|
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 |
$1,804.36 |
| 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 |
$1,403.40
|
| Rate for Payer: Cofinity Commercial |
$1,724.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,403.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Healthscope Commercial |
$1,804.36
|
| 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 CON
|
Facility
|
OP
|
$2,004.85
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,804.36 |
| Rate for Payer: Aetna Commercial |
$1,704.12
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,303.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$313.05
|
| Rate for Payer: BCN Commercial |
$313.05
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$1,403.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,403.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,804.36
|
| 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 |
$1,704.12
|
| 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 |
$1,704.12
|
| 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 |
$1,303.15
|
| 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 |
$1,263.06
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,483.59
|
| 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 NECK WO W CON
|
Facility
|
OP
|
$2,826.51
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,543.86 |
| Rate for Payer: Aetna Commercial |
$2,402.53
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.23
|
| 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 |
$511.71
|
| Rate for Payer: BCN Commercial |
$511.71
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,543.86
|
| 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 |
$2,402.53
|
| 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 |
$2,402.53
|
| 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 |
$1,837.23
|
| 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 |
$1,780.70
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,091.62
|
| 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 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 |
$187.55 |
| Max. Negotiated Rate |
$1,836.83 |
| Rate for Payer: Aetna Commercial |
$1,734.78
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.60
|
| 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 |
$1,632.74
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cofinity Commercial |
$1,755.19
|
| Rate for Payer: Cofinity Commercial |
$1,428.64
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,836.83
|
| 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 |
$1,734.78
|
| 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 |
$1,734.78
|
| 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 |
$1,326.60
|
| 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 |
$1,285.78
|
| 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 |
$1,510.28
|
| 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 PELVIS WO CON
|
Facility
|
OP
|
$1,900.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| 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 |
$1,520.13
|
| 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 |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| 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 |
$1,615.14
|
| 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 |
$1,615.14
|
| 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 |
$1,235.10
|
| 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 |
$1,197.10
|
| 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 |
$1,406.12
|
| 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 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 |
$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 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 |
$1,746.58 |
| 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 |
$1,358.46
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| 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 |
$187.55 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| 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 |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Commercial |
$1,358.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| 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 |
$1,649.55
|
| 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 |
$1,649.55
|
| 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 |
$1,261.42
|
| 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 |
$1,222.61
|
| 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 |
$1,436.08
|
| 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 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 |
$1,746.58 |
| 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 |
$1,358.46
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| 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 |
$126.94 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,261.42
|
| 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 |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Cofinity Commercial |
$1,358.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,358.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| 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 |
$1,649.55
|
| 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 |
$1,649.55
|
| 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 |
$1,261.42
|
| 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 |
$1,222.61
|
| 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 |
$1,436.08
|
| 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 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 |
$187.55 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.64
|
| 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 |
$1,698.02
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| 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 |
$1,804.14
|
| 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 |
$1,379.64
|
| 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 |
$1,337.19
|
| 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 |
$1,570.66
|
| 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 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
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
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
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.64
|
| 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 |
$1,698.02
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| 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 |
$1,804.14
|
| 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 |
$1,379.64
|
| 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 |
$1,337.19
|
| 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 |
$1,570.66
|
| 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 UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
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
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.64
|
| 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 |
$1,698.02
|
| 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 |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| 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 |
$1,804.14
|
| 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 |
$1,804.14
|
| 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 |
$1,379.64
|
| 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 |
$1,337.19
|
| 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 |
$1,570.66
|
| 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 UPPER EXTREMITY W CO
|
Facility
|
IP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,198.96 |
| Max. Negotiated Rate |
$1,712.80 |
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$1,332.18
|
| Rate for Payer: Cofinity Commercial |
$1,998.27
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,998.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.02
|
| Rate for Payer: Priority Health SBD |
$1,798.44
|
| Rate for Payer: Priority Health SBD |
$1,198.96
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$2,854.67
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,569.20 |
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
| 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 |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cofinity Commercial |
$1,332.18
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,998.27
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,998.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| 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 |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| 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 |
$2,426.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.64
|
| 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 |
$1,617.64
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| 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 |
$1,237.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.54
|
| 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 |
$1,198.96
|
| Rate for Payer: Priority Health SBD |
$1,798.44
|
| 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 |
$2,112.46
|
| Rate for Payer: UHC Exchange |
$1,408.30
|
| 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 UPPER EXTREMITY WO C
|
Facility
|
OP
|
$2,635.11
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,371.60 |
| Rate for Payer: Aetna Commercial |
$2,239.84
|
| Rate for Payer: Aetna Commercial |
$1,493.23
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
| 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 |
$2,108.09
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cofinity Commercial |
$1,229.72
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Cofinity Commercial |
$1,844.58
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,229.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,844.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
| 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 |
$1,581.07
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| 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 |
$2,239.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.23
|
| 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 |
$1,493.23
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| 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 |
$1,141.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.82
|
| 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 |
$1,106.75
|
| Rate for Payer: Priority Health SBD |
$1,660.12
|
| 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 |
$1,949.98
|
| Rate for Payer: UHC Exchange |
$1,299.99
|
| 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 UPPER EXTREMITY WO C
|
Facility
|
IP
|
$1,756.74
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,106.75 |
| Max. Negotiated Rate |
$1,581.07 |
| Rate for Payer: Aetna Commercial |
$1,493.23
|
| Rate for Payer: Aetna Commercial |
$2,239.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$1,229.72
|
| Rate for Payer: Cofinity Commercial |
$1,844.58
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,844.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,229.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
| Rate for Payer: Healthscope Commercial |
$1,581.07
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,239.84
|
| Rate for Payer: PHP Commercial |
$1,493.23
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.88
|
| Rate for Payer: Priority Health SBD |
$1,660.12
|
| Rate for Payer: Priority Health SBD |
$1,106.75
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
IP
|
$2,049.38
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,291.11 |
| Max. Negotiated Rate |
$1,844.44 |
| Rate for Payer: Aetna Commercial |
$1,741.97
|
| Rate for Payer: Aetna Commercial |
$2,612.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.15
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cofinity Commercial |
$1,434.57
|
| Rate for Payer: Cofinity Commercial |
$2,151.85
|
| Rate for Payer: Cofinity Commercial |
$2,643.70
|
| Rate for Payer: Cofinity Commercial |
$1,762.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,151.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,434.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,639.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,459.26
|
| Rate for Payer: Healthscope Commercial |
$1,844.44
|
| Rate for Payer: Healthscope Commercial |
$2,766.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,741.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,612.96
|
| Rate for Payer: PHP Commercial |
$1,741.97
|
| Rate for Payer: PHP Commercial |
$2,612.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.10
|
| Rate for Payer: Priority Health SBD |
$1,936.66
|
| Rate for Payer: Priority Health SBD |
$1,291.11
|
|
