|
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
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$859.18
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.02
|
| 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 |
$554.99
|
| Rate for Payer: BCN Commercial |
$554.99
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Advantage |
$707.56
|
| Rate for Payer: Cofinity Commercial |
$869.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$909.72
|
| 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 |
$859.18
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$859.18
|
| 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 |
$636.80
|
| 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) |
$657.02
|
| Rate for Payer: UHC Core |
$526.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$397.24
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$909.72 |
| Rate for Payer: Aetna Commercial |
$859.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.02
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Advantage |
$707.56
|
| Rate for Payer: Cofinity Commercial |
$869.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Healthscope Commercial |
$909.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| Rate for Payer: PHP Commercial |
$859.18
|
| Rate for Payer: Priority Health SBD |
$636.80
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$796.38 |
| Max. Negotiated Rate |
$1,137.68 |
| Rate for Payer: Aetna Commercial |
$1,074.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$821.66
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Advantage |
$884.86
|
| Rate for Payer: Cofinity Commercial |
$1,087.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Healthscope Commercial |
$1,137.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: PHP Commercial |
$1,074.48
|
| Rate for Payer: Priority Health SBD |
$796.38
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$1,137.68 |
| Rate for Payer: Aetna Commercial |
$1,074.48
|
| Rate for Payer: Aetna Medicare |
$632.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$821.66
|
| Rate for Payer: BCBS Complete |
$505.64
|
| Rate for Payer: BCBS Trust/PPO |
$76.47
|
| Rate for Payer: BCN Commercial |
$76.47
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Advantage |
$884.86
|
| Rate for Payer: Cofinity Commercial |
$1,087.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Healthscope Commercial |
$1,137.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,011.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: PHP Commercial |
$1,074.48
|
| Rate for Payer: Priority Health SBD |
$796.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.66
|
| Rate for Payer: UHC Core |
$658.59
|
| Rate for Payer: UHC Exchange |
$496.79
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna Commercial |
$2,022.71
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,546.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$675.37
|
| Rate for Payer: BCN Commercial |
$675.37
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Advantage |
$1,665.76
|
| Rate for Payer: Cofinity Commercial |
$2,046.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,141.69
|
| Rate for Payer: Mclaren Medicaid |
$408.52
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$2,022.71
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$1,499.19
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.78
|
| Rate for Payer: UHC Core |
$1,239.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$935.21
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,499.19 |
| Max. Negotiated Rate |
$2,141.69 |
| Rate for Payer: Aetna Commercial |
$2,022.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,546.78
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Advantage |
$1,665.76
|
| Rate for Payer: Cofinity Commercial |
$2,046.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Healthscope Commercial |
$2,141.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: PHP Commercial |
$2,022.71
|
| Rate for Payer: Priority Health SBD |
$1,499.19
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,305.93 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.38
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Advantage |
$1,451.03
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: Priority Health SBD |
$1,305.93
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.38
|
| 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 |
$615.55
|
| Rate for Payer: BCN Commercial |
$615.55
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Advantage |
$1,451.03
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| 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 |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| 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 |
$1,305.93
|
| 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) |
$1,347.38
|
| Rate for Payer: UHC Core |
$1,079.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$814.65
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
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 |
$838.16
|
| Rate for Payer: BCN Commercial |
$838.16
|
| 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 CHEST WO W CON
|
Facility
|
IP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
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 MR ELASTOGRAPHY
|
Facility
|
OP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna Commercial |
$312.10
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.67
|
| 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 |
$342.24
|
| Rate for Payer: BCN Commercial |
$342.24
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Advantage |
$257.03
|
| Rate for Payer: Cofinity Commercial |
$315.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$330.46
