|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$2,584.24
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
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 |
$2,087.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,087.00
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,669.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,669.60
|
| 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 MRA NECK W CON
|
Facility
|
IP
|
$2,452.72
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,839.54 |
| Max. Negotiated Rate |
$2,452.72 |
| Rate for Payer: Aetna Commercial |
$2,207.45
|
| Rate for Payer: ASR ASR |
$2,379.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,014.17
|
| Rate for Payer: BCN Commercial |
$2,014.17
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cofinity Commercial |
$2,305.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.18
|
| Rate for Payer: Healthscope Commercial |
$2,379.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,452.72
|
| Rate for Payer: Mclaren Commercial |
$2,207.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.81
|
| Rate for Payer: Nomi Health Commercial |
$2,011.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,839.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,158.39
|
|
|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,452.72
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,452.72 |
| Rate for Payer: Aetna Commercial |
$2,207.45
|
| 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 |
$2,379.14
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,022.27
|
| Rate for Payer: BCN Commercial |
$2,022.27
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cash Price |
$1,962.18
|
| Rate for Payer: Cofinity Commercial |
$2,305.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,379.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,452.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,207.45
|
| 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 |
$2,084.81
|
| Rate for Payer: Nomi Health Commercial |
$2,011.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,839.54
|
| 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 |
$1,446.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.29
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,158.39
|
| 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 MRA NECK WO CON
|
Facility
|
OP
|
$2,044.95
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,044.95 |
| Rate for Payer: Aetna Commercial |
$1,840.45
|
| 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 |
$1,983.60
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.06
|
| Rate for Payer: BCN Commercial |
$1,686.06
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cofinity Commercial |
$1,922.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,983.60
|
| Rate for Payer: Healthscope Whirlpool |
$2,044.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,840.45
|
| 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 |
$1,738.21
|
| Rate for Payer: Nomi Health Commercial |
$1,676.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.71
|
| 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 |
$1,303.17
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.53
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,799.56
|
| 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 MRA NECK WO CON
|
Facility
|
IP
|
$2,044.95
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,533.71 |
| Max. Negotiated Rate |
$2,044.95 |
| Rate for Payer: Aetna Commercial |
$1,840.45
|
| Rate for Payer: ASR ASR |
$1,983.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,679.31
|
| Rate for Payer: BCN Commercial |
$1,679.31
|
| Rate for Payer: Cash Price |
$1,635.96
|
| Rate for Payer: Cofinity Commercial |
$1,922.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.96
|
| Rate for Payer: Healthscope Commercial |
$1,983.60
|
| Rate for Payer: Healthscope Whirlpool |
$2,044.95
|
| Rate for Payer: Mclaren Commercial |
$1,840.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,738.21
|
| Rate for Payer: Nomi Health Commercial |
$1,676.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,799.56
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
IP
|
$2,883.04
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$2,162.28 |
| Max. Negotiated Rate |
$2,883.04 |
| Rate for Payer: Aetna Commercial |
$2,594.74
|
| Rate for Payer: ASR ASR |
$2,796.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,367.55
|
| Rate for Payer: BCN Commercial |
$2,367.55
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cofinity Commercial |
$2,710.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,306.43
|
| Rate for Payer: Healthscope Commercial |
$2,796.55
|
| Rate for Payer: Healthscope Whirlpool |
$2,883.04
|
| Rate for Payer: Mclaren Commercial |
$2,594.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,450.58
|
| Rate for Payer: Nomi Health Commercial |
$2,364.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,162.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,537.08
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,883.04
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,883.04 |
| Rate for Payer: Aetna Commercial |
$2,594.74
|
| 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 |
$2,796.55
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,377.07
|
| Rate for Payer: BCN Commercial |
$2,377.07
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cash Price |
$2,306.43
|
| Rate for Payer: Cofinity Commercial |
$2,710.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,306.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,796.55
|
| Rate for Payer: Healthscope Whirlpool |
$2,883.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,594.74
|
| 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 |
$2,450.58
|
| Rate for Payer: Nomi Health Commercial |
$2,364.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,162.28
|
| 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 |
$1,590.07
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,272.05
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,537.08
|
| 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 MRA PELVIS W CON
|
Facility
|
IP
|
$2,081.74
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,561.31 |
| Max. Negotiated Rate |
$2,081.74 |
| Rate for Payer: Aetna Commercial |
$1,873.57
|
| Rate for Payer: ASR ASR |
$2,019.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.52
|
| Rate for Payer: BCN Commercial |
$1,709.52
|
| Rate for Payer: Cash Price |
$1,665.39
|
| Rate for Payer: Cofinity Commercial |
$1,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.39
|
| Rate for Payer: Healthscope Commercial |
$2,019.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.74
|
| Rate for Payer: Mclaren Commercial |
$1,873.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.48
