|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,153.63
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,356.79 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.86
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Advantage |
$1,507.54
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,615.22
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: Priority Health SBD |
$1,356.79
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,782.39
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,504.15 |
| Rate for Payer: Cash Price |
$2,225.91
|
| Rate for Payer: Aetna Commercial |
$2,365.03
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.55
|
| 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 |
$2,225.91
|
| Rate for Payer: Cofinity Advantage |
$1,947.67
|
| Rate for Payer: Cofinity Commercial |
$2,392.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,504.15
|
| 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 |
$2,365.03
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,086.79
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,365.03
|
| 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 |
$1,752.91
|
| 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) |
$1,808.55
|
| Rate for Payer: UHC Core |
$1,449.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,093.48
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,782.39
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,752.91 |
| Max. Negotiated Rate |
$2,504.15 |
| Rate for Payer: Aetna Commercial |
$2,365.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.55
|
| Rate for Payer: Cash Price |
$2,225.91
|
| Rate for Payer: Cofinity Advantage |
$1,947.67
|
| Rate for Payer: Cofinity Commercial |
$2,392.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.91
|
| Rate for Payer: Healthscope Commercial |
$2,504.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,365.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,086.79
|
| Rate for Payer: PHP Commercial |
$2,365.03
|
| Rate for Payer: Priority Health SBD |
$1,752.91
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,440.78
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,196.70 |
| Rate for Payer: Aetna Commercial |
$2,074.66
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,586.51
|
| 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 |
$1,952.62
|
| Rate for Payer: Cash Price |
$1,952.62
|
| Rate for Payer: Cofinity Advantage |
$1,708.55
|
| Rate for Payer: Cofinity Commercial |
$2,099.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,952.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,196.70
|
| 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 |
$2,074.66
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,830.59
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,074.66
|
| 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 |
$1,537.69
|
| 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) |
$1,586.51
|
| Rate for Payer: UHC Core |
$1,271.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$959.23
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,440.78
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.69 |
| Max. Negotiated Rate |
$2,196.70 |
| Rate for Payer: Aetna Commercial |
$2,074.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,586.51
|
| Rate for Payer: Cash Price |
$1,952.62
|
| Rate for Payer: Cofinity Advantage |
$1,708.55
|
| Rate for Payer: Cofinity Commercial |
$2,099.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,952.62
|
| Rate for Payer: Healthscope Commercial |
$2,196.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,074.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,830.59
|
| Rate for Payer: PHP Commercial |
$2,074.66
|
| Rate for Payer: Priority Health SBD |
$1,537.69
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,225.42
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,402.01 |
| Max. Negotiated Rate |
$2,002.88 |
| Rate for Payer: Aetna Commercial |
$1,891.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.52
|
| Rate for Payer: Cash Price |
$1,780.34
|
| Rate for Payer: Cofinity Advantage |
$1,557.79
|
| Rate for Payer: Cofinity Commercial |
$1,913.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.34
|
| Rate for Payer: Healthscope Commercial |
$2,002.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,669.07
|
| Rate for Payer: PHP Commercial |
$1,891.61
|
| Rate for Payer: Priority Health SBD |
$1,402.01
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,225.42
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,002.88 |
| Rate for Payer: Aetna Commercial |
$1,891.61
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.52
|
| 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: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,780.34
|
| Rate for Payer: Cash Price |
$1,780.34
|
| Rate for Payer: Cofinity Advantage |
$1,557.79
|
| Rate for Payer: Cofinity Commercial |
$1,913.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,002.88
|
| 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 |
$1,891.61
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,669.07
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,891.61
|
| 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 |
$1,402.01
|
| 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) |
$1,446.52
|
| Rate for Payer: UHC Core |
$1,159.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$874.59
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,718.53 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Advantage |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,045.87
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| 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 |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Advantage |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| 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 |
$2,318.66
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,045.87
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| 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 |
$1,718.53
|
| 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) |
$1,773.09
|
| Rate for Payer: UHC Core |
$1,421.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,072.04
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
OP
|
$3,445.64
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,101.08 |
| Rate for Payer: Aetna Commercial |
$2,928.79
|
| Rate for Payer: Aetna Commercial |
$1,952.53
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.11
|
| 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 |
$1,837.67
|
| Rate for Payer: Cash Price |
$2,756.51
|
| Rate for Payer: Cash Price |
$1,837.67
|
| Rate for Payer: Cash Price |
$2,756.51
|
| Rate for Payer: Cofinity Advantage |
$2,411.95
|
| Rate for Payer: Cofinity Advantage |
$1,607.96
|
| Rate for Payer: Cofinity Commercial |
$2,963.25
|
| Rate for Payer: Cofinity Commercial |
$1,975.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.67
|
| 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 |
$2,067.38
|
| Rate for Payer: Healthscope Commercial |
