|
HC MR FAST BREAST SCREEN SELF PAY
|
Facility
|
OP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$99.55 |
| Max. Negotiated Rate |
$269.05 |
| Rate for Payer: Aetna Commercial |
$242.15
|
| Rate for Payer: Aetna Medicare |
$99.55
|
| Rate for Payer: ASR ASR |
$260.98
|
| Rate for Payer: BCBS Complete |
$107.62
|
| Rate for Payer: BCBS Trust/PPO |
$221.83
|
| Rate for Payer: BCN Commercial |
$221.83
|
| 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: MI Amish Medical Board Commercial |
$215.24
|
| 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: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$188.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.76
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$394.61 |
| Max. Negotiated Rate |
$1,066.51 |
| Rate for Payer: Aetna Commercial |
$959.86
|
| Rate for Payer: Aetna Medicare |
$394.61
|
| Rate for Payer: ASR ASR |
$1,034.51
|
| Rate for Payer: BCBS Complete |
$426.60
|
| Rate for Payer: BCBS Trust/PPO |
$879.34
|
| Rate for Payer: BCN Commercial |
$879.34
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Commercial |
$1,002.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Healthscope Commercial |
$1,034.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,066.51
|
| Rate for Payer: Mclaren Commercial |
$959.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$853.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Nomi Health Commercial |
$874.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$934.48
|
| Rate for Payer: Priority Health Narrow Network |
$747.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$938.53
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$799.88 |
| Max. Negotiated Rate |
$1,066.51 |
| Rate for Payer: Aetna Commercial |
$959.86
|
| Rate for Payer: ASR ASR |
$1,034.51
|
| Rate for Payer: BCBS Trust/PPO |
$875.82
|
| Rate for Payer: BCN Commercial |
$875.82
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Commercial |
$1,002.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Healthscope Commercial |
$1,034.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,066.51
|
| Rate for Payer: Mclaren Commercial |
$959.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Nomi Health Commercial |
$874.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$938.53
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,306.46 |
| Max. Negotiated Rate |
$3,075.28 |
| Rate for Payer: Aetna Commercial |
$2,767.75
|
| Rate for Payer: ASR ASR |
$2,983.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,525.42
|
| Rate for Payer: BCN Commercial |
$2,525.42
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Commercial |
$2,890.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Healthscope Commercial |
$2,983.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,075.28
|
| Rate for Payer: Mclaren Commercial |
$2,767.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,613.99
|
| Rate for Payer: Nomi Health Commercial |
$2,521.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,706.25
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,075.28 |
| Rate for Payer: Aetna Commercial |
$2,767.75
|
| 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 |
$2,983.02
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,535.57
|
| Rate for Payer: BCN Commercial |
$2,535.57
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Commercial |
$2,890.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,983.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,075.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,767.75
|
| 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 |
$2,613.99
|
| Rate for Payer: Nomi Health Commercial |
$2,521.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| 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 |
$2,168.71
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,734.97
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,706.25
|
| 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 LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,722.83 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: Aetna Commercial |
$3,101.09
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR ASR |
$3,342.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,886.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,829.57
|
| Rate for Payer: BCN Commercial |
$1,886.38
|
| Rate for Payer: BCN Commercial |
$2,829.57
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$3,238.91
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Healthscope Commercial |
$2,228.19
|
| Rate for Payer: Healthscope Commercial |
$3,342.28
|
| Rate for Payer: Healthscope Whirlpool |
$3,445.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,297.10
|
| Rate for Payer: Mclaren Commercial |
$3,101.09
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$2,825.43
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,032.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: Aetna Commercial |
$3,101.09
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR ASR |
$3,342.28
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,840.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$2,840.94
|
| Rate for Payer: BCN Commercial |
$1,893.96
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Cofinity Commercial |
$3,238.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,228.19
|
| Rate for Payer: Healthscope Commercial |
$3,342.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,445.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$3,101.09
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Nomi Health Commercial |
$2,825.43
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,032.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,478.67 |
| Max. Negotiated Rate |
$1,971.56 |
| Rate for Payer: Aetna Commercial |
$1,774.40
|
| Rate for Payer: Aetna Commercial |
$2,661.61
|
| Rate for Payer: ASR ASR |
$1,912.41
|
| Rate for Payer: ASR ASR |
$2,868.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,619.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,428.57
|
| Rate for Payer: BCN Commercial |
$1,619.05
|
| Rate for Payer: BCN Commercial |
$2,428.57
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$2,779.90
|
| Rate for Payer: Cofinity Commercial |
$1,853.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Healthscope Commercial |
$1,912.41
|
| Rate for Payer: Healthscope Commercial |
$2,868.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,957.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,971.56
|
| Rate for Payer: Mclaren Commercial |
$2,661.61
|
| Rate for Payer: Mclaren Commercial |
$1,774.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$2,425.02
