|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,129.84 |
| Rate for Payer: Aetna Commercial |
$1,916.86
|
| 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 |
$2,065.94
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,756.05
|
| Rate for Payer: BCN Commercial |
$1,756.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Commercial |
$2,002.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,065.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,129.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,916.86
|
| 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 |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$1,746.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$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 |
$1,874.26
|
| 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 SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,597.38 |
| Max. Negotiated Rate |
$2,129.84 |
| Rate for Payer: Aetna Commercial |
$1,916.86
|
| Rate for Payer: ASR ASR |
$2,065.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,749.02
|
| Rate for Payer: BCN Commercial |
$1,749.02
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Commercial |
$2,002.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Healthscope Commercial |
$2,065.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,129.84
|
| Rate for Payer: Mclaren Commercial |
$1,916.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$1,746.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,874.26
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,435.36 |
| Max. Negotiated Rate |
$3,247.14 |
| Rate for Payer: Aetna Commercial |
$2,922.43
|
| Rate for Payer: ASR ASR |
$3,149.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,666.55
|
| Rate for Payer: BCN Commercial |
$2,666.55
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$3,052.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$3,149.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,247.14
|
| Rate for Payer: Mclaren Commercial |
$2,922.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,760.07
|
| Rate for Payer: Nomi Health Commercial |
$2,662.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,857.48
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,247.14 |
| Rate for Payer: Aetna Commercial |
$2,922.43
|
| 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 |
$3,149.73
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,677.27
|
| Rate for Payer: BCN Commercial |
$2,677.27
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$3,052.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,149.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,247.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,922.43
|
| 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 |
$2,760.07
|
| Rate for Payer: Nomi Health Commercial |
$2,662.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| 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 |
$2,269.80
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,815.84
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,857.48
|
| 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 SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,230.12 |
| Max. Negotiated Rate |
$2,973.50 |
| Rate for Payer: Aetna Commercial |
$2,676.15
|
| Rate for Payer: ASR ASR |
$2,884.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,441.84
|
| Rate for Payer: BCN Commercial |
$2,441.84
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Commercial |
$2,795.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Healthscope Commercial |
$2,884.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,973.50
|
| Rate for Payer: Mclaren Commercial |
$2,676.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,527.47
|
| Rate for Payer: Nomi Health Commercial |
$2,438.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,616.68
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,973.50 |
| Rate for Payer: Aetna Commercial |
$2,676.15
|
| 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 |
$2,884.30
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,451.65
|
| Rate for Payer: BCN Commercial |
$2,451.65
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Commercial |
$2,795.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,884.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,973.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,676.15
|
| 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 |
$2,527.47
|
| Rate for Payer: Nomi Health Commercial |
$2,438.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| 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 |
$2,269.80
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,815.84
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,616.68
|
| 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 SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$875.50 |
| Max. Negotiated Rate |
$1,167.33 |
| Rate for Payer: Aetna Commercial |
$1,050.60
|
| Rate for Payer: ASR ASR |
$1,132.31
|
| Rate for Payer: BCBS Trust/PPO |
$958.61
|
| Rate for Payer: BCN Commercial |
$958.61
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,097.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,167.33
|
| Rate for Payer: Mclaren Commercial |
$1,050.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,027.25
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,004.08 |
| Rate for Payer: Aetna Commercial |
$1,050.60
|
| 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 |
$1,132.31
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$962.46
|
| Rate for Payer: BCN Commercial |
$962.46
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,097.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,167.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,050.60
|
| 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 |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| 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 |
$2,004.08
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.27
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,027.25
|
| 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 SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,480.94 |
| Max. Negotiated Rate |
$1,974.59 |
| Rate for Payer: Aetna Commercial |
$1,777.13
|
| Rate for Payer: ASR ASR |
$1,915.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,621.53
|
| Rate for Payer: BCN Commercial |
$1,621.53
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Commercial |
$1,856.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Healthscope Commercial |
$1,915.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.59
|
| Rate for Payer: Mclaren Commercial |
$1,777.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Nomi Health Commercial |
$1,619.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,737.64
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,974.59 |
| Rate for Payer: Aetna Commercial |
$1,777.13
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,915.35
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.05
|
| Rate for Payer: BCN Commercial |
$1,628.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Commercial |
$1,856.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,915.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,777.13
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Nomi Health Commercial |
$1,619.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| 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 |