|
| 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 |
$312.10
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$312.10
|
| 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 |
$231.32
|
| 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) |
$238.67
|
| Rate for Payer: UHC Core |
$191.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$144.30
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$231.32 |
| Max. Negotiated Rate |
$330.46 |
| Rate for Payer: Aetna Commercial |
$312.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.67
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Advantage |
$257.03
|
| Rate for Payer: Cofinity Commercial |
$315.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Healthscope Commercial |
$330.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| Rate for Payer: PHP Commercial |
$312.10
|
| Rate for Payer: Priority Health SBD |
$231.32
|
|
|
HC MR FAST BREAST SCREEN SELF PAY
|
Facility
|
IP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$242.15 |
| Rate for Payer: Aetna Commercial |
$228.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.88
|
| Rate for Payer: Cash Price |
$215.24
|
| Rate for Payer: Cofinity Advantage |
$188.34
|
| Rate for Payer: Cofinity Commercial |
$231.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.24
|
| Rate for Payer: Healthscope Commercial |
$242.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.79
|
| Rate for Payer: PHP Commercial |
$228.69
|
| Rate for Payer: Priority Health SBD |
$169.50
|
|
|
HC MR FAST BREAST SCREEN SELF PAY
|
Facility
|
OP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$105.74 |
| Max. Negotiated Rate |
$242.15 |
| Rate for Payer: Aetna Commercial |
$228.69
|
| Rate for Payer: Aetna Medicare |
$134.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.88
|
| Rate for Payer: BCBS Complete |
$107.62
|
| Rate for Payer: Cash Price |
$215.24
|
| Rate for Payer: Cofinity Advantage |
$188.34
|
| Rate for Payer: Cofinity Commercial |
$231.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.24
|
| Rate for Payer: Healthscope Commercial |
$242.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.79
|
| Rate for Payer: PHP Commercial |
$228.69
|
| Rate for Payer: Priority Health SBD |
$169.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.88
|
| Rate for Payer: UHC Core |
$140.18
|
| Rate for Payer: UHC Exchange |
$105.74
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$671.90 |
| Max. Negotiated Rate |
$959.86 |
| Rate for Payer: Aetna Commercial |
$906.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.23
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Advantage |
$746.56
|
| Rate for Payer: Cofinity Commercial |
$917.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Healthscope Commercial |
$959.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: PHP Commercial |
$906.53
|
| Rate for Payer: Priority Health SBD |
$671.90
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$419.14 |
| Max. Negotiated Rate |
$959.86 |
| Rate for Payer: Aetna Commercial |
$906.53
|
| Rate for Payer: Aetna Medicare |
$533.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.23
|
| Rate for Payer: BCBS Complete |
$426.60
|
| Rate for Payer: BCBS Trust/PPO |
$785.16
|
| Rate for Payer: BCN Commercial |
$785.16
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Advantage |
$746.56
|
| Rate for Payer: Cofinity Commercial |
$917.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Healthscope Commercial |
$959.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$853.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: PHP Commercial |
$906.53
|
| Rate for Payer: Priority Health SBD |
$671.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$555.65
|
| Rate for Payer: UHC Exchange |
$419.14
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,937.43 |
| Max. Negotiated Rate |
$2,767.75 |
| Rate for Payer: Aetna Commercial |
$2,613.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.93
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Advantage |
$2,152.70
|
| Rate for Payer: Cofinity Commercial |
$2,644.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Healthscope Commercial |
$2,767.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,613.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| Rate for Payer: PHP Commercial |
$2,613.99
|
| Rate for Payer: Priority Health SBD |
$1,937.43
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,767.75 |
| Rate for Payer: Aetna Commercial |
$2,613.99
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.93
|
| 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 |
$652.66
|
| Rate for Payer: BCN Commercial |
$652.66
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Advantage |
$2,152.70
|
| Rate for Payer: Cofinity Commercial |
$2,644.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,767.75
|
| 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 |
$2,613.99
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,613.99
|
| 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 |
$1,937.43
|
| 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) |
$1,998.93
|
| Rate for Payer: UHC Core |
$1,602.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,208.59
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Commercial |
$2,928.80
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$545.89
|
| Rate for Payer: BCBS Trust/PPO |
$545.89
|
| Rate for Payer: BCN Commercial |
$545.89
|
| Rate for Payer: BCN Commercial |
$545.89
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Advantage |
$2,411.95
|
| Rate for Payer: Cofinity Advantage |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$2,963.26
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Healthscope Commercial |
