|
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
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
IP
|
$2,252.05
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,418.79 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.75
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$1,576.43
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,364.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.83
|
| Rate for Payer: Priority Health SBD |
$1,418.79
|
| Rate for Payer: Priority Health SBD |
$2,128.19
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
OP
|
$3,378.08
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,040.27 |
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.83
|
| 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 |
$1,801.64
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Cofinity Commercial |
$1,576.43
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,364.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| 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 |
$3,040.27
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| 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 |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.37
|
| 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 |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| 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 |
$2,195.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.83
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,128.19
|
| Rate for Payer: Priority Health SBD |
$1,418.79
|
| 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 |
$2,499.78
|
| Rate for Payer: UHC Core |
$1,666.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,499.78
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| 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 LOWR EXTREM WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
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 Commercial |
$2,692.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,058.61
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$2,216.97
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,216.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| Rate for Payer: Priority Health SBD |
$1,995.27
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
OP
|
$3,167.10
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,850.39 |
| Rate for Payer: Aetna Commercial |
$2,692.03
|
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,058.61
|
| 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: 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 |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$2,216.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,216.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| 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 |
$2,850.39
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| 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 |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.03
|
| 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 |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.03
|
| 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 |
$2,058.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,995.27
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| 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 |
$2,343.65
|
| Rate for Payer: UHC Core |
$1,562.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$2,343.65
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| 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 MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$3,800.36
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,420.32 |
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| 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 |
$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 |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$1,773.50
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$2,660.25
|
| 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: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| 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 |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| 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 |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| 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 |
$2,470.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: Priority Health SBD |
$1,596.15
|
| 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 |
$2,812.27
|
| Rate for Payer: UHC Core |
$1,874.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,812.27
|
| Rate for Payer: UHC Exchange |
$1,874.84
|
| 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 LOWR EXTREM WO W
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
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 |
$3,230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| 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 |
$1,596.15
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
|
|
HC MR MRA NECK W CON
|
Facility
|
IP
|
$2,404.63
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,514.92 |
| Max. Negotiated Rate |
$2,164.17 |
| Rate for Payer: Aetna Commercial |
$2,043.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.01
|
| Rate for Payer: Cash Price |
$1,923.70
|
| Rate for Payer: Cofinity Commercial |
$1,683.24
|
| Rate for Payer: Cofinity Commercial |
$2,067.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,683.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.70
|
| Rate for Payer: Healthscope Commercial |
$2,164.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.94
|
| Rate for Payer: PHP Commercial |
$2,043.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.01
|
| Rate for Payer: Priority Health SBD |
$1,514.92
|
|
|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,404.63
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,164.17 |
| Rate for Payer: Aetna Commercial |
$2,043.94
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.01
|
| 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 |
$1,923.70
|
| Rate for Payer: Cash Price |
$1,923.70
|
| Rate for Payer: Cofinity Commercial |
$2,067.98
|
| Rate for Payer: Cofinity Commercial |
$1,683.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,683.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,164.17
|
| 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 |
$2,043.94
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,043.94
|
| 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 |
$1,563.01
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,514.92
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,779.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,779.43
|
| 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 NECK WO CON
|
Facility
|
OP
|
$2,004.85
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,804.37 |
| Rate for Payer: Aetna Commercial |
$1,704.12
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,303.15
|
| 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 |
$1,603.88
|
| Rate for Payer: Cash Price |
$1,603.88
|
| Rate for Payer: Cofinity Commercial |
$1,724.17
|
| Rate for Payer: Cofinity Commercial |
$1,403.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,403.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,804.37
|
| 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 |
$1,704.12
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,704.12
|
| 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 |
$1,303.15
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,263.06
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,483.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,483.59
|
| 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 NECK WO CON
|
Facility
|
IP
|
$2,004.85
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,263.06 |
| Max. Negotiated Rate |
$1,804.37 |
| Rate for Payer: Aetna Commercial |
$1,704.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,303.15
|
| Rate for Payer: Cash Price |
$1,603.88
|
| Rate for Payer: Cofinity Commercial |
