|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,470.29 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.97
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Advantage |
$1,633.66
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| Rate for Payer: Priority Health SBD |
$1,470.29
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.97
|
| 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 |
$280.89
|
| Rate for Payer: BCN Commercial |
$280.89
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Advantage |
$1,633.66
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| 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 |
$1,983.73
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| 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 |
$1,470.29
|
| 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) |
$1,516.97
|
| Rate for Payer: UHC Core |
$1,215.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$917.18
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$735.42 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: Priority Health SBD |
$735.42
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| 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 |
$280.89
|
| Rate for Payer: BCN Commercial |
$280.89
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| 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 |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$992.23
|
| 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 |
$735.42
|
| 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) |
$758.76
|
| Rate for Payer: UHC Core |
$608.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$458.76
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.76
|
| 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 |
$491.39
|
| Rate for Payer: BCN Commercial |
$491.39
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Advantage |
$1,979.13
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| 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 |
$2,403.23
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| 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 |
$1,781.22
|
| 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) |
$1,837.76
|
| Rate for Payer: UHC Core |
$1,473.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,111.14
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,781.22 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.76
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Advantage |
$1,979.13
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,403.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| Rate for Payer: Priority Health SBD |
$1,781.22
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$571.22 |
| Max. Negotiated Rate |
$816.03 |
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.36
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Advantage |
$634.69
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PHP Commercial |
$770.70
|
| Rate for Payer: Priority Health SBD |
$571.22
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.36
|
| 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 |
$491.39
|
| Rate for Payer: BCN Commercial |
$491.39
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Advantage |
$634.69
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| 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 |
$770.70
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$770.70
|
| 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 |
$571.22
|
| 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) |
$589.36
|
| Rate for Payer: UHC Core |
$472.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$356.33
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.23
|
| 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: BCBS Trust/PPO |
$431.57
|
| Rate for Payer: BCN Commercial |
$431.57
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Advantage |
$1,601.63
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| 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 |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| 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 |
$1,441.47
|
| 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) |
$1,487.23
|
| Rate for Payer: UHC Core |
$1,192.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$899.20
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,441.47 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.23
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Advantage |
$1,601.63
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: Priority Health SBD |
$1,441.47
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$525.49 |
| Max. Negotiated Rate |
$750.70 |
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.17
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Advantage |
$583.88
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: Priority Health SBD |
$525.49
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.17
|
| 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 |
$431.57
|
| Rate for Payer: BCN Commercial |
$431.57
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Advantage |
$583.88
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| 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 |
$708.99
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$525.49
|
| 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) |
$542.17
|
| Rate for Payer: UHC Core |
$434.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$327.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.80
|
| 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: BCBS Trust/PPO |
$282.42
|
| Rate for Payer: BCN Commercial |
$282.42
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Advantage |
$1,628.09
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| 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 |
$1,976.96
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,465.28
|
| 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) |
$1,511.80
|
| Rate for Payer: UHC Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$914.06
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,465.28 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.80
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Advantage |
$1,628.09
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: Priority Health SBD |
$1,465.28
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,341.80 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.40
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Advantage |
$1,490.89
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| Rate for Payer: Priority Health SBD |
$1,341.80
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.40
|
| 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 |
$282.42
|
| Rate for Payer: BCN Commercial |
$282.42
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Advantage |
$1,490.89
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| 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 |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| 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 |
$1,341.80
|
| 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) |
$1,384.40
|
| Rate for Payer: UHC Core |
$1,109.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$837.03
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,045.70 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.64
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Advantage |
$2,273.00
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,760.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: Priority Health SBD |
$2,045.70
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$489.87
|
| Rate for Payer: BCN Commercial |
$489.87
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Advantage |
$2,273.00
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| 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 |
$2,760.07
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$2,045.70
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,110.64
|
| Rate for Payer: UHC Core |
$1,691.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,276.13
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,676.15 |
| Rate for Payer: Aetna Commercial |
$2,527.47
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,932.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$489.87
|
| Rate for Payer: BCN Commercial |
$489.87
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Advantage |
$2,081.45
|
| Rate for Payer: Cofinity Commercial |
$2,557.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,676.15
|
| 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 |
$2,527.47
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,527.47
|
| 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 |
$1,873.31
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,932.78
|
| Rate for Payer: UHC Core |
$1,549.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,168.59
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,873.31 |
| Max. Negotiated Rate |
$2,676.15 |
| Rate for Payer: Aetna Commercial |
$2,527.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,932.78
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Advantage |
$2,081.45
|
| Rate for Payer: Cofinity Commercial |
$2,557.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Healthscope Commercial |
$2,676.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,527.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| Rate for Payer: PHP Commercial |
$2,527.47
|
| Rate for Payer: Priority Health SBD |
$1,873.31
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$735.42 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: Priority Health SBD |
$735.42
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| 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 |
$437.63
|
| Rate for Payer: BCN Commercial |
$437.63
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| 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 |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$992.23
|
| 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 |
$735.42
|
| 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) |
$758.76
|
| Rate for Payer: UHC Core |
$608.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$458.76
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,777.13 |
| Rate for Payer: Aetna Commercial |
$1,678.40
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,283.48
|
| 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 |
$281.66
|
| Rate for Payer: BCN Commercial |
$281.66
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Advantage |
$1,382.21
|
| Rate for Payer: Cofinity Commercial |
$1,698.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,777.13
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,678.40
|
| 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 |
$1,243.99
|
| 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) |
$1,283.48
|
| Rate for Payer: UHC Core |
$1,028.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$776.01
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,243.99 |
| Max. Negotiated Rate |
$1,777.13 |
| Rate for Payer: Aetna Commercial |
$1,678.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,283.48
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Advantage |
$1,382.21
|
| Rate for Payer: Cofinity Commercial |
$1,698.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Healthscope Commercial |
$1,777.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| Rate for Payer: PHP Commercial |
$1,678.40
|
| Rate for Payer: Priority Health SBD |
$1,243.99
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$725.33
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$456.96 |
| Max. Negotiated Rate |
$652.80 |
| Rate for Payer: Aetna Commercial |
$616.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.46
|
| Rate for Payer: Cash Price |
$580.26
|
| Rate for Payer: Cofinity Advantage |
$507.73
|
| Rate for Payer: Cofinity Commercial |
$623.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.26
|
| Rate for Payer: Healthscope Commercial |
$652.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.00
|
| Rate for Payer: PHP Commercial |
$616.53
|
| Rate for Payer: Priority Health SBD |
$456.96
|
|
