|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,899.44 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.74
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,110.49
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,110.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.74
|
| Rate for Payer: Priority Health SBD |
$1,899.44
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$558.22
|
| Rate for Payer: BCN Commercial |
$558.22
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Cofinity Commercial |
$2,110.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,110.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,899.44
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,231.09
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$323.86 |
| Max. Negotiated Rate |
$2,432.92 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Commercial |
$2,871.38
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$465.18
|
| Rate for Payer: BCBS Trust/PPO |
$465.18
|
| Rate for Payer: BCN Commercial |
$465.18
|
| Rate for Payer: BCN Commercial |
$465.18
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cash Price |
$2,702.47
|
| 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 |
$2,905.16
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,364.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health SBD |
$2,128.20
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| Rate for Payer: UHC Exchange |
$2,499.79
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: VA VA |
$774.08
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
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 Commercial |
$2,871.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.76
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Commercial |
$2,905.16
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,364.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health SBD |
$2,128.20
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,739.61 |
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,884.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$272.83
|
| Rate for Payer: BCBS Trust/PPO |
$272.83
|
| Rate for Payer: BCN Commercial |
$272.83
|
| Rate for Payer: BCN Commercial |
$272.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Cofinity Commercial |
$2,029.54
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,353.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,029.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,826.59
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,430.35
|
| Rate for Payer: UHC Exchange |
$2,145.52
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,217.73 |
| Max. Negotiated Rate |
$1,739.61 |
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,884.58
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Cofinity Commercial |
$2,029.54
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,029.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,353.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health SBD |
$1,826.59
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,470.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$558.22
|
| Rate for Payer: BCBS Trust/PPO |
$558.22
|
| Rate for Payer: BCN Commercial |
$558.22
|
| Rate for Payer: BCN Commercial |
$558.22
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$1,773.50
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$2,660.25
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,773.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,660.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: Priority Health SBD |
$1,596.15
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,874.84
|
| Rate for Payer: UHC Exchange |
$2,812.27
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,596.15 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,470.23
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$1,773.50
|
| Rate for Payer: Cofinity Commercial |
$2,660.25
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,660.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,773.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: Priority Health SBD |
$1,596.15
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
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 LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$323.86 |
| Max. Negotiated Rate |
$2,432.92 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$465.18
|
| Rate for Payer: BCN Commercial |
$465.18
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| 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 |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health SBD |
$1,507.54
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,770.76
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,242.08 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.51
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,380.09
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,380.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.51
|
| Rate for Payer: Priority Health SBD |
$1,242.08
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$272.83
|
| Rate for Payer: BCN Commercial |
$272.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Cofinity Commercial |
$1,380.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,380.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,242.08
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,458.95
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,862.19 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,921.31
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,069.10
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,069.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.48
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.31
|
| Rate for Payer: Priority Health SBD |
$1,862.19
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,921.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$367.75
|
| Rate for Payer: BCN Commercial |
$367.75
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Cofinity Commercial |
$2,069.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,069.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.48
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,862.19
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,187.34
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,447.17 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| 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: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$314.31
|
| Rate for Payer: BCN Commercial |
$314.31
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,699.85
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
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 |
$187.55 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna Commercial |
$2,684.77
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,053.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$464.55
|
| Rate for Payer: BCN Commercial |
$464.55
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$2,210.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,210.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,842.70
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,684.77
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,989.89
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,337.33
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
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 |
$2,210.98
|
| Rate for Payer: Cofinity Commercial |
$2,716.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,210.98
|
| 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
|
OP
|
$2,364.71
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| 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 Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| 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 |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$367.75
|
| Rate for Payer: BCBS Trust/PPO |
$367.75
|
| Rate for Payer: BCN Commercial |
$367.75
|
| Rate for Payer: BCN Commercial |
$367.75
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$2,482.95
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,655.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,482.95
|
| 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 |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| 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: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$2,234.65
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,749.89
|
| Rate for Payer: UHC Exchange |
$2,624.83
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
|
|
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 |
$2,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| 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 |
$2,234.65
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
|
|
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 |
$1,812.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| 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 |
$2,015.61
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| 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 Medicare |
$246.30
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| 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 |
$296.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$314.31
|
| Rate for Payer: BCBS Trust/PPO |
$314.31
|
| Rate for Payer: BCN Commercial |
$314.31
|
| Rate for Payer: BCN Commercial |
$314.31
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$2,239.57
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,493.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,239.57
|
| 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 |
$236.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| 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: Nomi Health Commercial |
$710.49
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$2,015.61
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,578.36
|
| Rate for Payer: UHC Exchange |
$2,367.54
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: VA VA |
$236.83
|
|
|
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) |
$1,969.30
|
| 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 |
$4,090.10
|
| 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: 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 |
$1,969.30
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| 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 Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$464.55
|
| Rate for Payer: BCBS Trust/PPO |
$464.55
|
| Rate for Payer: BCN Commercial |
$464.55
|
| Rate for Payer: BCN Commercial |
$464.55
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cofinity Commercial |
$2,120.79
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$3,181.18
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,120.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,181.18
|
| 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 |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| 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: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,241.98
|
| Rate for Payer: UHC Exchange |
$3,362.97
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
|
|
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
|
|
