|
HC XR SINUSES MIN 3 VW
|
Facility
|
OP
|
$364.79
|
|
|
Service Code
|
CPT 70220
|
| Hospital Charge Code |
32000015
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$328.31 |
| Rate for Payer: Aetna Commercial |
$310.07
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$62.08
|
| Rate for Payer: BCN Commercial |
$62.08
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.83
|
| Rate for Payer: Cash Price |
$291.83
|
| Rate for Payer: Cofinity Advantage |
$255.35
|
| Rate for Payer: Cofinity Commercial |
$313.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$328.31
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.07
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.59
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$310.07
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$229.82
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.11
|
| Rate for Payer: UHC Core |
$190.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$143.36
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$80.26 |
| Max. Negotiated Rate |
$1,760.71 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$566.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$80.26
|
| Rate for Payer: BCN Commercial |
$80.26
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$284.75
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$571.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$1,633.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,760.71
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,408.57
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: VA VA |
$544.45
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$249.78 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$62.08
|
| Rate for Payer: BCN Commercial |
$62.08
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.65 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.31 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$71.17
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR SMALL BOWEL
|
Facility
|
IP
|
$624.81
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$393.63 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.13
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Advantage |
$437.37
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: Priority Health SBD |
$393.63
|
|
|
HC XR SMALL BOWEL
|
Facility
|
OP
|
$624.81
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$565.19 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$186.26
|
| Rate for Payer: BCN Commercial |
$186.26
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Advantage |
$437.37
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$393.63
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.13
|
| Rate for Payer: UHC Core |
$325.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$245.55
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
OP
|
$290.04
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.79 |
| Max. Negotiated Rate |
$261.04 |
| Rate for Payer: Aetna Commercial |
$246.53
|
| Rate for Payer: Aetna Medicare |
$145.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.53
|
| Rate for Payer: BCBS Complete |
$116.02
|
| Rate for Payer: BCBS Trust/PPO |
$109.79
|
| Rate for Payer: BCN Commercial |
$109.79
|
| Rate for Payer: Cash Price |
$232.03
|
| Rate for Payer: Cash Price |
$232.03
|
| Rate for Payer: Cofinity Advantage |
$203.03
|
| Rate for Payer: Cofinity Commercial |
$249.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.03
|
| Rate for Payer: Healthscope Commercial |
$261.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.53
|
| Rate for Payer: PHP Commercial |
$246.53
|
| Rate for Payer: Priority Health SBD |
$182.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.53
|
| Rate for Payer: UHC Core |
$151.11
|
| Rate for Payer: UHC Exchange |
$113.99
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
IP
|
$290.04
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$182.73 |
| Max. Negotiated Rate |
$261.04 |
| Rate for Payer: Aetna Commercial |
$246.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.53
|
| Rate for Payer: Cash Price |
$232.03
|
| Rate for Payer: Cofinity Advantage |
$203.03
|
| Rate for Payer: Cofinity Commercial |
$249.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.03
|
| Rate for Payer: Healthscope Commercial |
$261.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.53
|
| Rate for Payer: PHP Commercial |
$246.53
|
| Rate for Payer: Priority Health SBD |
$182.73
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$670.07
|
| Rate for Payer: BCN Commercial |
$670.07
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
OP
|
$316.75
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$285.07 |
| Rate for Payer: Aetna Commercial |
$269.24
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.49
|
| Rate for Payer: BCN Commercial |
$51.49
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$253.40
|
| Rate for Payer: Cash Price |
$253.40
|
| Rate for Payer: Cofinity Advantage |
$221.72
|
| Rate for Payer: Cofinity Commercial |
$272.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.24
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.56
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$269.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$199.55
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.89
|
| Rate for Payer: UHC Core |
$165.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$124.48
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
IP
|
$316.75
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$199.55 |
| Max. Negotiated Rate |
$285.07 |
| Rate for Payer: Aetna Commercial |
$269.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.89
|
| Rate for Payer: Cash Price |
$253.40
|
| Rate for Payer: Cofinity Advantage |
$221.72
|
| Rate for Payer: Cofinity Commercial |
$272.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.40
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.56
|
| Rate for Payer: PHP Commercial |
$269.24
|
| Rate for Payer: Priority Health SBD |
$199.55
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
IP
|
$215.02
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.46 |
| Max. Negotiated Rate |
$193.52 |
| Rate for Payer: Aetna Commercial |
$182.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.76
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Advantage |
$150.51
|
| Rate for Payer: Cofinity Commercial |
$184.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Healthscope Commercial |
$193.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.26
|
| Rate for Payer: PHP Commercial |
$182.77
|
| Rate for Payer: Priority Health SBD |
$135.46
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
OP
|
$215.02
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$1,760.71 |
| Rate for Payer: Aetna Commercial |
$182.77
|
| Rate for Payer: Aetna Medicare |
$566.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$63.60
|
| Rate for Payer: BCCCP Commercial |
$40.47
|
| Rate for Payer: BCN Commercial |
$63.60
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Advantage |
$150.51
|
| Rate for Payer: Cofinity Commercial |
$184.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$193.52
|
| Rate for Payer: Mclaren Medicaid |
$284.75
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$571.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.77
|
| Rate for Payer: Nomi Health Commercial |
$1,633.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.26
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$182.77
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,760.71
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health SBD |
$135.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,408.57
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.76
|
| Rate for Payer: UHC Core |
$112.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$84.50
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: VA VA |
$544.45
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$327.98 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$108.27
|
| Rate for Payer: BCN Commercial |
$108.27
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
OP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$65.88
|
| Rate for Payer: BCN Commercial |
$65.88
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$242.83
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.54
|
| Rate for Payer: UHC Core |
$200.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$151.48
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
IP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$242.83 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health SBD |
$242.83
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
OP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$93.13
|
| Rate for Payer: BCN Commercial |
$93.13
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Advantage |
$335.31
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$301.78
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.36
|
| Rate for Payer: UHC Core |
$249.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$188.25
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
IP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$301.78 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.36
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Advantage |
$335.31
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: Priority Health SBD |
$301.78
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$65.88
|
| Rate for Payer: BCN Commercial |
$65.88
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.31 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
|
