|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$438.63 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS Trust/PPO |
$897.99
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.82
|
| Rate for Payer: Priority Health Narrow Network |
$768.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$712.78 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Trust/PPO |
$893.60
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$440.64 |
| Rate for Payer: Aetna Commercial |
$396.58
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$427.42
|
| Rate for Payer: ASR Commercial |
$427.42
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$360.84
|
| Rate for Payer: BCN Commercial |
$341.63
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$414.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$440.64
|
| Rate for Payer: Healthscope Whirlpool |
$427.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$396.58
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.09
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$308.89
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.42 |
| Max. Negotiated Rate |
$440.64 |
| Rate for Payer: Aetna Commercial |
$396.58
|
| Rate for Payer: ASR ASR |
$427.42
|
| Rate for Payer: ASR Commercial |
$427.42
|
| Rate for Payer: BCBS Trust/PPO |
$359.08
|
| Rate for Payer: BCN Commercial |
$341.63
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$414.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$440.64
|
| Rate for Payer: Healthscope Whirlpool |
$427.42
|
| Rate for Payer: Mclaren Commercial |
$396.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.76
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$537.03
|
| Rate for Payer: Aetna Medicare |
$226.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: ASR ASR |
$578.80
|
| Rate for Payer: ASR Commercial |
$578.80
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCBS Trust/PPO |
$488.64
|
| Rate for Payer: BCN Commercial |
$462.62
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$560.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Healthscope Whirlpool |
$578.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$226.48
|
| Rate for Payer: Mclaren Commercial |
$537.03
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: Nomi Health Commercial |
$489.29
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$249.13
|
| Rate for Payer: PHP Medicaid |
$121.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.83
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health Narrow Network |
$418.29
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$525.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$351.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP DNSP |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$226.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.86 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$537.03
|
| Rate for Payer: ASR ASR |
$578.80
|
| Rate for Payer: ASR Commercial |
$578.80
|
| Rate for Payer: BCBS Trust/PPO |
$486.25
|
| Rate for Payer: BCN Commercial |
$462.62
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$560.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Healthscope Whirlpool |
$578.80
|
| Rate for Payer: Mclaren Commercial |
$537.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: Nomi Health Commercial |
$489.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$525.10
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$577.73
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.15
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$494.55
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$577.73
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.15
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$494.55
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$577.73
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.15
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$494.55
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,062.27 |
| Max. Negotiated Rate |
$1,634.26 |
| Rate for Payer: Aetna Commercial |
$1,470.83
|
| Rate for Payer: ASR ASR |
$1,585.23
|
| Rate for Payer: ASR Commercial |
$1,585.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.76
|
| Rate for Payer: BCN Commercial |
$1,267.04
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,536.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Healthscope Commercial |
$1,634.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,585.23
|
| Rate for Payer: Mclaren Commercial |
$1,470.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: Nomi Health Commercial |
$1,340.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,438.15
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,634.26 |
| Rate for Payer: Aetna Commercial |
$1,470.83
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,585.23
|
| Rate for Payer: ASR Commercial |
$1,585.23
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.30
|
| Rate for Payer: BCN Commercial |
$1,267.04
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,536.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,634.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,585.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,470.83
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: Nomi Health Commercial |
$1,340.09
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.94
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,145.62
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,438.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$899.09 |
| Max. Negotiated Rate |
$1,383.22 |
| Rate for Payer: Aetna Commercial |
$1,244.90
|
| Rate for Payer: ASR ASR |
$1,341.72
|
| Rate for Payer: ASR Commercial |
$1,341.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.19
|
| Rate for Payer: BCN Commercial |
$1,072.41
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,300.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Healthscope Commercial |
$1,383.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,341.72
|
| Rate for Payer: Mclaren Commercial |
$1,244.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: Nomi Health Commercial |
$1,134.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,217.23
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,383.22 |
| Rate for Payer: Aetna Commercial |
$1,244.90
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,341.72
|
| Rate for Payer: ASR Commercial |
$1,341.72
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.72
|
| Rate for Payer: BCN Commercial |
$1,072.41
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,300.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,383.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,341.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,244.90
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: Nomi Health Commercial |
$1,134.24
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.98
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$969.64
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,217.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
IP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,222.95 |
| Max. Negotiated Rate |
$1,881.46 |
| Rate for Payer: Aetna Commercial |
$1,693.31
|
| Rate for Payer: ASR ASR |
$1,825.02
|
| Rate for Payer: ASR Commercial |
$1,825.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.20
|
| Rate for Payer: BCN Commercial |
$1,458.70
