|
HC MR MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,447.17 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Advantage |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| 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 |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Advantage |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| 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 |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| 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 |
$1,447.17
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,493.12
|
| Rate for Payer: UHC Core |
$1,196.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$902.76
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
IP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,247.06 |
| Max. Negotiated Rate |
$1,781.51 |
| Rate for Payer: Aetna Commercial |
$1,682.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.65
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Advantage |
$1,385.62
|
| Rate for Payer: Cofinity Commercial |
$1,702.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Healthscope Commercial |
$1,781.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,682.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: PHP Commercial |
$1,682.54
|
| Rate for Payer: Priority Health SBD |
$1,247.06
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,781.51 |
| Rate for Payer: Aetna Commercial |
$1,682.54
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.65
|
| 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 |
$1,583.57
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Advantage |
$1,385.62
|
| Rate for Payer: Cofinity Commercial |
$1,702.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,781.51
|
| 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 |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,682.54
|
| 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 |
$1,247.06
|
| 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) |
$1,286.65
|
| Rate for Payer: UHC Core |
$1,031.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$777.93
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,781.51 |
| Rate for Payer: Aetna Commercial |
$1,682.54
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.65
|
| 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 |
$1,583.57
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Advantage |
$1,385.62
|
| Rate for Payer: Cofinity Commercial |
$1,702.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,781.51
|
| 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 |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,682.54
|
| 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 |
$1,247.06
|
| 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) |
$1,286.65
|
| Rate for Payer: UHC Core |
$1,031.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$777.93
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,247.06 |
| Max. Negotiated Rate |
$1,781.51 |
| Rate for Payer: Aetna Commercial |
$1,682.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.65
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Advantage |
$1,385.62
|
| Rate for Payer: Cofinity Commercial |
$1,702.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Healthscope Commercial |
$1,781.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,682.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: PHP Commercial |
$1,682.54
|
| Rate for Payer: Priority Health SBD |
$1,247.06
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| 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 |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| 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 |
$1,363.93
|
| 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) |
$1,407.23
|
| Rate for Payer: UHC Core |
$1,127.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$850.83
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.93 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| Rate for Payer: Priority Health SBD |
$1,363.93
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| 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 |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| 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 |
$1,363.93
|
| 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) |
$1,407.23
|
| Rate for Payer: UHC Core |
$1,127.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$850.83
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.93 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| Rate for Payer: Priority Health SBD |
$1,363.93
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| 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 |
$1,363.93
|
| 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) |
$1,407.23
|
| Rate for Payer: UHC Core |
$1,127.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$850.83
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,363.93 |
| Max. Negotiated Rate |
$1,948.47 |
| Rate for Payer: Aetna Commercial |
$1,840.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.23
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Advantage |
$1,515.48
|
| Rate for Payer: Cofinity Commercial |
$1,861.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: PHP Commercial |
$1,840.22
|
| Rate for Payer: Priority Health SBD |
$1,363.93
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$2,911.76
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,834.41 |
| Max. Negotiated Rate |
$2,620.58 |
| Rate for Payer: Aetna Commercial |
$2,475.00
|
| Rate for Payer: Aetna Commercial |
$1,649.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,892.64
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cash Price |
$1,552.94
|
| Rate for Payer: Cofinity Advantage |
$2,038.23
|
| Rate for Payer: Cofinity Advantage |
$1,358.82
|
| Rate for Payer: Cofinity Commercial |
$2,504.11
|
| Rate for Payer: Cofinity Commercial |
$1,669.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,329.41
|
| Rate for Payer: Healthscope Commercial |
$1,747.05
|
| Rate for Payer: Healthscope Commercial |
$2,620.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,475.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,183.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,455.88
|
| Rate for Payer: PHP Commercial |
$1,649.99
|
| Rate for Payer: PHP Commercial |
$2,475.00
|
| Rate for Payer: Priority Health SBD |
$1,222.94
|
| Rate for Payer: Priority Health SBD |
$1,834.41
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$2,911.76
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,620.58 |
