|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$796.60 |
| Max. Negotiated Rate |
$1,138.00 |
| Rate for Payer: Aetna Commercial |
$1,024.20
|
| Rate for Payer: ASR ASR |
$1,103.86
|
| Rate for Payer: BCBS Trust/PPO |
$882.29
|
| Rate for Payer: BCN Commercial |
$882.29
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$1,069.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Healthscope Commercial |
$1,138.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,103.86
|
| Rate for Payer: Mclaren Commercial |
$1,024.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,001.44
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,698.84 |
| Rate for Payer: Aetna Commercial |
$1,024.20
|
| 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 |
$1,103.86
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$882.29
|
| Rate for Payer: BCN Commercial |
$882.29
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$1,069.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,138.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,103.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,024.20
|
| 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 |
$967.30
|
| 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 |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.07
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,001.44
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,570.23 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| Rate for Payer: ASR ASR |
$2,175.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.14
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$2,108.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| 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 |
$2,175.88
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.14
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$2,108.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| 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 |
$1,906.70
|
| 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 |
$1,570.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,460.76
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.61
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,460.76 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| 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 |
$1,088.34
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$869.89
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| 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 |
$953.70
|
| 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 |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,460.76
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.61
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$785.40 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: BCBS Trust/PPO |
$869.89
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,902.28 |
| Max. Negotiated Rate |
$2,717.54 |
| Rate for Payer: Aetna Commercial |
$2,445.79
|
| Rate for Payer: ASR ASR |
$2,636.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.91
|
| Rate for Payer: BCN Commercial |
$2,106.91
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$2,554.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Healthscope Commercial |
$2,717.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,636.01
|
| Rate for Payer: Mclaren Commercial |
$2,445.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.44
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,717.54 |
| Rate for Payer: Aetna Commercial |
$2,445.79
|
| 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 |
$2,636.01
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.91
|
| Rate for Payer: BCN Commercial |
$2,106.91
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$2,554.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,717.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,636.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,445.79
|
| 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 |
$2,309.91
|
| 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 |
$1,902.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,969.24
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.39
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.44
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,969.24 |
| Rate for Payer: Aetna Commercial |
$784.34
|
| 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 |
$845.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$675.67
|
| Rate for Payer: BCN Commercial |
$675.67
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$819.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$871.49
|
| Rate for Payer: Healthscope Whirlpool |
$845.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$784.34
|
| 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 |
$740.77
|
| 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 |
$610.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,969.24
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.39
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.91
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$610.04 |
| Max. Negotiated Rate |
$871.49 |
| Rate for Payer: Aetna Commercial |
$784.34
|
| Rate for Payer: ASR ASR |
$845.35
|
| Rate for Payer: BCBS Trust/PPO |
$675.67
|
| Rate for Payer: BCN Commercial |
$675.67
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$819.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Healthscope Commercial |
$871.49
|
| Rate for Payer: Healthscope Whirlpool |
$845.35
|
| Rate for Payer: Mclaren Commercial |
$784.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$740.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.91
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,199.20
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,539.44 |
| Max. Negotiated Rate |
$2,199.20 |
| Rate for Payer: Aetna Commercial |
$1,979.28
|
| Rate for Payer: ASR ASR |
$2,133.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.04
|
| Rate for Payer: BCN Commercial |
$1,705.04
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$2,067.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Healthscope Commercial |
$2,199.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,133.22
|
| Rate for Payer: Mclaren Commercial |
$1,979.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,935.30
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,199.20
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,199.20 |
| Rate for Payer: Aetna Commercial |
$1,979.28
|
| 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 |
$2,133.22
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.04
|
| Rate for Payer: BCN Commercial |
$1,705.04
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$2,067.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,199.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,133.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,979.28
|
| 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 |
$1,869.32
|
| 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 |
$1,539.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.15
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,290.52
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,935.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$801.72
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,613.15 |
| Rate for Payer: Aetna Commercial |
$721.55
|
| 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 |
$777.67
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$621.57
|
| Rate for Payer: BCN Commercial |
$621.57
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cofinity Commercial |
$753.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$801.72
|
| Rate for Payer: Healthscope Whirlpool |
$777.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$721.55
|
| 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 |
$681.46
|
| 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 |
$561.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.15
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,290.52
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$705.51
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$801.72
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$561.20 |
| Max. Negotiated Rate |
$801.72 |
| Rate for Payer: Aetna Commercial |
$721.55
|
| Rate for Payer: ASR ASR |
$777.67
|
| Rate for Payer: BCBS Trust/PPO |
$621.57
|
| Rate for Payer: BCN Commercial |
$621.57
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cofinity Commercial |
$753.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.38
