|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
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 UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
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 UNI WO W CON
|
Facility
|
OP
|
$1,600.76
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,600.76 |
| Rate for Payer: Aetna Commercial |
$1,440.68
|
| Rate for Payer: Aetna Commercial |
$2,161.02
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$2,329.10
|
| Rate for Payer: ASR ASR |
$1,552.74
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.83
|
| Rate for Payer: BCN Commercial |
$1,319.83
|
| Rate for Payer: BCN Commercial |
$1,979.73
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$1,504.71
|
| Rate for Payer: Cofinity Commercial |
$2,257.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,552.74
|
| Rate for Payer: Healthscope Commercial |
$2,329.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,401.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,161.02
|
| Rate for Payer: Mclaren Commercial |
$1,440.68
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,402.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,103.87
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,683.19
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$1,600.76
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,200.57 |
| Max. Negotiated Rate |
$1,600.76 |
| Rate for Payer: Aetna Commercial |
$1,440.68
|
| Rate for Payer: Aetna Commercial |
$2,161.02
|
| Rate for Payer: ASR ASR |
$1,552.74
|
| Rate for Payer: ASR ASR |
$2,329.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.81
|
| Rate for Payer: BCN Commercial |
$1,314.54
|
| Rate for Payer: BCN Commercial |
$1,971.81
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cofinity Commercial |
$2,257.06
|
| Rate for Payer: Cofinity Commercial |
$1,504.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Healthscope Commercial |
$1,552.74
|
| Rate for Payer: Healthscope Commercial |
$2,329.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,401.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.76
|
| Rate for Payer: Mclaren Commercial |
$2,161.02
|
| Rate for Payer: Mclaren Commercial |
$1,440.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.67
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$2,401.13
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$297.33 |
| Max. Negotiated Rate |
$2,401.13 |
| Rate for Payer: Aetna Commercial |
$2,161.02
|
| Rate for Payer: Aetna Commercial |
$1,440.68
|
| Rate for Payer: Aetna Medicare |
$888.42
|
| Rate for Payer: Aetna Medicare |
$592.28
|
| Rate for Payer: ASR ASR |
$1,552.74
|
| Rate for Payer: ASR ASR |
$2,329.10
|
| Rate for Payer: BCBS Complete |
$960.45
|
| Rate for Payer: BCBS Complete |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.73
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCN Commercial |
$1,319.83
|
| Rate for Payer: BCN Commercial |
$1,979.73
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$1,504.71
|
| Rate for Payer: Cofinity Commercial |
$2,257.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Healthscope Commercial |
$2,329.10
|
| Rate for Payer: Healthscope Commercial |
$1,552.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,401.13
|
| Rate for Payer: Mclaren Commercial |
$2,161.02
|
| Rate for Payer: Mclaren Commercial |
$1,440.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,280.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,920.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$371.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$371.66
|
| Rate for Payer: Priority Health Narrow Network |
$297.33
|
| Rate for Payer: Priority Health Narrow Network |
$297.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.99
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$1,600.76
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,200.57 |
| Max. Negotiated Rate |
$1,600.76 |
| Rate for Payer: Aetna Commercial |
$1,440.68
|
| Rate for Payer: Aetna Commercial |
$2,161.02
|
| Rate for Payer: ASR ASR |
$1,552.74
|
| Rate for Payer: ASR ASR |
$2,329.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.81
|
| Rate for Payer: BCN Commercial |
$1,314.54
|
| Rate for Payer: BCN Commercial |
$1,971.81
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cofinity Commercial |
$2,257.06
|
| Rate for Payer: Cofinity Commercial |
$1,504.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Healthscope Commercial |
$1,552.74
|
| Rate for Payer: Healthscope Commercial |
$2,329.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,401.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.76
|
| Rate for Payer: Mclaren Commercial |
$2,161.02
|
| Rate for Payer: Mclaren Commercial |
$1,440.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.67
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,175.58 |
| Rate for Payer: Aetna Commercial |
$1,958.02
|
| 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 |
$2,110.31
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.77
|
| Rate for Payer: BCCCP Commercial |
$207.57
|
| Rate for Payer: BCN Commercial |
$1,793.77
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| 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 |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,110.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| 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 |
$1,849.24
|
| 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 |
$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 |
$291.03
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$232.82
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
| 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 BREAST WO CON BIL
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
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 WO CON UNI
|
Facility
|
IP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,200.11 |
| Max. Negotiated Rate |
$1,600.14 |
| Rate for Payer: Aetna Commercial |
$1,440.13
|
| Rate for Payer: ASR ASR |
$1,552.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.03
|
| Rate for Payer: BCN Commercial |
$1,314.03
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Commercial |
$1,504.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Healthscope Commercial |
$1,552.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.14
|
| Rate for Payer: Mclaren Commercial |