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,602.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.97
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,971.56 |
| Rate for Payer: Aetna Commercial |
$1,774.40
|
| Rate for Payer: Aetna Commercial |
$2,661.61
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,912.41
|
| Rate for Payer: ASR ASR |
$2,868.62
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,438.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.55
|
| Rate for Payer: BCN Commercial |
$2,438.33
|
| Rate for Payer: BCN Commercial |
$1,625.55
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cofinity Commercial |
$1,853.27
|
| Rate for Payer: Cofinity Commercial |
$2,779.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,912.41
|
| Rate for Payer: Healthscope Commercial |
$2,868.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,971.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,957.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$2,661.61
|
| Rate for Payer: Mclaren Commercial |
$1,774.40
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Nomi Health Commercial |
$2,425.02
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,838.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,838.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.07
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,602.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,584.24
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,584.24 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| Rate for Payer: Aetna Commercial |
$3,488.73
|
| 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 |
$2,506.71
|
| Rate for Payer: ASR ASR |
$3,760.08
|
| 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 |
$3,196.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,130.71
|
| Rate for Payer: BCN Commercial |
$3,196.07
|
| Rate for Payer: BCN Commercial |
$2,130.71
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cofinity Commercial |
$2,429.19
|
| Rate for Payer: Cofinity Commercial |
$3,643.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,101.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| 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 |
$2,506.71
|
| Rate for Payer: Healthscope Commercial |
$3,760.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,584.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,876.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$3,488.73
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| 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 |
$2,196.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Nomi Health Commercial |
$3,178.62
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,907.28
|
| 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 |
$2,168.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,168.71
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,734.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,734.97
|
| 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 |
$3,411.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.13
|
| 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 LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,584.24
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,938.18 |
| Max. Negotiated Rate |
$2,584.24 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| Rate for Payer: Aetna Commercial |
$3,488.73
|
| Rate for Payer: ASR ASR |
$2,506.71
|
| Rate for Payer: ASR ASR |
$3,760.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,122.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,183.28
|
| Rate for Payer: BCN Commercial |
$2,122.18
|
| Rate for Payer: BCN Commercial |
$3,183.28
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cofinity Commercial |
$3,643.79
|
| Rate for Payer: Cofinity Commercial |
$2,429.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,101.10
|
| Rate for Payer: Healthscope Commercial |
$2,506.71
|
| Rate for Payer: Healthscope Commercial |
$3,760.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,876.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,584.24
|
| Rate for Payer: Mclaren Commercial |
$3,488.73
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| Rate for Payer: Nomi Health Commercial |
$3,178.62
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,907.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,411.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.13
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,440.78
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,440.78 |
| Rate for Payer: Aetna Commercial |
$2,196.70
|
| 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 |
$2,367.56
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,012.42
|
| Rate for Payer: BCN Commercial |
$2,012.42
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,952.62
|
| Rate for Payer: Cash Price |
$1,952.62
|
| Rate for Payer: Cofinity Commercial |
$2,294.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,952.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,367.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,440.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$2,196.70
|
| 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 |
$2,074.66
|
| Rate for Payer: Nomi Health Commercial |
$2,001.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,830.59
|
| 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 |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,147.89
|
| 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 LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,440.78
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,830.59 |
| Max. Negotiated Rate |
$2,440.78 |
| Rate for Payer: Aetna Commercial |
$2,196.70
|
| Rate for Payer: ASR ASR |
$2,367.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,004.37
|
| Rate for Payer: BCN Commercial |
$2,004.37
|
| Rate for Payer: Cash Price |
$1,952.62
|
| Rate for Payer: Cofinity Commercial |
$2,294.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,952.62
|
| Rate for Payer: Healthscope Commercial |
$2,367.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,440.78
|
| Rate for Payer: Mclaren Commercial |
$2,196.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,074.66
|
| Rate for Payer: Nomi Health Commercial |
$2,001.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,830.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,147.89
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
OP
|
$2,010.99
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,010.99 |
| Rate for Payer: Aetna Commercial |
$1,809.89
|
| 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 |
$1,950.66
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.06
|
