|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
OP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna Commercial |
$2,684.77
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,053.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,716.35
|
| Rate for Payer: Cofinity Commercial |
$2,210.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,210.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,842.70
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,684.77
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,989.89
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,337.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,337.33
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
IP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,989.89 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna Commercial |
$2,684.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,053.06
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,210.99
|
| Rate for Payer: Cofinity Commercial |
$2,716.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,210.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Healthscope Commercial |
$2,842.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: PHP Commercial |
$2,684.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: Priority Health SBD |
$1,989.89
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,364.71
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,489.77 |
| Max. Negotiated Rate |
$2,128.24 |
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,305.60
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Commercial |
$2,482.95
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,482.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,655.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: Priority Health SBD |
$2,234.65
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,547.07
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,192.36 |
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,305.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Commercial |
$2,482.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,482.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,655.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,234.65
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,624.83
|
| Rate for Payer: UHC Core |
$1,749.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,624.83
|
| Rate for Payer: UHC Exchange |
$1,749.89
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,343.74 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.60
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Commercial |
$2,239.57
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,239.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,493.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: Priority Health SBD |
$2,015.61
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$3,199.38
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,879.44 |
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Commercial |
$2,239.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,239.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,493.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$2,015.61
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$2,367.54
|
| Rate for Payer: UHC Core |
$1,578.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$2,367.54
|
| Rate for Payer: UHC Exchange |
$1,578.36
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,908.71 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.96
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$2,120.79
|
| Rate for Payer: Cofinity Commercial |
$3,181.18
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,181.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,120.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Healthscope Commercial |
$4,090.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.31
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$4,544.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$4,090.09 |
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,120.79
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Commercial |
$3,181.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,181.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,120.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$4,090.09
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.31
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$3,362.97
|
| Rate for Payer: UHC Core |
$2,241.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$3,362.97
|
| Rate for Payer: UHC Exchange |
$2,241.98
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,666.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,418.80 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,330.18 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,562.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
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 Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| 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: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,018.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,018.59
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,418.80 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,666.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,562.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,330.18 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| 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 Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| 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: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,018.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,018.59
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Cofinity Commercial |
$1,675.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,675.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,507.54
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,770.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,770.76
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,507.54 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.40
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$1,675.04
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,675.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health SBD |
$1,507.54
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,374.52 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,418.16
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,527.25
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.51
|
| Rate for Payer: PHP Commercial |
$1,854.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.16
|
| Rate for Payer: Priority Health SBD |
$1,374.52
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,418.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Cofinity Commercial |
$1,527.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.51
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,854.51
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.16
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,374.52
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,614.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,614.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,684.83 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,738.32
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$1,872.04
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,872.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,273.19
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.32
|
| Rate for Payer: Priority Health SBD |
$1,684.83
|
|
