|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,865.12 |
| Rate for Payer: Aetna Commercial |
$2,705.95
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Commercial |
$2,737.78
|
| Rate for Payer: Cofinity Commercial |
$2,228.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,228.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,865.12
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.95
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,705.95
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.26
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,005.59
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,355.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,355.77
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,005.59 |
| Max. Negotiated Rate |
$2,865.12 |
| Rate for Payer: Aetna Commercial |
$2,705.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.26
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Commercial |
$2,228.43
|
| Rate for Payer: Cofinity Commercial |
$2,737.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,228.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Healthscope Commercial |
$2,865.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.95
|
| Rate for Payer: PHP Commercial |
$2,705.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.26
|
| Rate for Payer: Priority Health SBD |
$2,005.59
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,623.68 |
| Rate for Payer: Aetna Commercial |
$2,477.92
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,894.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,507.07
|
| Rate for Payer: Cofinity Commercial |
$2,040.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,040.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,623.68
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.92
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,477.92
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.88
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,836.58
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,157.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,157.25
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,836.58 |
| Max. Negotiated Rate |
$2,623.68 |
| Rate for Payer: Aetna Commercial |
$2,477.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,894.88
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,040.64
|
| Rate for Payer: Cofinity Commercial |
$2,507.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,040.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Healthscope Commercial |
$2,623.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.92
|
| Rate for Payer: PHP Commercial |
$2,477.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.88
|
| Rate for Payer: Priority Health SBD |
$1,836.58
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$721.00 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.89
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$801.11
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health SBD |
$721.00
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Cofinity Commercial |
$801.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$721.00
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$846.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$846.89
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,742.28 |
| Rate for Payer: Aetna Commercial |
$1,645.49
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cofinity Commercial |
$1,664.85
|
| Rate for Payer: Cofinity Commercial |
$1,355.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,355.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,742.28
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,645.49
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.32
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,219.60
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,432.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,432.54
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,219.60 |
| Max. Negotiated Rate |
$1,742.28 |
| Rate for Payer: Aetna Commercial |
$1,645.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.32
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cofinity Commercial |
$1,355.11
|
| Rate for Payer: Cofinity Commercial |
$1,664.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,355.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.70
|
| Rate for Payer: Healthscope Commercial |
$1,742.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: PHP Commercial |
$1,645.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.32
|
| Rate for Payer: Priority Health SBD |
$1,219.60
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
OP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna Commercial |
$604.44
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$611.55
|
| Rate for Payer: Cofinity Commercial |
$497.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$497.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$640.00
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.44
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$604.44
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.22
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$448.00
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$526.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$526.22
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$448.00 |
| Max. Negotiated Rate |
$640.00 |
| Rate for Payer: Aetna Commercial |
$604.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.22
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$497.78
|
| Rate for Payer: Cofinity Commercial |
$611.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$497.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Healthscope Commercial |
$640.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.44
|
| Rate for Payer: PHP Commercial |
$604.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.22
|
| Rate for Payer: Priority Health SBD |
$448.00
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,663.08 |
| Max. Negotiated Rate |
$2,375.83 |
| Rate for Payer: Aetna Commercial |
$2,243.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.88
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cofinity Commercial |
$1,847.87
|
| Rate for Payer: Cofinity Commercial |
$2,270.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,847.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.85
|
| Rate for Payer: Healthscope Commercial |
$2,375.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.84
|
| Rate for Payer: PHP Commercial |
$2,243.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.88
|
| Rate for Payer: Priority Health SBD |
$1,663.08
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
OP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,375.83 |
| Rate for Payer: Aetna Commercial |
$2,243.84
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cofinity Commercial |
$2,270.24
|
| Rate for Payer: Cofinity Commercial |
$1,847.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,847.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,375.83
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.84
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,243.84
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.88
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,663.08
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,953.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,953.46
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
IP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$582.43 |
| Max. Negotiated Rate |
$832.05 |
| Rate for Payer: Aetna Commercial |
$785.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.92
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$647.15
|
| Rate for Payer: Cofinity Commercial |
$795.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Healthscope Commercial |
$832.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.83
|
| Rate for Payer: PHP Commercial |
$785.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.92
|
| Rate for Payer: Priority Health SBD |
$582.43
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
OP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$980.43 |
| Rate for Payer: Aetna Commercial |
$785.83
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$795.07
|
| Rate for Payer: Cofinity Commercial |
$647.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$832.05
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.83
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$785.83
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.92
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$582.43
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$684.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$684.13
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Cofinity Commercial |
$1,451.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,451.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,305.93
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,533.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,533.95
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,305.93 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.38
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,451.03
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,451.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health SBD |
$1,305.93
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.45
|
| Rate for Payer: Cofinity Commercial |
$1,808.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,808.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,628.08
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,912.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,912.35
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,628.08 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$1,808.97
|
| Rate for Payer: Cofinity Commercial |
$2,222.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,808.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health SBD |
$1,628.08
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$3,092.67 |
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,603.60
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,405.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,405.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,603.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$2,164.87
|
| Rate for Payer: Priority Health SBD |
$1,443.24
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$2,542.86
|
| Rate for Payer: UHC Core |
$1,695.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$2,542.86
|
| Rate for Payer: UHC Exchange |
$1,695.24
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$433.81
|
| Rate for Payer: UHCCP Medicaid |
$433.81
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: VA VA |
$770.53
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,443.24 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.59
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$1,603.60
|
| Rate for Payer: Cofinity Commercial |
$2,405.41
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,405.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,603.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health SBD |
$1,443.24
|
| Rate for Payer: Priority Health SBD |
$2,164.87
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,693.55 |
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,094.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,094.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,396.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,885.48
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$2,214.69
|
| Rate for Payer: UHC Core |
$1,476.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$2,214.69
|
| Rate for Payer: UHC Exchange |
$1,476.46
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,256.99 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.34
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$2,094.98
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,094.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,396.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: Priority Health SBD |
$1,885.48
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$3,689.05
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,320.14 |
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,397.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Cofinity Commercial |
$1,721.56
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Cofinity Commercial |
$2,582.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,582.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,721.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,324.10
|
| Rate for Payer: Priority Health SBD |
$1,549.40
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$2,729.90
|
| Rate for Payer: UHC Core |
$1,819.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,729.90
|
| Rate for Payer: UHC Exchange |
$1,819.93
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,549.40 |
| Max. Negotiated Rate |
$2,213.43 |
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,397.88
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$1,721.56
|
| Rate for Payer: Cofinity Commercial |
$2,582.34
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,582.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,721.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health SBD |
$1,549.40
|
| Rate for Payer: Priority Health SBD |
$2,324.10
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$2,261.21 |
| Rate for Payer: Aetna Commercial |
$2,135.59
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$2,160.72
|
| Rate for Payer: Cofinity Commercial |
$1,758.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,758.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$2,261.21
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$2,135.59
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$1,582.85
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$1,859.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,859.22
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$433.81
|
| Rate for Payer: VA VA |
$770.53
|
|