$1,403.39
|
| Rate for Payer: Cofinity Commercial |
$1,724.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,403.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Healthscope Commercial |
$1,804.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,704.12
|
| Rate for Payer: PHP Commercial |
$1,704.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.15
|
| Rate for Payer: Priority Health SBD |
$1,263.06
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,826.51
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,543.86 |
| Rate for Payer: Aetna Commercial |
$2,402.53
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.23
|
| 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 |
$2,261.21
|
| Rate for Payer: Cash Price |
$2,261.21
|
| Rate for Payer: Cofinity Commercial |
$2,430.80
|
| Rate for Payer: Cofinity Commercial |
$1,978.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,978.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,543.86
|
| 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 |
$2,402.53
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,402.53
|
| 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 |
$1,837.23
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,780.70
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,091.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,091.62
|
| 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 NECK WO W CON
|
Facility
|
IP
|
$2,826.51
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,780.70 |
| Max. Negotiated Rate |
$2,543.86 |
| Rate for Payer: Aetna Commercial |
$2,402.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.23
|
| Rate for Payer: Cash Price |
$2,261.21
|
| Rate for Payer: Cofinity Commercial |
$1,978.56
|
| Rate for Payer: Cofinity Commercial |
$2,430.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,978.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.21
|
| Rate for Payer: Healthscope Commercial |
$2,543.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.53
|
| Rate for Payer: PHP Commercial |
$2,402.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.23
|
| Rate for Payer: Priority Health SBD |
$1,780.70
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
IP
|
$2,040.92
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,285.78 |
| Max. Negotiated Rate |
$1,836.83 |
| Rate for Payer: Aetna Commercial |
$1,734.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.60
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cofinity Commercial |
$1,428.64
|
| Rate for Payer: Cofinity Commercial |
$1,755.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.74
|
| Rate for Payer: Healthscope Commercial |
$1,836.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,734.78
|
| Rate for Payer: PHP Commercial |
$1,734.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.60
|
| Rate for Payer: Priority Health SBD |
$1,285.78
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,040.92
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,836.83 |
| Rate for Payer: Aetna Commercial |
$1,734.78
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.60
|
| 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 |
$1,632.74
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cofinity Commercial |
$1,428.64
|
| Rate for Payer: Cofinity Commercial |
$1,755.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,836.83
|
| 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 |
$1,734.78
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,734.78
|
| 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 |
$1,326.60
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,285.78
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,510.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,510.28
|
| 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 PELVIS WO CON
|
Facility
|
OP
|
$1,900.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| 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 |
$1,520.13
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Cofinity Commercial |
$1,330.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,330.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| 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 |
$1,615.14
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| 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 |
$1,235.10
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,197.10
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,406.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,406.12
|
| 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 PELVIS WO CON
|
Facility
|
IP
|
$1,900.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,197.10 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,330.11
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,330.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health SBD |
$1,197.10
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| 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 PELVIS WO W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| 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 SPINAL CANAL W CON
|
Facility
|
IP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,222.61 |
| Max. Negotiated Rate |
$1,746.59 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,358.45
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health SBD |
$1,222.61
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,746.59 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| 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 |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Commercial |
$1,358.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,746.59
|
| 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 |
$1,649.55
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| 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 |
$1,261.42
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,222.61
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,436.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,436.08
|
| 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 SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,222.61 |
| Max. Negotiated Rate |
$1,746.59 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,358.45
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health SBD |
$1,222.61
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,746.59 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| 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 |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Commercial |
$1,358.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,746.59
|
| 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 |
$1,649.55
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| 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 |
$1,261.42
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,222.61
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,436.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,436.08
|
| 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 UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.64
|
| 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 |
$1,698.02
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Cofinity Commercial |
$1,485.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,485.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| 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 |
$1,804.14
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| 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 |
$1,379.64
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,337.19
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,570.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,570.66
|
| 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 UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,337.19 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.64
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,485.76
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,485.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health SBD |
$1,337.19
|
|
