|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,440.80
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,440.80 |
| Rate for Payer: Aetna Commercial |
$1,296.72
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,397.58
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.94
|
| Rate for Payer: BCN Commercial |
$1,187.94
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cofinity Commercial |
$1,354.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,397.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,440.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,296.72
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.68
|
| Rate for Payer: Nomi Health Commercial |
$1,181.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.60
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,262.43
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.00
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,267.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,895.09
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,421.32 |
| Max. Negotiated Rate |
$1,895.09 |
| Rate for Payer: Aetna Commercial |
$1,705.58
|
| Rate for Payer: ASR ASR |
$1,838.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.25
|
| Rate for Payer: BCN Commercial |
$1,556.25
|
| Rate for Payer: Cash Price |
$1,516.07
|
| Rate for Payer: Cofinity Commercial |
$1,781.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,516.07
|
| Rate for Payer: Healthscope Commercial |
$1,838.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,895.09
|
| Rate for Payer: Mclaren Commercial |
$1,705.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,610.83
|
| Rate for Payer: Nomi Health Commercial |
$1,553.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,421.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,667.68
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,895.09
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$701.18 |
| Max. Negotiated Rate |
$1,895.09 |
| Rate for Payer: Aetna Commercial |
$1,705.58
|
| Rate for Payer: Aetna Medicare |
$701.18
|
| Rate for Payer: ASR ASR |
$1,838.24
|
| Rate for Payer: BCBS Complete |
$758.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,562.50
|
| Rate for Payer: BCN Commercial |
$1,562.50
|
| Rate for Payer: Cash Price |
$1,516.07
|
| Rate for Payer: Cofinity Commercial |
$1,781.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,516.07
|
| Rate for Payer: Healthscope Commercial |
$1,838.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,895.09
|
| Rate for Payer: Mclaren Commercial |
$1,705.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,516.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,610.83
|
| Rate for Payer: Nomi Health Commercial |
$1,553.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,421.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,660.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,667.68
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,579.23
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,184.42 |
| Max. Negotiated Rate |
$1,579.23 |
| Rate for Payer: Aetna Commercial |
$1,421.31
|
| Rate for Payer: ASR ASR |
$1,531.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.86
|
| Rate for Payer: BCN Commercial |
$1,296.86
|
| Rate for Payer: Cash Price |
$1,263.38
|
| Rate for Payer: Cofinity Commercial |
$1,484.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.38
|
| Rate for Payer: Healthscope Commercial |
$1,531.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,579.23
|
| Rate for Payer: Mclaren Commercial |
$1,421.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.35
|
| Rate for Payer: Nomi Health Commercial |
$1,294.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,184.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,389.72
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,579.23
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$584.32 |
| Max. Negotiated Rate |
$1,579.23 |
| Rate for Payer: Aetna Commercial |
$1,421.31
|
| Rate for Payer: Aetna Medicare |
$584.32
|
| Rate for Payer: ASR ASR |
$1,531.85
|
| Rate for Payer: BCBS Complete |
$631.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,302.08
|
| Rate for Payer: BCN Commercial |
$1,302.08
|
| Rate for Payer: Cash Price |
$1,263.38
|
| Rate for Payer: Cofinity Commercial |
$1,484.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.38
|
| Rate for Payer: Healthscope Commercial |
$1,531.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,579.23
|
| Rate for Payer: Mclaren Commercial |
$1,421.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,263.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.35
|
| Rate for Payer: Nomi Health Commercial |
$1,294.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,184.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,383.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,389.72
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
IP
|
$2,413.21
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,809.91 |
| Max. Negotiated Rate |
$2,413.21 |
| Rate for Payer: Aetna Commercial |
$2,171.89
|
| Rate for Payer: ASR ASR |
$2,340.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.73
|
| Rate for Payer: BCN Commercial |
$1,981.73
|
| Rate for Payer: Cash Price |
$1,930.57
|
| Rate for Payer: Cofinity Commercial |
$2,268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.57
|
| Rate for Payer: Healthscope Commercial |
$2,340.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,413.21
|
| Rate for Payer: Mclaren Commercial |
$2,171.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.23
|
| Rate for Payer: Nomi Health Commercial |
$1,978.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,123.62
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
OP
|
$2,413.21
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$892.89 |
| Max. Negotiated Rate |
$2,413.21 |
| Rate for Payer: Aetna Commercial |
$2,171.89
|
| Rate for Payer: Aetna Medicare |
$892.89
|
| Rate for Payer: ASR ASR |
$2,340.81
|
| Rate for Payer: BCBS Complete |
$965.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.69
|
| Rate for Payer: BCN Commercial |
$1,989.69
|
| Rate for Payer: Cash Price |
$1,930.57
|
| Rate for Payer: Cofinity Commercial |
