|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,357.48
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,357.48 |
| Rate for Payer: Aetna Commercial |
$2,121.73
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,286.76
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.75
|
| Rate for Payer: BCN Commercial |
$1,827.75
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cofinity Commercial |
$2,216.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,357.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,286.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,121.73
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.86
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,226.28
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$981.02
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,074.58
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA NECK W CON
|
Facility
|
IP
|
$2,357.48
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,650.24 |
| Max. Negotiated Rate |
$2,357.48 |
| Rate for Payer: Aetna Commercial |
$2,121.73
|
| Rate for Payer: ASR ASR |
$2,286.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.75
|
| Rate for Payer: BCN Commercial |
$1,827.75
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cofinity Commercial |
$2,216.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.98
|
| Rate for Payer: Healthscope Commercial |
$2,357.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,286.76
|
| Rate for Payer: Mclaren Commercial |
$2,121.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,074.58
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
OP
|
$1,965.54
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,965.54 |
| Rate for Payer: Aetna Commercial |
$1,768.99
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$1,906.57
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.88
|
| Rate for Payer: BCN Commercial |
$1,523.88
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cofinity Commercial |
$1,847.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,965.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,906.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,768.99
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.71
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,104.68
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$883.74
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,729.68
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
IP
|
$1,965.54
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,375.88 |
| Max. Negotiated Rate |
$1,965.54 |
| Rate for Payer: Aetna Commercial |
$1,768.99
|
| Rate for Payer: ASR ASR |
$1,906.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.88
|
| Rate for Payer: BCN Commercial |
$1,523.88
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cofinity Commercial |
$1,847.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.43
|
| Rate for Payer: Healthscope Commercial |
$1,965.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,906.57
|
| Rate for Payer: Mclaren Commercial |
$1,768.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,729.68
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,771.09
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,771.09 |
| Rate for Payer: Aetna Commercial |
$2,493.98
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,687.96
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.43
|
| Rate for Payer: BCN Commercial |
$2,148.43
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cofinity Commercial |
$2,604.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,216.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,771.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,687.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,493.98
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,355.43
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,939.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,347.89
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,078.31
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,438.56
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
IP
|
$2,771.09
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,939.76 |
| Max. Negotiated Rate |
$2,771.09 |
| Rate for Payer: Aetna Commercial |
$2,493.98
|
| Rate for Payer: ASR ASR |
$2,687.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.43
|
| Rate for Payer: BCN Commercial |
$2,148.43
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cofinity Commercial |
$2,604.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,216.87
|
| Rate for Payer: Healthscope Commercial |
$2,771.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,687.96
|
| Rate for Payer: Mclaren Commercial |
$2,493.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,355.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,939.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,438.56
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
IP
|
$2,000.90
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,400.63 |
| Max. Negotiated Rate |
$2,000.90 |
| Rate for Payer: Aetna Commercial |
$1,800.81
|
| Rate for Payer: ASR ASR |
$1,940.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.30
|
| Rate for Payer: BCN Commercial |
$1,551.30
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cofinity Commercial |
$1,880.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.72
|
| Rate for Payer: Healthscope Commercial |
$2,000.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,940.87
|
| Rate for Payer: Mclaren Commercial |
$1,800.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,700.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.79
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,000.90
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,000.90 |
| Rate for Payer: Aetna Commercial |
$1,800.81
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$1,940.87
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.30
|
| Rate for Payer: BCN Commercial |
$1,551.30
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cofinity Commercial |
$1,880.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,000.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,940.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,800.81
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,700.76
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,696.78
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,357.42
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.79
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
OP
|
$1,862.90
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,862.90 |
| Rate for Payer: Aetna Commercial |
$1,676.61
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$1,807.01
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.31
|
| Rate for Payer: BCN Commercial |
$1,444.31
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,751.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,862.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,807.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,676.61
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,575.18
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.14
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,639.35
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
IP
|
$1,862.90
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,304.03 |
| Max. Negotiated Rate |
$1,862.90 |
| Rate for Payer: Aetna Commercial |
$1,676.61
|
| Rate for Payer: ASR ASR |
$1,807.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.31
|
| Rate for Payer: BCN Commercial |
$1,444.31