| Rate for Payer: BCN Commercial |
$1,658.06
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,608.79
|
| Rate for Payer: Cash Price |
$1,608.79
|
| Rate for Payer: Cofinity Commercial |
$1,890.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,950.66
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,809.89
|
| 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 |
$1,709.34
|
| Rate for Payer: Nomi Health Commercial |
$1,649.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,508.24
|
| 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 |
$1,838.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.07
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,769.67
|
| 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 LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
IP
|
$2,010.99
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,508.24 |
| Max. Negotiated Rate |
$2,010.99 |
| Rate for Payer: Aetna Commercial |
$1,809.89
|
| Rate for Payer: ASR ASR |
$1,950.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.42
|
| Rate for Payer: BCN Commercial |
$1,651.42
|
| Rate for Payer: Cash Price |
$1,608.79
|
| Rate for Payer: Cofinity Commercial |
$1,890.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.79
|
| Rate for Payer: Healthscope Commercial |
$1,950.66
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.99
|
| Rate for Payer: Mclaren Commercial |
$1,809.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,709.34
|
| Rate for Payer: Nomi Health Commercial |
$1,649.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,508.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,769.67
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$3,014.98
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,014.98 |
| Rate for Payer: Aetna Commercial |
$2,713.48
|
| 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 |
$2,924.53
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,485.85
|
| Rate for Payer: BCN Commercial |
$2,485.85
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,834.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,924.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,014.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,713.48
|
| 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 |
$2,562.73
|
| Rate for Payer: Nomi Health Commercial |
$2,472.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,261.24
|
| 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 |
$1,902.99
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.39
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,653.18
|
| 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 LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$3,014.98
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,261.24 |
| Max. Negotiated Rate |
$3,014.98 |
| Rate for Payer: Aetna Commercial |
$2,713.48
|
| Rate for Payer: ASR ASR |
$2,924.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,475.90
|
| Rate for Payer: BCN Commercial |
$2,475.90
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,834.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Healthscope Commercial |
$2,924.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,014.98
|
| Rate for Payer: Mclaren Commercial |
$2,713.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: Nomi Health Commercial |
$2,472.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,261.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,653.18
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,343.04
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,757.28 |
| Max. Negotiated Rate |
$2,343.04 |
| Rate for Payer: Aetna Commercial |
$2,108.74
|
| Rate for Payer: ASR ASR |
$2,272.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.10
|
| Rate for Payer: BCN Commercial |
$1,924.10
|
| Rate for Payer: Cash Price |
$1,874.43
|
| Rate for Payer: Cofinity Commercial |
$2,202.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.43
|
| Rate for Payer: Healthscope Commercial |
$2,272.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,343.04
|
| Rate for Payer: Mclaren Commercial |
$2,108.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.58
|
| Rate for Payer: Nomi Health Commercial |
$1,921.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.88
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,343.04
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,343.04 |
| Rate for Payer: Aetna Commercial |
$2,108.74
|
| 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 |
$2,272.75
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.84
|
| Rate for Payer: BCN Commercial |
$1,931.84
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,874.43
|
| Rate for Payer: Cash Price |
$1,874.43
|
| Rate for Payer: Cofinity Commercial |
$2,202.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,272.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,343.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$2,108.74
|
| 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 |
$1,991.58
|
| Rate for Payer: Nomi Health Commercial |
$1,921.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.28
|
| 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 |
$2,024.04
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,619.23
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.88
|
| 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 LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
OP
|
$3,221.72
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,221.72 |
| Rate for Payer: Aetna Commercial |
$2,899.55
|
| 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 |
$3,125.07
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,656.31
|
| Rate for Payer: BCN Commercial |
$2,656.31
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,577.38
|
| Rate for Payer: Cash Price |
$2,577.38
|
| Rate for Payer: Cofinity Commercial |
$3,028.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,577.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,125.07
|
| Rate for Payer: Healthscope Whirlpool |
$3,221.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,899.55
|
| 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 |
$2,738.46
|
| Rate for Payer: Nomi Health Commercial |
$2,641.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,416.29
|
| 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 |
$1,830.98
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,464.78
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,835.11
|
| 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 LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
IP
|
$3,221.72
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,416.29 |
| Max. Negotiated Rate |
$3,221.72 |
| Rate for Payer: Aetna Commercial |