|
| Rate for Payer: Nomi Health Commercial |
$1,707.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.93
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,081.74
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,081.74 |
| Rate for Payer: Aetna Commercial |
$1,873.57
|
| 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 |
$2,019.29
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.39
|
| Rate for Payer: BCN Commercial |
$1,716.39
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,665.39
|
| Rate for Payer: Cash Price |
$1,665.39
|
| Rate for Payer: Cofinity Commercial |
$1,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,019.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,873.57
|
| 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 |
$1,769.48
|
| Rate for Payer: Nomi Health Commercial |
$1,707.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.31
|
| 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 |
$2,001.65
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,601.32
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.93
|
| 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 MRA PELVIS WO CON
|
Facility
|
IP
|
$1,938.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,453.62 |
| Max. Negotiated Rate |
$1,938.16 |
| Rate for Payer: Aetna Commercial |
$1,744.34
|
| Rate for Payer: ASR ASR |
$1,880.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.62
|
| Rate for Payer: BCN Commercial |
$1,591.62
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Commercial |
$1,821.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Healthscope Commercial |
$1,880.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.16
|
| Rate for Payer: Mclaren Commercial |
$1,744.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.44
|
| Rate for Payer: Nomi Health Commercial |
$1,589.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,705.58
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
OP
|
$1,938.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,938.16 |
| Rate for Payer: Aetna Commercial |
$1,744.34
|
| 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 |
$1,880.02
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.01
|
| Rate for Payer: BCN Commercial |
$1,598.01
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Commercial |
$1,821.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,880.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,744.34
|
| 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 |
$1,647.44
|
| Rate for Payer: Nomi Health Commercial |
$1,589.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| 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 |
$1,858.20
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,486.56
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,705.58
|
| 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 MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,722.83 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,886.38
|
| Rate for Payer: BCN Commercial |
$1,886.38
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,228.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,297.10
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| 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 |
$2,228.19
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$1,893.96
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,228.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,297.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| 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 |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| 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 |
$2,012.72
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.27
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
| 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 MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,979.46 |
| Rate for Payer: Aetna Commercial |
$1,781.51
|
| 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 |
$1,920.08
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.06
|
| Rate for Payer: BCN Commercial |
$1,632.06
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Commercial |
$1,860.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,920.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,979.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,781.51
|
| 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 |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$1,623.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| 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 |
$1,839.44
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.55
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,741.92
|
| 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 MRA SPINAL CANAL W CON
|
Facility
|
IP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,484.60 |
| Max. Negotiated Rate |
$1,979.46 |
| Rate for Payer: Aetna Commercial |
$1,781.51
|
| Rate for Payer: ASR ASR |
$1,920.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.53
|
| Rate for Payer: BCN Commercial |
$1,625.53
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Commercial |
$1,860.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Healthscope Commercial |
$1,920.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,979.46
|
| Rate for Payer: Mclaren Commercial |
$1,781.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$1,623.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,741.92
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,979.46 |
| Rate for Payer: Aetna Commercial |
$1,781.51
|
| 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 |
$1,920.08
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.06
|
| Rate for Payer: BCN Commercial |
$1,632.06
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Commercial |
$1,860.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,920.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,979.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,781.51
|
| 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 |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$1,623.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,839.44
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.55
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,741.92
|
| 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 MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,979.46
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,484.60 |
| Max. Negotiated Rate |
$1,979.46 |
| Rate for Payer: Aetna Commercial |
$1,781.51
|
| Rate for Payer: ASR ASR |
$1,920.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.53
|
| Rate for Payer: BCN Commercial |
$1,625.53
|
| Rate for Payer: Cash Price |
$1,583.57
|
| Rate for Payer: Cofinity Commercial |
