|
HC MR BRAIN WO W CON
|
Facility
|
OP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,906.14 |
| Rate for Payer: Aetna Commercial |
$2,744.68
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,098.88
|
| 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 |
$489.87
|
| Rate for Payer: BCN Commercial |
$489.87
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Advantage |
$2,260.33
|
| Rate for Payer: Cofinity Commercial |
$2,776.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,906.14
|
| 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 |
$2,744.68
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,744.68
|
| 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 |
$2,034.30
|
| 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) |
$2,098.88
|
| Rate for Payer: UHC Core |
$1,682.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,269.01
|
| 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 W CON
|
Facility
|
IP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,034.30 |
| Max. Negotiated Rate |
$2,906.14 |
| Rate for Payer: Aetna Commercial |
$2,744.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,098.88
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Advantage |
$2,260.33
|
| Rate for Payer: Cofinity Commercial |
$2,776.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Healthscope Commercial |
$2,906.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,744.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: PHP Commercial |
$2,744.68
|
| Rate for Payer: Priority Health SBD |
$2,034.30
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$793.31 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.49
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Advantage |
$881.45
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: Priority Health SBD |
$793.31
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.49
|
| 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: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Advantage |
$881.45
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| 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 |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| 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 |
$793.31
|
| 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) |
$818.49
|
| Rate for Payer: UHC Core |
$656.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$494.87
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
IP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$809.17 |
| Max. Negotiated Rate |
$1,155.96 |
| Rate for Payer: Aetna Commercial |
$1,091.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.86
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Advantage |
$899.08
|
| Rate for Payer: Cofinity Commercial |
$1,104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Healthscope Commercial |
$1,155.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,091.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: PHP Commercial |
$1,091.74
|
| Rate for Payer: Priority Health SBD |
$809.17
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
OP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,155.96 |
| Rate for Payer: Aetna Commercial |
$1,091.74
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.86
|
| 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: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Advantage |
$899.08
|
| Rate for Payer: Cofinity Commercial |
$1,104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,155.96
|
| 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 |
$1,091.74
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,091.74
|
| 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 |
$809.17
|
| 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) |
$834.86
|
| Rate for Payer: UHC Core |
$669.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$504.77
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.13
|
| 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: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Advantage |
$1,522.91
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| 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 |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| 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 |
$1,370.62
|
| 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) |
$1,414.13
|
| Rate for Payer: UHC Core |
$1,133.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$855.00
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,370.62 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.13
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Advantage |
$1,522.91
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: Priority Health SBD |
$1,370.62
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
IP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,398.03 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Aetna Commercial |
$1,886.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.41
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Advantage |
$1,553.36
|
| Rate for Payer: Cofinity Commercial |
$1,908.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Healthscope Commercial |
$1,997.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: PHP Commercial |
$1,886.23
|
| Rate for Payer: Priority Health SBD |
$1,398.03
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
OP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$215.47 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Aetna Commercial |
$1,886.23
|
| Rate for Payer: Aetna Medicare |
$1,109.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.41
|
| Rate for Payer: BCBS Complete |
$887.64
|
| Rate for Payer: BCBS Trust/PPO |
$541.36
|
| Rate for Payer: BCCCP Commercial |
$324.98
|
| Rate for Payer: BCN Commercial |
$541.36
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Advantage |
$1,553.36
|
| Rate for Payer: Cofinity Commercial |
$1,908.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Healthscope Commercial |
$1,997.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,775.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: PHP Commercial |
$1,886.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$269.34
|
| Rate for Payer: Priority Health SBD |
$1,398.03
|
| Rate for Payer: Priority Health Tiered Network |
$215.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,442.41
|
| Rate for Payer: UHC Core |
$1,156.15
|
| Rate for Payer: UHC Exchange |
$872.10
|
|
|
HC MR BREAST CAD
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
|
|
HC MR BREAST CAD
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$16.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$21.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: BCBS Complete |
$16.98
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.59
|
| Rate for Payer: UHC Core |
$22.12
|
| Rate for Payer: UHC Exchange |
$16.68
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$583.75 |
| Max. Negotiated Rate |
$833.92 |
| Rate for Payer: Aetna Commercial |
$787.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.28
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Advantage |
$648.61
|
| Rate for Payer: Cofinity Commercial |
$796.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Healthscope Commercial |
$833.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: PHP Commercial |
$787.59
|
| Rate for Payer: Priority Health SBD |
$583.75
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
OP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$833.92 |
| Rate for Payer: Aetna Commercial |
$787.59