$2,899.55
|
| Rate for Payer: ASR ASR |
$3,125.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,645.68
|
| Rate for Payer: BCN Commercial |
$2,645.68
|
| Rate for Payer: Cash Price |
$2,577.38
|
| Rate for Payer: Cofinity Commercial |
$3,028.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,577.38
|
| Rate for Payer: Healthscope Commercial |
$3,125.07
|
| Rate for Payer: Healthscope Whirlpool |
$3,221.72
|
| Rate for Payer: Mclaren Commercial |
$2,899.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,738.46
|
| Rate for Payer: Nomi Health Commercial |
$2,641.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,416.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,835.11
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$2,412.00
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,412.00 |
| Rate for Payer: Aetna Commercial |
$2,170.80
|
| Rate for Payer: Aetna Commercial |
$3,256.21
|
| 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 |
$2,339.64
|
| Rate for Payer: ASR ASR |
$3,509.47
|
| 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 |
$2,983.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,988.69
|
| Rate for Payer: BCN Commercial |
$2,983.05
|
| Rate for Payer: BCN Commercial |
$1,988.69
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$2,894.41
|
| Rate for Payer: Cash Price |
$2,894.41
|
| Rate for Payer: Cofinity Commercial |
$2,267.28
|
| Rate for Payer: Cofinity Commercial |
$3,400.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,894.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.60
|
| 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 |
$2,339.64
|
| Rate for Payer: Healthscope Commercial |
$3,509.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,618.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$3,256.21
|
| Rate for Payer: Mclaren Commercial |
$2,170.80
|
| 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 |
$2,050.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,075.31
|
| Rate for Payer: Nomi Health Commercial |
$2,966.77
|
| Rate for Payer: Nomi Health Commercial |
$1,977.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,713.51
|
| 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 |
$1,902.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,902.99
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.39
|
| 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 |
$3,183.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,122.56
|
| 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 LOWER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,412.00
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,809.00 |
| Max. Negotiated Rate |
$2,412.00 |
| Rate for Payer: Aetna Commercial |
$2,170.80
|
| Rate for Payer: Aetna Commercial |
$3,256.21
|
| Rate for Payer: ASR ASR |
$2,339.64
|
| Rate for Payer: ASR ASR |
$3,509.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,980.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,971.11
|
| Rate for Payer: BCN Commercial |
$1,980.73
|
| Rate for Payer: BCN Commercial |
$2,971.11
|
| Rate for Payer: Cash Price |
$2,894.41
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cofinity Commercial |
$3,400.93
|
| Rate for Payer: Cofinity Commercial |
$2,267.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,894.41
|
| Rate for Payer: Healthscope Commercial |
$2,339.64
|
| Rate for Payer: Healthscope Commercial |
$3,509.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,618.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.00
|
| Rate for Payer: Mclaren Commercial |
$3,256.21
|
| Rate for Payer: Mclaren Commercial |
$2,170.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,075.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.20
|
| Rate for Payer: Nomi Health Commercial |
$2,966.77
|
| Rate for Payer: Nomi Health Commercial |
$1,977.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,713.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,183.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,122.56
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
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 Commercial |
$2,937.03
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: ASR ASR |
$3,165.47
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,690.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.77
|
| Rate for Payer: BCN Commercial |
$2,690.65
|
| Rate for Payer: BCN Commercial |
$1,793.77
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| 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: Cash Price |
$2,610.70
|
| Rate for Payer: Cash Price |
$2,610.70
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Cofinity Commercial |
$3,067.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,610.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,110.31
|
| Rate for Payer: Healthscope Commercial |
$3,165.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.58
|
| Rate for Payer: Healthscope Whirlpool |
$3,263.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$2,937.03
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,773.86
|
| Rate for Payer: Nomi Health Commercial |
$2,675.96
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,447.53
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,024.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,024.04
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,619.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,619.23
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,871.77
|
| 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 Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
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: Aetna Commercial |
$2,937.03
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: ASR ASR |
$3,165.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,786.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,679.88
|
| Rate for Payer: BCN Commercial |
$1,786.59
|
| Rate for Payer: BCN Commercial |
$2,679.88
|
| Rate for Payer: Cash Price |
$2,610.70
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$3,067.57
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,610.70
|
| Rate for Payer: Healthscope Commercial |
$2,110.31
|
| Rate for Payer: Healthscope Commercial |
$3,165.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,263.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.58
|
| Rate for Payer: Mclaren Commercial |
$2,937.03
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,773.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$2,675.96
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,447.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,871.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
|
