|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| 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: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| 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 |
$1,914.25
|
| 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 |
$1,914.25
|
| 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 |
$1,463.84
|
| 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 |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| 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: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| 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 |
$1,794.69
|
| 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 |
$1,794.69
|
| 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 |
$1,372.41
|
| 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 |
$1,330.18
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,330.18 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| 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: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| 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 |
$2,318.66
|
| 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 |
$2,318.66
|
| 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 |
$1,773.09
|
| 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 |
$1,718.53
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,018.59
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,718.53 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,418.80 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| 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: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| 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 |
$1,914.25
|
| 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 |
$1,914.25
|
| 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 |
$1,463.84
|
| 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 |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| 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: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| 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 |
$1,794.69
|
| 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 |
$1,794.69
|
| 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 |
$1,372.41
|
| 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 |
$1,330.18
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,330.18 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,718.53 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health SBD |
$1,718.53
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,773.09
|
| 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: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Cofinity Commercial |
$1,909.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| 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 |
$2,318.66
|
| 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 |
$2,318.66
|
| 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 |
$1,773.09
|
| 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 |
$1,718.53
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,018.59
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.40
|
| 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: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| 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 |
$2,033.98
|
| 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 |
$2,033.98
|
| 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 |
$1,555.40
|
| 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 |
$1,507.54
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,770.76
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,507.54 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.40
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$1,675.04
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,675.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health SBD |
$1,507.54
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,374.52 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,418.16
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,527.25
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.51
|
| Rate for Payer: PHP Commercial |
$1,854.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.16
|
| Rate for Payer: Priority Health SBD |
$1,374.52
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,418.16
|
| 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: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Cofinity Commercial |
$1,527.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| 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 |
$1,854.51
|
| 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 |
$1,854.51
|
| 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 |
$1,418.16
|
| 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 |
$1,374.52
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,614.52
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
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 BIL WO W
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,738.32
|
| 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: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Cofinity Commercial |
$1,872.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,872.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| 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 |
$2,273.19
|
| 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 |
$2,273.19
|
| 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 |
$1,738.32
|
| 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 |
$1,684.83
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,979.01
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
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 |
$187.55 |
| 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 |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| 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: 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: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| 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 |
$2,702.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| 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 |
$2,026.84
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| 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 |
$2,871.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.24
|
| 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 |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| 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 |
$1,463.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.75
|
| 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 |
$1,418.79
|
| Rate for Payer: Priority Health SBD |
$2,128.19
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,499.78
|
| Rate for Payer: UHC Exchange |
$1,666.52
|
| 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 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 |
$2,026.84 |
| 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 |
$1,576.44
|
| 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 |
$1,576.44
|
| 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 |
$2,026.84
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| 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: 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 |
$2,128.19
|
| Rate for Payer: Priority Health SBD |
$1,418.79
|
|
|
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 |
$126.94 |
| Max. Negotiated Rate |
$2,850.39 |
| Rate for Payer: Aetna Commercial |
$2,692.04
|
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,058.62
|
| 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: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Cofinity Commercial |
$2,216.97
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,216.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| 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 |
$1,900.26
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| 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 |
$2,692.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| 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 |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| 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 |
$1,372.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.62
|
| 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 |
$1,330.18
|
| Rate for Payer: Priority Health SBD |
$1,995.27
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$2,343.65
|
| Rate for Payer: UHC Exchange |
$1,562.44
|
| 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 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 |
$2,692.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,058.62
|
| 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 |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.04
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health SBD |
$1,995.27
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
|
|
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 |
$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 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 |
$187.55 |
| 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 |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| 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: 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: 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 |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| 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 |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| 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 |
$2,280.21
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| 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 |
$3,230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| 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 |
$1,596.15
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,812.27
|
| Rate for Payer: UHC Exchange |
$1,874.84
|
| 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 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 |
$187.55 |
| Max. Negotiated Rate |
$2,164.17 |
| Rate for Payer: Aetna Commercial |
$2,043.94
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.01
|
| 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 |
$344.48
|
| Rate for Payer: BCN Commercial |
$344.48
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,164.17
|
| 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 |
$2,043.94
|
| 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 |
$2,043.94
|
| 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 |
$1,563.01
|
| 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 |
$1,514.92
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$1,779.43
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