$1,440.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.12
|
| Rate for Payer: Nomi Health Commercial |
$1,312.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.12
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,600.14 |
| Rate for Payer: Aetna Commercial |
$1,440.13
|
| 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 |
$1,552.14
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.32
|
| Rate for Payer: BCCCP Commercial |
$201.08
|
| Rate for Payer: BCN Commercial |
$1,319.32
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Commercial |
$1,504.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,552.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,600.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,440.13
|
| 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 |
$1,360.12
|
| Rate for Payer: Nomi Health Commercial |
$1,312.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| 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 |
$291.03
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$232.82
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,408.12
|
| 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 CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,196.70
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,196.70 |
| Rate for Payer: Aetna Commercial |
$1,977.03
|
| 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 |
$2,130.80
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,811.18
|
| Rate for Payer: BCN Commercial |
$1,811.18
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cofinity Commercial |
$2,064.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,757.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,130.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,196.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,977.03
|
| 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 |
$1,867.19
|
| Rate for Payer: Nomi Health Commercial |
$1,801.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,647.53
|
| 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 |
$1,924.75
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,539.89
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,933.10
|
| 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 CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,196.70
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,647.53 |
| Max. Negotiated Rate |
$2,196.70 |
| Rate for Payer: Aetna Commercial |
$1,977.03
|
| Rate for Payer: ASR ASR |
$2,130.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.93
|
| Rate for Payer: BCN Commercial |
$1,803.93
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cofinity Commercial |
$2,064.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,757.36
|
| Rate for Payer: Healthscope Commercial |
$2,130.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,196.70
|
| Rate for Payer: Mclaren Commercial |
$1,977.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,867.19
|
| Rate for Payer: Nomi Health Commercial |
$1,801.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,647.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,933.10
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$758.10 |
| Max. Negotiated Rate |
$1,010.80 |
| Rate for Payer: Aetna Commercial |
$909.72
|
| Rate for Payer: ASR ASR |
$980.48
|
| Rate for Payer: BCBS Trust/PPO |
$830.07
|
| Rate for Payer: BCN Commercial |
$830.07
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Commercial |
$950.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Healthscope Commercial |
$980.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,010.80
|
| Rate for Payer: Mclaren Commercial |
$909.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.18
|
| Rate for Payer: Nomi Health Commercial |
$828.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$889.50
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,010.80 |
| Rate for Payer: Aetna Commercial |
$909.72
|
| 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 |
$980.48
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$833.40
|
| Rate for Payer: BCN Commercial |
$833.40
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Commercial |
$950.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$980.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,010.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$909.72
|
| 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 |
$859.18
|
| Rate for Payer: Nomi Health Commercial |
$828.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| 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 |
$885.66
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$708.57
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$889.50
|
| 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 CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$467.71 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna Commercial |
$1,137.68
|
| Rate for Payer: Aetna Medicare |
$467.71
|
| Rate for Payer: ASR ASR |
$1,226.17
|
| Rate for Payer: BCBS Complete |
$505.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.24
|
| Rate for Payer: BCN Commercial |
$1,042.24
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Commercial |
$1,188.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Healthscope Commercial |
$1,226.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,264.09
|
| Rate for Payer: Mclaren Commercial |
$1,137.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,011.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Nomi Health Commercial |
$1,036.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,107.60
|
| Rate for Payer: Priority Health Narrow Network |
$886.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.40
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$948.07 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna Commercial |
$1,137.68
|
| Rate for Payer: ASR ASR |
$1,226.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.07
|
| Rate for Payer: BCN Commercial |
$1,038.07
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Commercial |
$1,188.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Healthscope Commercial |
$1,226.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,264.09
|
| Rate for Payer: Mclaren Commercial |
$1,137.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Nomi Health Commercial |
$1,036.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.40