|
| Rate for Payer: Healthscope Commercial |
$801.72
|
| Rate for Payer: Healthscope Whirlpool |
$777.67
|
| Rate for Payer: Mclaren Commercial |
$721.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$705.51
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,235.53
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,235.53 |
| Rate for Payer: Aetna Commercial |
$2,011.98
|
| 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 |
$2,168.46
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.21
|
| Rate for Payer: BCN Commercial |
$1,733.21
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cofinity Commercial |
$2,101.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,788.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,235.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,168.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$2,011.98
|
| 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 |
$1,900.20
|
| 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 |
$1,564.87
|
| 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 |
$1,967.27
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,235.53
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,564.87 |
| Max. Negotiated Rate |
$2,235.53 |
| Rate for Payer: Aetna Commercial |
$2,011.98
|
| Rate for Payer: ASR ASR |
$2,168.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.21
|
| Rate for Payer: BCN Commercial |
$1,733.21
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cofinity Commercial |
$2,101.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,788.42
|
| Rate for Payer: Healthscope Commercial |
$2,235.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,168.46
|
| Rate for Payer: Mclaren Commercial |
$2,011.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,900.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,564.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,967.27
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,047.14
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,433.00 |
| Max. Negotiated Rate |
$2,047.14 |
| Rate for Payer: Aetna Commercial |
$1,842.43
|
| Rate for Payer: ASR ASR |
$1,985.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,587.15
|
| Rate for Payer: BCN Commercial |
$1,587.15
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cofinity Commercial |
$1,924.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.71
|
| Rate for Payer: Healthscope Commercial |
$2,047.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,985.73
|
| Rate for Payer: Mclaren Commercial |
$1,842.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,740.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,801.48
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,047.14
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,047.14 |
| Rate for Payer: Aetna Commercial |
$1,842.43
|
| 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 |
$1,985.73
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,587.15
|
| Rate for Payer: BCN Commercial |
$1,587.15
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cofinity Commercial |
$1,924.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,047.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,985.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,842.43
|
| 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 |
$1,740.07
|
| 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 |
$1,433.00
|
| 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 |
$1,801.48
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,121.05
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$3,121.05 |
| Rate for Payer: Aetna Commercial |
$2,808.94
|
| 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 |
$3,027.42
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.75
|
| Rate for Payer: BCN Commercial |
$2,419.75
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cofinity Commercial |
$2,933.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,496.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,121.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,027.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,808.94
|
| 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 |
$2,652.89
|
| 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 |
$2,184.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,924.08
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,539.26
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,746.52
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,121.05
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,184.74 |
| Max. Negotiated Rate |
$3,121.05 |
| Rate for Payer: Aetna Commercial |
$2,808.94
|
| Rate for Payer: ASR ASR |
$3,027.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.75
|
| Rate for Payer: BCN Commercial |
$2,419.75
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cofinity Commercial |
$2,933.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,496.84
|
| Rate for Payer: Healthscope Commercial |
$3,121.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,027.42
|
| Rate for Payer: Mclaren Commercial |
$2,808.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,652.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,184.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,746.52
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,858.04
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,858.04 |
| Rate for Payer: Aetna Commercial |
$2,572.24
|
| 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 |
$2,772.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,215.84
|
| Rate for Payer: BCN Commercial |
$2,215.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cofinity Commercial |
$2,686.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,286.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,858.04
|
| Rate for Payer: Healthscope Whirlpool |
$2,772.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,572.24
|
| 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 |
$2,429.33
|
| 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 |
$2,000.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,924.08
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,539.26
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,515.08
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,858.04
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,000.63 |
| Max. Negotiated Rate |
$2,858.04 |
| Rate for Payer: Aetna Commercial |
$2,572.24
|
| Rate for Payer: ASR ASR |
$2,772.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,215.84
|
| Rate for Payer: BCN Commercial |
$2,215.84
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cofinity Commercial |
$2,686.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,286.43
|
| Rate for Payer: Healthscope Commercial |
$2,858.04
|
| Rate for Payer: Healthscope Whirlpool |
$2,772.30
|
| Rate for Payer: Mclaren Commercial |
$2,572.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,429.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,000.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,515.08
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$785.40 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: BCBS Trust/PPO |
$869.89
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,698.84 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| 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 |
$1,088.34
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$869.89
|
| Rate for Payer: BCN Commercial |
$869.89
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,122.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| 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 |
$953.70
|
| 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 |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.07
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.36
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,897.91
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,328.54 |
| Max. Negotiated Rate |
$1,897.91 |
| Rate for Payer: Aetna Commercial |
$1,708.12
|
| Rate for Payer: ASR ASR |
$1,840.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.45
|
| Rate for Payer: BCN Commercial |
$1,471.45
|
| Rate for Payer: Cash Price |
$1,518.33
|
| Rate for Payer: Cofinity Commercial |
$1,784.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.33
|
| Rate for Payer: Healthscope Commercial |
$1,897.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,840.97
|
| Rate for Payer: Mclaren Commercial |
$1,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,670.16
|
|