$2,268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.57
|
| Rate for Payer: Healthscope Commercial |
$2,340.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,413.21
|
| Rate for Payer: Mclaren Commercial |
$2,171.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,930.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.23
|
| Rate for Payer: Nomi Health Commercial |
$1,978.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,114.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,123.62
|
|
|
HC MR BRAIN W CON
|
Facility
|
IP
|
$2,537.03
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,902.77 |
| Max. Negotiated Rate |
$2,537.03 |
| Rate for Payer: Aetna Commercial |
$2,283.33
|
| Rate for Payer: ASR ASR |
$2,460.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,083.41
|
| Rate for Payer: BCN Commercial |
$2,083.41
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cofinity Commercial |
$2,384.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.62
|
| Rate for Payer: Healthscope Commercial |
$2,460.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,537.03
|
| Rate for Payer: Mclaren Commercial |
$2,283.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,156.48
|
| Rate for Payer: Nomi Health Commercial |
$2,080.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,902.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.59
|
|
|
HC MR BRAIN W CON
|
Facility
|
OP
|
$2,537.03
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,537.03 |
| Rate for Payer: Aetna Commercial |
$2,283.33
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$2,460.92
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,091.78
|
| Rate for Payer: BCN Commercial |
$2,091.78
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cash Price |
$2,029.62
|
| Rate for Payer: Cofinity Commercial |
$2,384.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,460.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,537.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,283.33
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,156.48
|
| Rate for Payer: Nomi Health Commercial |
$2,080.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,902.77
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,114.36
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,585.77 |
| Max. Negotiated Rate |
$2,114.36 |
| Rate for Payer: Aetna Commercial |
$1,902.92
|
| Rate for Payer: ASR ASR |
$2,050.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,736.31
|
| Rate for Payer: BCN Commercial |
$1,736.31
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Commercial |
$1,987.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Healthscope Commercial |
$2,050.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.36
|
| Rate for Payer: Mclaren Commercial |
$1,902.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$1,733.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,860.64
|
|
|
HC MR BRAIN WO CON
|
Facility
|
OP
|
$2,114.36
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,114.36 |
| Rate for Payer: Aetna Commercial |
$1,902.92
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$2,050.93
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,743.29
|
| Rate for Payer: BCN Commercial |
$1,743.29
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Commercial |
$1,987.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,050.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,902.92
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$1,733.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,682.06
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.65
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,860.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
IP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,421.78 |
| Max. Negotiated Rate |
$3,229.04 |
| Rate for Payer: Aetna Commercial |
$2,906.14
|
| Rate for Payer: ASR ASR |
$3,132.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,651.69
|
| Rate for Payer: BCN Commercial |
$2,651.69
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Commercial |
$3,035.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Healthscope Commercial |
$3,132.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,229.04
|
| Rate for Payer: Mclaren Commercial |
$2,906.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,744.68
|
| Rate for Payer: Nomi Health Commercial |
$2,647.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,841.56
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
OP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,229.04 |
| Rate for Payer: Aetna Commercial |
$2,906.14
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$3,132.17
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,662.34
|
| Rate for Payer: BCN Commercial |
$2,662.34
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Commercial |
$3,035.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,132.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,229.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,906.14
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,744.68
|
| Rate for Payer: Nomi Health Commercial |
$2,647.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,323.06
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,858.45
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,841.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$944.41 |
| Max. Negotiated Rate |
$1,259.22 |
| Rate for Payer: Aetna Commercial |
$1,133.30
|
| Rate for Payer: ASR ASR |
$1,221.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.07
|
| Rate for Payer: BCN Commercial |
$1,034.07
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,183.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,221.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,259.22
|
| Rate for Payer: Mclaren Commercial |
$1,133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.11
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,259.22 |
| Rate for Payer: Aetna Commercial |
$1,133.30
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$1,221.44
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.23
|
| Rate for Payer: BCN Commercial |
$1,038.23