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,768.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Healthscope Commercial |
$1,881.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,825.02
|
| Rate for Payer: Mclaren Commercial |
$1,693.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: Nomi Health Commercial |
$1,542.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,655.68
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,881.46 |
| Rate for Payer: Aetna Commercial |
$1,693.31
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,825.02
|
| Rate for Payer: ASR Commercial |
$1,825.02
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.73
|
| Rate for Payer: BCN Commercial |
$1,458.70
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,768.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,881.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,825.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,693.31
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: Nomi Health Commercial |
$1,542.80
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.54
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,318.90
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,655.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,260.10 |
| Max. Negotiated Rate |
$1,938.61 |
| Rate for Payer: Aetna Commercial |
$1,744.75
|
| Rate for Payer: ASR ASR |
$1,880.45
|
| Rate for Payer: ASR Commercial |
$1,880.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.77
|
| Rate for Payer: BCN Commercial |
$1,503.00
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,822.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,938.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,880.45
|
| Rate for Payer: Mclaren Commercial |
$1,744.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: Nomi Health Commercial |
$1,589.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,705.98
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,938.61 |
| Rate for Payer: Aetna Commercial |
$1,744.75
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,880.45
|
| Rate for Payer: ASR Commercial |
$1,880.45
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,587.53
|
| Rate for Payer: BCN Commercial |
$1,503.00
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,822.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,938.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,880.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,744.75
|
| 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 |
$1,647.82
|
| Rate for Payer: Nomi Health Commercial |
$1,589.66
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| 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 |
$1,260.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.61
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,358.97
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,705.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
OP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,617.92 |
| Rate for Payer: Aetna Commercial |
$1,456.13
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,569.38
|
| Rate for Payer: ASR Commercial |
$1,569.38
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.91
|
| Rate for Payer: BCN Commercial |
$1,254.37
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,520.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,617.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,569.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,456.13
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: Nomi Health Commercial |
$1,326.69
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,417.62
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.16
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,423.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,051.65 |
| Max. Negotiated Rate |
$1,617.92 |
| Rate for Payer: Aetna Commercial |
$1,456.13
|
| Rate for Payer: ASR ASR |
$1,569.38
|
| Rate for Payer: ASR Commercial |
$1,569.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,318.44
|
| Rate for Payer: BCN Commercial |
$1,254.37
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,520.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Healthscope Commercial |
$1,617.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,569.38
|
| Rate for Payer: Mclaren Commercial |
$1,456.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: Nomi Health Commercial |
$1,326.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,423.77
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,203.10
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,432.02 |
| Max. Negotiated Rate |
$2,203.10 |
| Rate for Payer: Aetna Commercial |
$1,982.79
|
| Rate for Payer: ASR ASR |
$2,137.01
|
| Rate for Payer: ASR Commercial |
$2,137.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,795.31
|
| Rate for Payer: BCN Commercial |
$1,708.06
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cofinity Commercial |
$2,070.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,762.48
|
| Rate for Payer: Healthscope Commercial |
$2,203.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,137.01
|
| Rate for Payer: Mclaren Commercial |
$1,982.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,872.63
|
| Rate for Payer: Nomi Health Commercial |
$1,806.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,938.73
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,203.10
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$2,203.10 |
| Rate for Payer: Aetna Commercial |
$1,982.79
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$2,137.01
|
| Rate for Payer: ASR Commercial |
$2,137.01
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.12
|
| Rate for Payer: BCN Commercial |
$1,708.06
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cofinity Commercial |
$2,070.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,762.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$2,203.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,137.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,982.79
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,872.63
|
| Rate for Payer: Nomi Health Commercial |
$1,806.54
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,930.36
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.37
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,938.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
OP
|
$1,977.38
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,977.38 |
| Rate for Payer: Aetna Commercial |
$1,779.64
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,918.06
|
| Rate for Payer: ASR Commercial |
$1,918.06
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,619.28
|
| Rate for Payer: BCN Commercial |
$1,533.06
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,858.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,977.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,918.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,779.64
|
| 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 |
$1,680.77
|
| Rate for Payer: Nomi Health Commercial |
$1,621.45
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| 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 |
$1,285.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,732.58
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.14
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,740.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