| Rate for Payer: Aetna Commercial |
$2,475.00
|
| Rate for Payer: Aetna Commercial |
$1,649.99
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,892.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.76
|
| 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 |
$1,552.94
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cash Price |
$1,552.94
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cofinity Advantage |
$2,038.23
|
| Rate for Payer: Cofinity Advantage |
$1,358.82
|
| Rate for Payer: Cofinity Commercial |
$2,504.11
|
| Rate for Payer: Cofinity Commercial |
$1,669.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,329.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,747.05
|
| Rate for Payer: Healthscope Commercial |
$2,620.58
|
| 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 |
$2,475.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.99
|
| 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 |
$1,455.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,183.82
|
| 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 |
$2,475.00
|
| Rate for Payer: PHP Commercial |
$1,649.99
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,834.41
|
| Rate for Payer: Priority Health SBD |
$1,222.94
|
| 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) |
$1,892.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,261.76
|
| Rate for Payer: UHC Core |
$1,517.03
|
| Rate for Payer: UHC Core |
$1,011.35
|
| 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 |
$1,144.32
|
| Rate for Payer: UHC Exchange |
$762.88
|
| 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 UPPER EXTREMITY WO C
|
Facility
|
OP
|
$2,687.81
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,419.03 |
| Rate for Payer: Aetna Commercial |
$2,284.64
|
| Rate for Payer: Aetna Commercial |
$1,523.09
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,747.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.72
|
| 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 |
$1,433.50
|
| Rate for Payer: Cash Price |
$2,150.25
|
| Rate for Payer: Cash Price |
$1,433.50
|
| Rate for Payer: Cash Price |
$2,150.25
|
| Rate for Payer: Cofinity Advantage |
$1,881.47
|
| Rate for Payer: Cofinity Advantage |
$1,254.31
|
| Rate for Payer: Cofinity Commercial |
$2,311.52
|
| Rate for Payer: Cofinity Commercial |
$1,541.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,150.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.50
|
| 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 |
$1,612.68
|
| Rate for Payer: Healthscope Commercial |
$2,419.03
|
| 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 |
$2,284.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.09
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,015.86
|
| 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 |
$2,284.64
|
| Rate for Payer: PHP Commercial |
$1,523.09
|
| 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 |
$1,693.32
|
| Rate for Payer: Priority Health SBD |
$1,128.88
|
| 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) |
$1,747.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.72
|
| Rate for Payer: UHC Core |
$1,400.35
|
| Rate for Payer: UHC Core |
$933.56
|
| 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 |
$1,056.31
|
| Rate for Payer: UHC Exchange |
$704.20
|
| 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 UPPER EXTREMITY WO C
|
Facility
|
IP
|
$2,687.81
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,693.32 |
| Max. Negotiated Rate |
$2,419.03 |
| Rate for Payer: Aetna Commercial |
$2,284.64
|
| Rate for Payer: Aetna Commercial |
$1,523.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,747.08
|
| Rate for Payer: Cash Price |
$2,150.25
|
| Rate for Payer: Cash Price |
$1,433.50
|
| Rate for Payer: Cofinity Advantage |
$1,881.47
|
| Rate for Payer: Cofinity Advantage |
$1,254.31
|
| Rate for Payer: Cofinity Commercial |
$2,311.52
|
| Rate for Payer: Cofinity Commercial |
$1,541.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,150.25
|
| Rate for Payer: Healthscope Commercial |
$1,612.68
|
| Rate for Payer: Healthscope Commercial |
$2,419.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,284.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,015.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.90
|
| Rate for Payer: PHP Commercial |
$1,523.09
|
| Rate for Payer: PHP Commercial |
$2,284.64
|
| Rate for Payer: Priority Health SBD |
$1,128.88
|
| Rate for Payer: Priority Health SBD |
$1,693.32
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
IP
|
$3,135.55
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,975.40 |
| Max. Negotiated Rate |
$2,821.99 |
| Rate for Payer: Aetna Commercial |
$2,665.22
|
| Rate for Payer: Aetna Commercial |
$1,776.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,038.11
|
| Rate for Payer: Cash Price |
$2,508.44
|
| Rate for Payer: Cash Price |
$1,672.30
|
| Rate for Payer: Cofinity Advantage |
$2,194.89
|
| Rate for Payer: Cofinity Advantage |
$1,463.26
|
| Rate for Payer: Cofinity Commercial |
$2,696.57
|
| Rate for Payer: Cofinity Commercial |
$1,797.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,508.44
|
| Rate for Payer: Healthscope Commercial |
$1,881.33
|
| Rate for Payer: Healthscope Commercial |
$2,821.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,665.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,776.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,351.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,567.78
|
| Rate for Payer: PHP Commercial |
$1,776.81
|
| Rate for Payer: PHP Commercial |
$2,665.22
|
| Rate for Payer: Priority Health SBD |
$1,316.93
|
| Rate for Payer: Priority Health SBD |
$1,975.40
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
OP
|
$3,135.55
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,821.99 |
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Aetna Commercial |
$2,665.22
|
| Rate for Payer: Aetna Commercial |
$1,776.81
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,038.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.74
|
| 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: Cash Price |
$1,672.30
|
| Rate for Payer: Cash Price |
$2,508.44
|
| Rate for Payer: Cash Price |
$1,672.30
|
| Rate for Payer: Cash Price |
$2,508.44
|
| Rate for Payer: Cofinity Advantage |
$2,194.89
|
| Rate for Payer: Cofinity Advantage |
$1,463.26
|
| Rate for Payer: Cofinity Commercial |
$2,696.57
|
| Rate for Payer: Cofinity Commercial |
$1,797.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,508.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,881.33