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,183.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,221.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,259.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,133.30
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,103.33
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$882.71
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
OP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,284.40 |
| Rate for Payer: Aetna Commercial |
$1,155.96
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$1,245.87
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.99
|
| Rate for Payer: BCN Commercial |
$1,058.99
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Commercial |
$1,207.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,245.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,284.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,155.96
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,091.74
|
| Rate for Payer: Nomi Health Commercial |
$1,053.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,125.39
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$900.36
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,130.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
IP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$963.30 |
| Max. Negotiated Rate |
$1,284.40 |
| Rate for Payer: Aetna Commercial |
$1,155.96
|
| Rate for Payer: ASR ASR |
$1,245.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,054.75
|
| Rate for Payer: BCN Commercial |
$1,054.75
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Commercial |
$1,207.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Healthscope Commercial |
$1,245.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,284.40
|
| Rate for Payer: Mclaren Commercial |
$1,155.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,091.74
|
| Rate for Payer: Nomi Health Commercial |
$1,053.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,130.27
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,175.58 |
| Rate for Payer: Aetna Commercial |
$1,958.02
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.77
|
| Rate for Payer: BCN Commercial |
$1,793.77
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,110.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,906.24
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,525.08
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,631.68 |
| Max. Negotiated Rate |
$2,175.58 |
| Rate for Payer: Aetna Commercial |
$1,958.02
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,786.59
|
| Rate for Payer: BCN Commercial |
$1,786.59
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$2,110.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.58
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
OP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$295.87 |
| Max. Negotiated Rate |
$2,219.09 |
| Rate for Payer: Aetna Commercial |
$1,997.18
|
| Rate for Payer: Aetna Medicare |
$821.06
|
| Rate for Payer: ASR ASR |
$2,152.52
|
| Rate for Payer: BCBS Complete |
$887.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,829.64
|
| Rate for Payer: BCCCP Commercial |
$324.98
|
| Rate for Payer: BCN Commercial |
$1,829.64
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Commercial |
$2,085.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Healthscope Commercial |
$2,152.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,219.09
|
| Rate for Payer: Mclaren Commercial |
$1,997.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,775.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Nomi Health Commercial |
$1,819.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$369.84
|
| Rate for Payer: Priority Health Narrow Network |
$295.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,952.80
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
IP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,664.32 |
| Max. Negotiated Rate |
$2,219.09 |
| Rate for Payer: Aetna Commercial |
$1,997.18
|
| Rate for Payer: ASR ASR |
$2,152.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,822.32
|
| Rate for Payer: BCN Commercial |
$1,822.32
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Commercial |
$2,085.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Healthscope Commercial |
$2,152.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,219.09
|
| Rate for Payer: Mclaren Commercial |
$1,997.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Nomi Health Commercial |
$1,819.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,952.80
|
|
|
HC MR BREAST CAD
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$15.71
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$16.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Narrow Network |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC MR BREAST CAD
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
OP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$926.58 |
| Rate for Payer: Aetna Commercial |
$833.92
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$898.78
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$763.97
|
| Rate for Payer: BCN Commercial |
$763.97
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Commercial |
$870.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$898.78
|
| Rate for Payer: Healthscope Whirlpool |
$926.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$833.92
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Nomi Health Commercial |
$759.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$811.87
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$649.53
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$694.93 |
| Max. Negotiated Rate |
$926.58 |
| Rate for Payer: Aetna Commercial |
$833.92
|
| Rate for Payer: ASR ASR |
$898.78
|
| Rate for Payer: BCBS Trust/PPO |
$760.91
|
| Rate for Payer: BCN Commercial |
$760.91
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Commercial |
$870.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Healthscope Commercial |
$898.78
|
| Rate for Payer: Healthscope Whirlpool |
$926.58
|
| Rate for Payer: Mclaren Commercial |
$833.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Nomi Health Commercial |
$759.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.39
|
|
