotiated Rate |
$1,902.92 |
| Rate for Payer: Aetna Commercial |
$1,797.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.33
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Advantage |
$1,480.05
|
| Rate for Payer: Cofinity Commercial |
$1,818.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Healthscope Commercial |
$1,902.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: PHP Commercial |
$1,797.21
|
| Rate for Payer: Priority Health SBD |
$1,332.05
|
|