$3,101.08
|
| 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 |
$2,928.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.53
|
| 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 |
$1,722.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.23
|
| 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 |
$2,928.79
|
| Rate for Payer: PHP Commercial |
$1,952.53
|
| 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 |
$2,170.75
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| 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) |
$2,239.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,493.11
|
| Rate for Payer: UHC Core |
$1,795.18
|
| Rate for Payer: UHC Core |
$1,196.78
|
| 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 |
$1,354.14
|
| Rate for Payer: UHC Exchange |
$902.76
|
| 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 MRA LOWR EXTREM W CON
|
Facility
|
IP
|
$3,445.64
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,170.75 |
| Max. Negotiated Rate |
$3,101.08 |
| Rate for Payer: Aetna Commercial |
$2,928.79
|
| Rate for Payer: Aetna Commercial |
$1,952.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.67
|
| Rate for Payer: Cash Price |
$2,756.51
|
| Rate for Payer: Cash Price |
$1,837.67
|
| Rate for Payer: Cofinity Advantage |
$2,411.95
|
| Rate for Payer: Cofinity Advantage |
$1,607.96
|
| Rate for Payer: Cofinity Commercial |
$2,963.25
|
| Rate for Payer: Cofinity Commercial |
$1,975.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.51
|
| Rate for Payer: Healthscope Commercial |
$2,067.38
|
| Rate for Payer: Healthscope Commercial |
$3,101.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.82
|
| Rate for Payer: PHP Commercial |
$1,952.53
|
| Rate for Payer: PHP Commercial |
$2,928.79
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Priority Health SBD |
$2,170.75
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
OP
|
$3,230.44
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,907.40 |
| Rate for Payer: Aetna Commercial |
$2,745.87
|
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.86
|
| 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: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cash Price |
$2,584.35
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cash Price |
$2,584.35
|
| Rate for Payer: Cofinity Advantage |
$2,261.31
|
| Rate for Payer: Cofinity Advantage |
$1,507.54
|
| Rate for Payer: Cofinity Commercial |
$2,778.18
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,584.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| 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 |
$1,938.27
|
| Rate for Payer: Healthscope Commercial |
$2,907.40
|
| 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 |
$2,745.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,615.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,422.83
|
| 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 |
$2,745.87
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| 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 |
$2,035.18
|
| Rate for Payer: Priority Health SBD |
$1,356.79
|
| 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) |
$2,099.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.86
|
| Rate for Payer: UHC Core |
$1,683.06
|
| Rate for Payer: UHC Core |
$1,122.04
|
| 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 |
$1,269.56
|
| Rate for Payer: UHC Exchange |
$846.38
|
| 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 MRA LOWR EXTREM WO CON
|
Facility
|
IP
|
$3,230.44
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,035.18 |
| Max. Negotiated Rate |
$2,907.40 |
| Rate for Payer: Aetna Commercial |
$2,745.87
|
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.79
|
| Rate for Payer: Cash Price |
$2,584.35
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Advantage |
$2,261.31
|
| Rate for Payer: Cofinity Advantage |
$1,507.54
|
| Rate for Payer: Cofinity Commercial |
$2,778.18
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,584.35
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Healthscope Commercial |
$2,907.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,745.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,422.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,615.22
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: PHP Commercial |
$2,745.87
|
| Rate for Payer: Priority Health SBD |
$1,356.79
|
| Rate for Payer: Priority Health SBD |
$2,035.18
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$3,876.37
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,488.73 |
| Rate for Payer: Aetna Commercial |
$3,294.91
|
| Rate for Payer: Aetna Commercial |
$2,196.60
|
| 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: 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 |
$2,067.39
|
| Rate for Payer: Cash Price |
$3,101.10
|
| 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 |
$3,101.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| 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: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| 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 |
$1,938.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,907.28
|
| 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) |
$2,519.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,679.76
|
| 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
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
IP
|
$3,876.37
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,442.11 |
| Max. Negotiated Rate |
$3,488.73 |
| Rate for Payer: Aetna Commercial |
$3,294.91
|
| Rate for Payer: Aetna Commercial |
$2,196.60
|
| 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 |
$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: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Healthscope Commercial |
$3,488.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| 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: 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 MRA NECK W CON
|
Facility
|
IP
|
$2,452.72
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,545.21 |
| Max. Negotiated Rate |
$2,207.45 |
| Rate for Payer: Aetna Commercial |
$2,084.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.27
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cofinity Advantage |
$1,716.90
|
| Rate for Payer: Cofinity Commercial |
$2,109.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.18
|
| Rate for Payer: Healthscope Commercial |
$2,207.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,839.54
|
| Rate for Payer: PHP Commercial |
$2,084.81
|
| Rate for Payer: Priority Health SBD |
$1,545.21
|
|
|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,452.72
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,207.45 |
| Rate for Payer: Aetna Commercial |
$2,084.81
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.27
|
| 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 |
$408.10
|
| Rate for Payer: BCN Commercial |
$408.10
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cofinity Advantage |