|
| Rate for Payer: Healthscope Commercial |
$2,821.99
|
| 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 |
$2,665.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,776.81
|
| 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 |
$1,567.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,351.66
|
| 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 |
$2,665.22
|
| Rate for Payer: PHP Commercial |
$1,776.81
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,975.40
|
| Rate for Payer: Priority Health SBD |
$1,316.93
|
| 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) |
$2,038.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,358.74
|
| Rate for Payer: UHC Core |
$1,633.62
|
| Rate for Payer: UHC Core |
$1,089.08
|
| 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 |
$1,232.27
|
| Rate for Payer: UHC Exchange |
$821.52
|
| 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 MRCP
|
Facility
|
IP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,356.18 |
| Max. Negotiated Rate |
$1,937.39 |
| Rate for Payer: Aetna Commercial |
$1,829.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.23
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Advantage |
$1,506.86
|
| Rate for Payer: Cofinity Commercial |
$1,851.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Healthscope Commercial |
$1,937.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: PHP Commercial |
$1,829.76
|
| Rate for Payer: Priority Health SBD |
$1,356.18
|
|
|
HC MR MRCP
|
Facility
|
OP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,937.39 |
| Rate for Payer: Aetna Commercial |
$1,829.76
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$295.28
|
| Rate for Payer: BCN Commercial |
$295.28
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Advantage |
$1,506.86
|
| Rate for Payer: Cofinity Commercial |
$1,851.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,937.39
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,829.76
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,356.18
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.23
|
| Rate for Payer: UHC Core |
$1,121.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$846.00
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,025.52
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$646.08 |
| Max. Negotiated Rate |
$922.97 |
| Rate for Payer: Aetna Commercial |
$871.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.59
|
| Rate for Payer: Cash Price |
$820.42
|
| Rate for Payer: Cofinity Advantage |
$717.86
|
| Rate for Payer: Cofinity Commercial |
$881.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.42
|
| Rate for Payer: Healthscope Commercial |
$922.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$871.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$769.14
|
| Rate for Payer: PHP Commercial |
$871.69
|
| Rate for Payer: Priority Health SBD |
$646.08
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,025.52
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$403.03 |
| Max. Negotiated Rate |
$922.97 |
| Rate for Payer: Aetna Commercial |
$871.69
|
| Rate for Payer: Aetna Medicare |
$512.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.59
|
| Rate for Payer: BCBS Complete |
$410.21
|
| Rate for Payer: BCBS Trust/PPO |
$785.16
|
| Rate for Payer: BCN Commercial |
$785.16
|
| Rate for Payer: Cash Price |
$820.42
|
| Rate for Payer: Cash Price |
$820.42
|
| Rate for Payer: Cofinity Advantage |
$717.86
|
| Rate for Payer: Cofinity Commercial |
$881.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.42
|
| Rate for Payer: Healthscope Commercial |
$922.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$871.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$769.14
|
| Rate for Payer: PHP Commercial |
$871.69
|
| Rate for Payer: Priority Health SBD |
$646.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.59
|
| Rate for Payer: UHC Core |
$534.30
|
| Rate for Payer: UHC Exchange |
$403.03
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
IP
|
$2,261.31
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,424.63 |
| Max. Negotiated Rate |
$2,035.18 |
| Rate for Payer: Aetna Commercial |
$1,922.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.85
|
| Rate for Payer: Cash Price |
$1,809.05
|
| Rate for Payer: Cofinity Advantage |
$1,582.92
|
| Rate for Payer: Cofinity Commercial |
$1,944.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,809.05
|
| Rate for Payer: Healthscope Commercial |
$2,035.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,922.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,695.98
|
| Rate for Payer: PHP Commercial |
$1,922.11
|
| Rate for Payer: Priority Health SBD |
$1,424.63
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
OP
|
$2,261.31
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,035.18 |
| Rate for Payer: Aetna Commercial |
$1,922.11
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.85
|
| 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 |
$397.51
|
| Rate for Payer: BCN Commercial |
$397.51
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,809.05
|
| Rate for Payer: Cash Price |
$1,809.05
|
| Rate for Payer: Cofinity Advantage |
$1,582.92
|
| Rate for Payer: Cofinity Commercial |
$1,944.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,809.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,035.18
|
| 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 |
$1,922.11
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,695.98
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,922.11
|
| 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 |
$1,424.63
|
| 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) |
$1,469.85
|
| Rate for Payer: UHC Core |
$1,178.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$888.69
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
IP
|
$2,189.42
|
|
|
Service Code
|
CPT 70542
|
| Hospital Charge Code |
61000003
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,379.33 |
| Max. Negotiated Rate |
$1,970.48 |
| Rate for Payer: Aetna Commercial |
$1,861.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.12
|
| Rate for Payer: Cash Price |
$1,751.54
|
| Rate for Payer: Cofinity Advantage |
$1,532.59
|
| Rate for Payer: Cofinity Commercial |
$1,882.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.54
|
| Rate for Payer: Healthscope Commercial |
$1,970.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.07
|
| Rate for Payer: PHP Commercial |
$1,861.01
|
| Rate for Payer: Priority Health SBD |
$1,379.33
|
|