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Advantage |
$648.61
|
| Rate for Payer: Cofinity Commercial |
$796.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$833.92
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$787.59
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$583.75
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.28
|
| Rate for Payer: UHC Core |
$482.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$364.15
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$793.31 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.49
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Advantage |
$881.45
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: Priority Health SBD |
$793.31
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.49
|
| 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: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Advantage |
$881.45
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| 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 |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| 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 |
$793.31
|
| 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) |
$818.49
|
| Rate for Payer: UHC Core |
$656.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$494.87
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$2,401.13
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,512.71 |
| Max. Negotiated Rate |
$2,161.02 |
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.73
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cofinity Advantage |
$1,680.79
|
| Rate for Payer: Cofinity Advantage |
$1,120.53
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: Priority Health SBD |
$1,008.48
|
| Rate for Payer: Priority Health SBD |
$1,512.71
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
OP
|
$2,401.13
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,161.02 |
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Advantage |
$1,680.79
|
| Rate for Payer: Cofinity Advantage |
$1,120.53
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| 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 Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,512.71
|
| Rate for Payer: Priority Health SBD |
$1,008.48
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,560.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.49
|
| Rate for Payer: UHC Core |
$1,250.99
|
| Rate for Payer: UHC Core |
$834.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$943.64
|
| Rate for Payer: UHC Exchange |
$629.10
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$2,401.13
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$216.53 |
| Max. Negotiated Rate |
$2,161.02 |
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Medicare |
$1,200.57
|
| Rate for Payer: Aetna Medicare |
$800.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.49
|
| Rate for Payer: BCBS Complete |
$640.30
|
| Rate for Payer: BCBS Complete |
$960.45
|
| Rate for Payer: BCBS Trust/PPO |
$548.17
|
| Rate for Payer: BCBS Trust/PPO |
$548.17
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCN Commercial |
$548.17
|
| Rate for Payer: BCN Commercial |
$548.17
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Advantage |
$1,680.79
|
| Rate for Payer: Cofinity Advantage |
$1,120.53
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,280.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,920.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.66
|
| Rate for Payer: Priority Health SBD |
$1,512.71
|
| Rate for Payer: Priority Health SBD |
$1,008.48
|
| Rate for Payer: Priority Health Tiered Network |
$216.53
|
| Rate for Payer: Priority Health Tiered Network |
$216.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,560.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.49
|
| Rate for Payer: UHC Core |
$834.00
|
| Rate for Payer: UHC Core |
$1,250.99
|
| Rate for Payer: UHC Exchange |
$943.64
|
| Rate for Payer: UHC Exchange |
$629.10
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$1,600.76
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,008.48 |
| Max. Negotiated Rate |
$1,440.68 |
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.49
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cofinity Advantage |
$1,680.79
|
| Rate for Payer: Cofinity Advantage |
$1,120.53
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: Priority Health SBD |
$1,512.71
|
| Rate for Payer: Priority Health SBD |
$1,008.48
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.13
|
| 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 |
$333.14
|
| Rate for Payer: BCCCP Commercial |
$207.57
|
| Rate for Payer: BCN Commercial |
$333.14
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Advantage |
$1,522.91
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| 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 |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| 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 |
$1,370.62
|
| 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) |
$1,414.13
|
| Rate for Payer: UHC Core |
$1,133.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$855.00
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,370.62 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.13
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Advantage |
$1,522.91
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: Priority Health SBD |
$1,370.62
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,440.13 |
| Rate for Payer: Aetna Commercial |
$1,360.12
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.09
|
| 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 |
$334.66
|
| Rate for Payer: BCCCP Commercial |
$201.08
|
| Rate for Payer: BCN Commercial |
$334.66
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Advantage |
$1,120.10
|
| Rate for Payer: Cofinity Commercial |
$1,376.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,440.13
|
| 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 |
$1,360.12
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,360.12
|
| 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 |
$1,008.09
|
| 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) |
$1,040.09
|
| Rate for Payer: UHC Core |
$833.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$628.86
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,008.09 |
| Max. Negotiated Rate |
$1,440.13 |
| Rate for Payer: Healthscope Commercial |
$1,440.13
|
| Rate for Payer: Aetna Commercial |
$1,360.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.09
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Advantage |
$1,120.10
|
| Rate for Payer: Cofinity Commercial |
$1,376.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| Rate for Payer: PHP Commercial |
$1,360.12
|
| Rate for Payer: Priority Health SBD |
$1,008.09
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,196.70
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,383.92 |
| Max. Negotiated Rate |
$1,977.03 |
| Rate for Payer: Aetna Commercial |
$1,867.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,427.86
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cofinity Advantage |
$1,537.69
|
| Rate for Payer: Cofinity Commercial |
$1,889.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,757.36
|
| Rate for Payer: Healthscope Commercial |
$1,977.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,867.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,647.53
|
| Rate for Payer: PHP Commercial |
$1,867.19
|
| Rate for Payer: Priority Health SBD |
$1,383.92
|
|
