|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,582.85 |
| Max. Negotiated Rate |
$2,261.21 |
| Rate for Payer: Aetna Commercial |
$2,135.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.10
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$1,758.72
|
| Rate for Payer: Cofinity Commercial |
$2,160.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,758.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Healthscope Commercial |
$2,261.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: PHP Commercial |
$2,135.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health SBD |
$1,582.85
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,447.17 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| 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 |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| 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 |
$1,952.54
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| 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 |
$1,493.12
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,699.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,699.85
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,551.82 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.08
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$1,724.24
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,724.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,093.72
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health SBD |
$1,551.82
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Cofinity Commercial |
$1,724.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,724.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| 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 |
$2,093.72
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| 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 |
$1,601.08
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,551.82
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,822.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,822.77
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| 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 |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| 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 |
$1,952.54
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| 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 |
$1,493.12
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,699.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,699.85
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,447.17 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.12
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,607.97
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,607.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health SBD |
$1,447.17
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
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 BIL NO JOINT WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
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 NO JOINT W CON
|
Facility
|
IP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,467.38 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,270.94
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$1,630.42
|
| Rate for Payer: Cofinity Commercial |
$2,445.62
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,445.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,630.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health SBD |
$1,467.38
|
| Rate for Payer: Priority Health SBD |
$2,201.06
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,493.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,144.38 |
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,270.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.96
|
| 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 |
$1,863.34
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$1,630.42
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Cofinity Commercial |
$2,445.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,445.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,630.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| 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 |
$3,144.38
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| 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 |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| 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 |
$2,270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,201.06
|
| Rate for Payer: Priority Health SBD |
$1,467.38
|
| 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 |
$2,585.38
|
| Rate for Payer: UHC Core |
$1,723.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,585.38
|
| Rate for Payer: UHC Exchange |
$1,723.59
|
| 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 NO JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
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 NO JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
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 NO JOINT WO W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
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 NO JOINT WO W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| 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 |
$362.23
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| 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 |
$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 |
$1,832.69
|
| 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 |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| 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 |
$2,233.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,164.87
|
| Rate for Payer: Priority Health SBD |
$1,443.24
|
| 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 |
$2,542.86
|
| Rate for Payer: UHC Core |
$1,695.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$2,542.86
|
| Rate for Payer: UHC Exchange |
$1,695.24
|
| 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 MSMART BM CMPT1
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$154.22 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$987.55 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$364.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$197.52
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health SBD |
$107.59
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$70.58 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna Medicare |
$88.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.70
|
| Rate for Payer: BCBS Complete |
$70.58
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$123.52
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health SBD |
$111.17
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$111.17 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.70
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$123.52
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health SBD |
$111.17
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$117.33 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: BCBS Complete |
$23.46
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Mclaren Medicaid |
$22.34
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$23.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health SBD |
$42.95
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Medicare Advantage |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$23.47
|
| Rate for Payer: VA VA |
$41.68
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$61.36 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.32
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health SBD |
$42.95
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.16
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.16 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health SBD |
$36.16
|
|