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,751.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Healthscope Commercial |
$1,862.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,807.01
|
| Rate for Payer: Mclaren Commercial |
$1,676.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,639.35
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,009.19
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,567.61
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,545.53 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
IP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,331.82 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,712.34
|
| Rate for Payer: ASR ASR |
$1,845.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.09
|
| Rate for Payer: BCN Commercial |
$1,475.09
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,788.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Healthscope Commercial |
$1,902.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.52
|
| Rate for Payer: Mclaren Commercial |
$1,712.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.29
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,712.34
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$1,845.52
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.09
|
| Rate for Payer: BCN Commercial |
$1,475.09
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,788.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,902.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,712.34
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.28
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,247.42
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.29
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,331.82 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,712.34
|
| Rate for Payer: ASR ASR |
$1,845.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.09
|
| Rate for Payer: BCN Commercial |
$1,475.09
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,788.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Healthscope Commercial |
$1,902.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.52
|
| Rate for Payer: Mclaren Commercial |
$1,712.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.29
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,712.34
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$1,845.52
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.09
|
| Rate for Payer: BCN Commercial |
$1,475.09
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,788.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,902.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,712.34
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.28
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,247.42
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.29
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,456.63 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,893.62
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,477.44
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,425.87
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.70
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,456.63 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,456.63 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,080.90 |
| Rate for Payer: Aetna Commercial |
$1,872.81
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$2,018.47
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.32
|
| Rate for Payer: BCN Commercial |
$1,613.32
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,956.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,080.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,872.81
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,449.48
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.58
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.19
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,903.11 |
| Rate for Payer: Aetna Commercial |
$1,712.80
|
| Rate for Payer: Aetna Commercial |
$2,569.20
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$1,846.02
|
| Rate for Payer: ASR ASR |
$2,769.03
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,213.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.48
|
| Rate for Payer: BCN Commercial |
$1,475.48
|
| Rate for Payer: BCN Commercial |
$2,213.23
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$1,788.92
|
| Rate for Payer: Cofinity Commercial |
$2,683.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,903.11
|
| Rate for Payer: Healthscope Commercial |
$2,854.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,769.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,846.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,712.80
|
| Rate for Payer: Mclaren Commercial |
$2,569.20
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,425.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,425.87
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.70
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,512.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.74
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$2,854.67
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,998.27 |
| Max. Negotiated Rate |
$2,854.67 |
| Rate for Payer: Aetna Commercial |
$2,569.20
|
| Rate for Payer: Aetna Commercial |
$1,712.80
|
| Rate for Payer: ASR ASR |
$1,846.02
|
| Rate for Payer: ASR ASR |
$2,769.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,213.23
|
| Rate for Payer: BCN Commercial |
$2,213.23
|
| Rate for Payer: BCN Commercial |
$1,475.48
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cofinity Commercial |
$1,788.92
|
| Rate for Payer: Cofinity Commercial |
$2,683.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Healthscope Commercial |
$1,903.11
|
| Rate for Payer: Healthscope Commercial |
$2,854.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,769.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,846.02
|
| Rate for Payer: Mclaren Commercial |
$1,712.80
|
| Rate for Payer: Mclaren Commercial |
$2,569.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,512.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,674.74
|
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
OP
|
$2,635.11
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,635.11 |
| Rate for Payer: Aetna Commercial |
$2,371.60
|
| Rate for Payer: Aetna Commercial |
$1,581.07
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$1,704.04
|
| Rate for Payer: ASR ASR |
$2,556.06
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,043.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.00
|
| Rate for Payer: BCN Commercial |
$1,362.00
|
| Rate for Payer: BCN Commercial |
$2,043.00
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$2,477.00
|
| Rate for Payer: Cofinity Commercial |
$1,651.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,756.74
|
| Rate for Payer: Healthscope Commercial |
$2,635.11
|
| Rate for Payer: Healthscope Whirlpool |
$2,556.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,704.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$2,371.60
|
| Rate for Payer: Mclaren Commercial |
$1,581.07
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,493.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,239.84
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,229.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,449.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,449.48
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.58
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,545.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,318.90
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: VA VA |
$217.81
|
|