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,784.74 |
| Max. Negotiated Rate |
$2,379.66 |
| Rate for Payer: Aetna Commercial |
$2,141.69
|
| Rate for Payer: ASR ASR |
$2,308.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,954.18
|
| Rate for Payer: BCN Commercial |
$1,954.18
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Commercial |
$2,236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Healthscope Commercial |
$2,308.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,379.66
|
| Rate for Payer: Mclaren Commercial |
$2,141.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Nomi Health Commercial |
$1,951.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,094.10
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,379.66 |
| Rate for Payer: Aetna Commercial |
$2,141.69
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: ASR ASR |
$2,308.27
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.03
|
| Rate for Payer: BCN Commercial |
$1,962.03
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Commercial |
$2,236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,308.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,379.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$2,141.69
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Nomi Health Commercial |
$1,951.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,004.08
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.27
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,094.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,554.67 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,702.27
|
| Rate for Payer: BCN Commercial |
$1,702.27
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$2,010.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,072.90
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| 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 |
$2,010.71
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.11
|
| Rate for Payer: BCN Commercial |
$1,709.11
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,010.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,072.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| 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 |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| 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 |
$1,738.36
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,390.69
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
| 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 CHEST WO W CON
|
Facility
|
OP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,113.86 |
| Rate for Payer: Aetna Commercial |
$2,802.47
|
| 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 |
$3,020.44
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,567.38
|
| Rate for Payer: BCN Commercial |
$2,567.38
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,927.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,020.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,802.47
|
| 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 |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| 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 |
$2,290.97
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,832.78
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,740.20
|
| 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 CHEST WO W CON
|
Facility
|
IP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,335.39 |
| Max. Negotiated Rate |
$3,113.86 |
| Rate for Payer: Aetna Commercial |
$2,802.47
|
| Rate for Payer: ASR ASR |
$3,020.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,557.10
|
| Rate for Payer: BCN Commercial |
$2,557.10
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,927.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Healthscope Commercial |
$3,020.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.86
|
| Rate for Payer: Mclaren Commercial |
$2,802.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,740.20
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$275.38 |
| Max. Negotiated Rate |
$367.18 |
| Rate for Payer: Aetna Commercial |
$330.46
|
| Rate for Payer: ASR ASR |
$356.16
|
| Rate for Payer: BCBS Trust/PPO |
$301.53
|
| Rate for Payer: BCN Commercial |
$301.53
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Commercial |
$345.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Healthscope Commercial |
$356.16
|
| Rate for Payer: Healthscope Whirlpool |
$367.18
|
| Rate for Payer: Mclaren Commercial |
$330.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.10
|
| Rate for Payer: Nomi Health Commercial |
$301.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.12
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$368.50 |
| Rate for Payer: Aetna Commercial |
$330.46
|
| 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 |
$356.16
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$302.74
|
| Rate for Payer: BCN Commercial |
$302.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Commercial |
$345.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$356.16
|
| Rate for Payer: Healthscope Whirlpool |
$367.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$330.46
|
| 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 |
$312.10
|
| Rate for Payer: Nomi Health Commercial |
$301.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| 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 |
$291.03
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$232.82
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.12
|
| 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 FAST BREAST SCREEN SELF PAY
|
Facility
|
IP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$201.79 |
| Max. Negotiated Rate |
$269.05 |
| Rate for Payer: Aetna Commercial |
$242.15
|
| Rate for Payer: ASR ASR |
$260.98
|
| Rate for Payer: BCBS Trust/PPO |
$220.94
|
| Rate for Payer: BCN Commercial |
$220.94
|
| Rate for Payer: Cash Price |
$215.24
|
| Rate for Payer: Cofinity Commercial |
$252.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.24
|
| Rate for Payer: Healthscope Commercial |
$260.98
|
| Rate for Payer: Healthscope Whirlpool |
$269.05
|
| Rate for Payer: Mclaren Commercial |
$242.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.69
|
| Rate for Payer: Nomi Health Commercial |
$220.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.76
|
|