$3,101.09
|
| Rate for Payer: Mclaren Medicaid |
$408.52
|
| Rate for Payer: Mclaren Medicaid |
$408.52
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$2,928.80
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$2,170.76
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,493.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.67
|
| Rate for Payer: UHC Core |
$1,795.18
|
| Rate for Payer: UHC Core |
$1,196.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,354.14
|
| Rate for Payer: UHC Exchange |
$902.76
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,447.17 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Commercial |
$2,928.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.67
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cofinity Advantage |
$1,607.97
|
| Rate for Payer: Cofinity Advantage |
$2,411.95
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Commercial |
$2,963.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$3,101.09
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Commercial |
$2,928.80
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Priority Health SBD |
$2,170.76
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,242.08 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Commercial |
$2,513.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,922.27
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cofinity Advantage |
$1,380.09
|
| Rate for Payer: Cofinity Advantage |
$2,070.14
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Cofinity Commercial |
$2,543.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Healthscope Commercial |
$2,661.61
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: PHP Commercial |
$2,513.74
|
| Rate for Payer: Priority Health SBD |
$1,242.08
|
| Rate for Payer: Priority Health SBD |
$1,863.12
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Commercial |
$2,513.74
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,922.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$324.05
|
| Rate for Payer: BCBS Trust/PPO |
$324.05
|
| Rate for Payer: BCN Commercial |
$324.05
|
| Rate for Payer: BCN Commercial |
$324.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Advantage |
$2,070.14
|
| Rate for Payer: Cofinity Advantage |
$1,380.09
|
| Rate for Payer: Cofinity Commercial |
$2,543.31
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Healthscope Commercial |
$2,661.61
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$2,513.74
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| 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 Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,863.12
|
| Rate for Payer: Priority Health SBD |
$1,242.08
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,281.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.27
|
| Rate for Payer: UHC Core |
$1,540.77
|
| Rate for Payer: UHC Core |
$1,027.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$1,162.23
|
| Rate for Payer: UHC Exchange |
$774.82
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,584.24
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,628.07 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.60
|
| Rate for Payer: Aetna Commercial |
$3,294.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,519.64
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cofinity Advantage |
$1,808.97
|
| Rate for Payer: Cofinity Advantage |
$2,713.46
|
| Rate for Payer: Cofinity Commercial |
$2,222.45
|
| Rate for Payer: Cofinity Commercial |
$3,333.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,101.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| Rate for Payer: Healthscope Commercial |
$3,488.73
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,907.28
|
| Rate for Payer: PHP Commercial |
$2,196.60
|
| Rate for Payer: PHP Commercial |
$3,294.91
|
| Rate for Payer: Priority Health SBD |
$1,628.07
|
| Rate for Payer: Priority Health SBD |
$2,442.11
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,584.24
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Aetna Commercial |
$2,196.60
|
| Rate for Payer: Aetna Commercial |
$3,294.91
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,519.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| 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: BCBS Trust/PPO |
$652.66
|
| Rate for Payer: BCBS Trust/PPO |
$652.66
|
| Rate for Payer: BCN Commercial |
$652.66
|
| Rate for Payer: BCN Commercial |
$652.66
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cofinity Advantage |
$2,713.46
|
| Rate for Payer: Cofinity Advantage |
$1,808.97
|
| Rate for Payer: Cofinity Commercial |
$3,333.68
|
| Rate for Payer: Cofinity Commercial |
$2,222.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,101.10
|
| 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 |
$2,325.82
|
| Rate for Payer: Healthscope Commercial |
$3,488.73
|
| 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: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| 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 |
$2,907.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.18
|
| 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 |
$3,294.91
|
| Rate for Payer: PHP Commercial |
$2,196.60
|
| 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 |
$2,442.11
|
| Rate for Payer: Priority Health SBD |
$1,628.07
|
| 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) |
$1,679.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,519.64
|
| Rate for Payer: UHC Core |
$2,019.59
|
| Rate for Payer: UHC Core |
$1,346.39
|
| 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 |
$1,523.41
|
| Rate for Payer: UHC Exchange |
$1,015.61
|
| 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
|
|