$1,716.90
|
| Rate for Payer: Cofinity Commercial |
$2,109.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,207.45
|
| 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 |
$2,084.81
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,839.54
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,084.81
|
| 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 |
$1,545.21
|
| 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) |
$1,594.27
|
| Rate for Payer: UHC Core |
$1,277.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$963.92
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
OP
|
$2,044.95
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,840.45 |
| Rate for Payer: Aetna Commercial |
$1,738.21
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.22
|
| 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 |
$370.24
|
| Rate for Payer: BCN Commercial |
$370.24
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cofinity Advantage |
$1,431.46
|
| Rate for Payer: Cofinity Commercial |
$1,758.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,840.45
|
| 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 |
$1,738.21
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.71
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| 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 |
$1,288.32
|
| 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) |
$1,329.22
|
| Rate for Payer: UHC Core |
$1,065.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$803.67
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
IP
|
$2,044.95
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,288.32 |
| Max. Negotiated Rate |
$1,840.45 |
| Rate for Payer: Aetna Commercial |
$1,738.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.22
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cofinity Advantage |
$1,431.46
|
| Rate for Payer: Cofinity Commercial |
$1,758.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.96
|
| Rate for Payer: Healthscope Commercial |
$1,840.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,738.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.71
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: Priority Health SBD |
$1,288.32
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
IP
|
$2,883.04
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,816.32 |
| Max. Negotiated Rate |
$2,594.74 |
| Rate for Payer: Aetna Commercial |
$2,450.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,873.98
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cofinity Advantage |
$2,018.13
|
| Rate for Payer: Cofinity Commercial |
$2,479.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,306.43
|
| Rate for Payer: Healthscope Commercial |
$2,594.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,450.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,162.28
|
| Rate for Payer: PHP Commercial |
$2,450.58
|
| Rate for Payer: Priority Health SBD |
$1,816.32
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,883.04
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,594.74 |
| Rate for Payer: Aetna Commercial |
$2,450.58
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,873.98
|
| 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 |
$604.96
|
| Rate for Payer: BCN Commercial |
$604.96
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cofinity Advantage |
$2,018.13
|
| Rate for Payer: Cofinity Commercial |
$2,479.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,306.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,594.74
|
| 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 |
$2,450.58
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,162.28
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,450.58
|
| 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 |
$1,816.32
|
| 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) |
$1,873.98
|
| Rate for Payer: UHC Core |
$1,502.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,133.03
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,081.74
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,873.57 |
| Rate for Payer: Aetna Commercial |
$1,769.48
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.13
|
| 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 |
$1,665.39
|
| Rate for Payer: Cash Price |
$1,665.39
|
| Rate for Payer: Cofinity Advantage |
$1,457.22
|
| Rate for Payer: Cofinity Commercial |
$1,790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,873.57
|
| 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 |
$1,769.48
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.31
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,769.48
|
| 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 |
$1,311.50
|
| 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) |
$1,353.13
|
| Rate for Payer: UHC Core |
$1,084.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$818.12
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
IP
|
$2,081.74
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,311.50 |
| Max. Negotiated Rate |
$1,873.57 |
| Rate for Payer: Aetna Commercial |
$1,769.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.13
|
| Rate for Payer: Cash Price |
$1,665.39
|
| Rate for Payer: Cofinity Advantage |
$1,457.22
|
| Rate for Payer: Cofinity Commercial |
$1,790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.39
|
| Rate for Payer: Healthscope Commercial |
$1,873.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.31
|
| Rate for Payer: PHP Commercial |
$1,769.48
|
| Rate for Payer: Priority Health SBD |
$1,311.50
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
IP
|
$1,938.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,221.04 |
| Max. Negotiated Rate |
$1,744.34 |
| Rate for Payer: Aetna Commercial |
$1,647.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.80
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Advantage |
$1,356.71
|
| Rate for Payer: Cofinity Commercial |
$1,666.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Healthscope Commercial |
$1,744.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| Rate for Payer: PHP Commercial |
$1,647.44
|
| Rate for Payer: Priority Health SBD |
$1,221.04
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
OP
|
$1,938.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,744.34 |
| Rate for Payer: Aetna Commercial |
$1,647.44
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.80
|
| 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: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Advantage |
$1,356.71
|
| Rate for Payer: Cofinity Commercial |
$1,666.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,744.34
|
| 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 |
$1,647.44
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,647.44
|
| 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 |
$1,221.04
|
| 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) |
$1,259.80
|
| Rate for Payer: UHC Core |
$1,009.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$761.70
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