$1,860.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,583.57
|
| Rate for Payer: Healthscope Commercial |
$1,920.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,979.46
|
| Rate for Payer: Mclaren Commercial |
$1,781.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,682.54
|
| Rate for Payer: Nomi Health Commercial |
$1,623.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,741.92
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| 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 |
$2,100.02
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.02
|
| Rate for Payer: BCN Commercial |
$1,785.02
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| 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 |
$1,896.95
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,517.64
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
| 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 MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,623.73 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| Rate for Payer: ASR ASR |
$2,100.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.87
|
| Rate for Payer: BCN Commercial |
$1,777.87
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| 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 |
$2,100.02
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.02
|
| Rate for Payer: BCN Commercial |
$1,785.02
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| 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 |
$1,682.06
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.65
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
| 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 MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,623.73 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| Rate for Payer: ASR ASR |
$2,100.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.87
|
| Rate for Payer: BCN Commercial |
$1,777.87
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| 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 |
$2,100.02
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.02
|
| Rate for Payer: BCN Commercial |
$1,785.02
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| 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 |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| 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 |
$1,709.91
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,367.93
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
| 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 MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,164.97
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,623.73 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$1,948.47
|
| Rate for Payer: ASR ASR |
$2,100.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.87
|
| Rate for Payer: BCN Commercial |
$1,777.87
|
| Rate for Payer: Cash Price |
$1,731.98
|
| Rate for Payer: Cofinity Commercial |
$2,035.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,731.98
|
| Rate for Payer: Healthscope Commercial |
$2,100.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,164.97
|
| Rate for Payer: Mclaren Commercial |
$1,948.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.22
|
| Rate for Payer: Nomi Health Commercial |
$1,775.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.17
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$1,941.17
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,455.88 |
| Max. Negotiated Rate |
$1,941.17 |
| Rate for Payer: Aetna Commercial |
$1,747.05
|
| Rate for Payer: Aetna Commercial |
$2,620.58
|
| Rate for Payer: ASR ASR |
$1,882.93
|
| Rate for Payer: ASR ASR |
$2,824.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.14
|
| Rate for Payer: BCN Commercial |
$1,594.09
|
| Rate for Payer: BCN Commercial |
$2,391.14
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cash Price |
$1,552.94
|
| Rate for Payer: Cofinity Commercial |
$2,737.05
|
| Rate for Payer: Cofinity Commercial |
$1,824.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,329.41
|
| Rate for Payer: Healthscope Commercial |
$1,882.93
|
| Rate for Payer: Healthscope Commercial |
$2,824.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,911.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,941.17
|
| Rate for Payer: Mclaren Commercial |
$2,620.58
|
| Rate for Payer: Mclaren Commercial |
$1,747.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,475.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.99
|
| Rate for Payer: Nomi Health Commercial |
$2,387.64
|
| Rate for Payer: Nomi Health Commercial |
$1,591.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,455.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,183.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,562.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,708.23
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$1,941.17
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,941.17 |
| Rate for Payer: Aetna Commercial |
$1,747.05
|
| Rate for Payer: Aetna Commercial |
$2,620.58
|
| 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 |
$1,882.93
|
| Rate for Payer: ASR ASR |
$2,824.41
|
| 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 |
$2,400.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.49
|
| Rate for Payer: BCN Commercial |
$2,400.75
|
| Rate for Payer: BCN Commercial |
$1,600.49
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,552.94
|
| Rate for Payer: Cash Price |
$1,552.94
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cash Price |
$2,329.41
|
| Rate for Payer: Cofinity Commercial |
$1,824.70
|
| Rate for Payer: Cofinity Commercial |
$2,737.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,329.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.94
|
| 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 |
$1,882.93
|
| Rate for Payer: Healthscope Commercial |
$2,824.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,941.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,911.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,620.58
|
| Rate for Payer: Mclaren Commercial |
$1,747.05
|
| 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 |
$1,649.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,475.00
|
| Rate for Payer: Nomi Health Commercial |
$2,387.64
|
| Rate for Payer: Nomi Health Commercial |
$1,591.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,455.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,183.82
|
| 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 |
$1,682.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,682.06
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.65
|
| 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 |
$2,562.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,708.23
|
| 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
|
|