$1,717.18
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.74
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,737.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$725.33
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$544.00 |
| Max. Negotiated Rate |
$725.33 |
| Rate for Payer: Aetna Commercial |
$652.80
|
| Rate for Payer: ASR ASR |
$703.57
|
| Rate for Payer: BCBS Trust/PPO |
$595.64
|
| Rate for Payer: BCN Commercial |
$595.64
|
| Rate for Payer: Cash Price |
$580.26
|
| Rate for Payer: Cofinity Commercial |
$681.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.26
|
| Rate for Payer: Healthscope Commercial |
$703.57
|
| Rate for Payer: Healthscope Whirlpool |
$725.33
|
| Rate for Payer: Mclaren Commercial |
$652.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.53
|
| Rate for Payer: Nomi Health Commercial |
$594.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.29
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
OP
|
$725.33
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,717.18 |
| Rate for Payer: Aetna Commercial |
$652.80
|
| 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 |
$703.57
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$598.03
|
| Rate for Payer: BCN Commercial |
$598.03
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$580.26
|
| Rate for Payer: Cash Price |
$580.26
|
| Rate for Payer: Cofinity Commercial |
$681.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$703.57
|
| Rate for Payer: Healthscope Whirlpool |
$725.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$652.80
|
| 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 |
$616.53
|
| Rate for Payer: Nomi Health Commercial |
$594.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.00
|
| 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 |
$1,717.18
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.74
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.29
|
| 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 SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,692.61
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,019.46 |
| Max. Negotiated Rate |
$2,692.61 |
| Rate for Payer: Aetna Commercial |
$2,423.35
|
| Rate for Payer: ASR ASR |
$2,611.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,211.17
|
| Rate for Payer: BCN Commercial |
$2,211.17
|
| Rate for Payer: Cash Price |
$2,154.09
|
| Rate for Payer: Cofinity Commercial |
$2,531.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,154.09
|
| Rate for Payer: Healthscope Commercial |
$2,611.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,692.61
|
| Rate for Payer: Mclaren Commercial |
$2,423.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,288.72
|
| Rate for Payer: Nomi Health Commercial |
$2,207.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,019.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,369.50
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
OP
|
$2,692.61
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,692.61 |
| Rate for Payer: Aetna Commercial |
$2,423.35
|
| 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 |
$2,611.83
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,220.06
|
| Rate for Payer: BCN Commercial |
$2,220.06
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,154.09
|
| Rate for Payer: Cash Price |
$2,154.09
|
| Rate for Payer: Cofinity Commercial |
$2,531.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,154.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,611.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,692.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,423.35
|
| 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 |
$2,288.72
|
| Rate for Payer: Nomi Health Commercial |
$2,207.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,019.46
|
| 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 |
$2,290.97
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,832.78
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,369.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
OP
|
$942.99
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,290.97 |
| Rate for Payer: Aetna Commercial |
$848.69
|
| 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 |
$914.70
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$777.50
|
| Rate for Payer: BCN Commercial |
$777.50
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$754.39
|
| Rate for Payer: Cash Price |
$754.39
|
| Rate for Payer: Cofinity Commercial |
$886.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$914.70
|
| Rate for Payer: Healthscope Whirlpool |
$942.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$848.69
|
| 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 |
$801.54
|
| Rate for Payer: Nomi Health Commercial |
$773.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.24
|
| 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 |
$2,290.97
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,832.78
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.83
|
| 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 SPINE THORACIC WO W LTD
|
Facility
|
IP
|
$942.99
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$707.24 |
| Max. Negotiated Rate |
$942.99 |
| Rate for Payer: Aetna Commercial |
$848.69
|
| Rate for Payer: ASR ASR |
$914.70
|
| Rate for Payer: BCBS Trust/PPO |
$774.38
|
| Rate for Payer: BCN Commercial |
$774.38
|
| Rate for Payer: Cash Price |
$754.39
|
| Rate for Payer: Cofinity Commercial |
$886.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.39
|
| Rate for Payer: Healthscope Commercial |
$914.70
|
| Rate for Payer: Healthscope Whirlpool |
$942.99
|
| Rate for Payer: Mclaren Commercial |
$848.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.54
|
| Rate for Payer: Nomi Health Commercial |
$773.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.83
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
IP
|
$2,114.36
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,585.77 |
| Max. Negotiated Rate |
$2,114.36 |
| Rate for Payer: Aetna Commercial |
$1,902.92
|
| Rate for Payer: ASR ASR |
$2,050.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,736.31
|
| Rate for Payer: BCN Commercial |
$1,736.31
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Commercial |
$1,987.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Healthscope Commercial |
$2,050.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.36
|
| Rate for Payer: Mclaren Commercial |
$1,902.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$1,733.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,860.64
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,114.36
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,114.36 |
| Rate for Payer: Aetna Commercial |
$1,902.92
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$2,050.93
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,743.29
|
| Rate for Payer: BCN Commercial |
$1,743.29
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Commercial |
$1,987.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,050.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,114.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,902.92
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$1,733.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,860.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,635.94
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,976.95 |
| Max. Negotiated Rate |
$2,635.94 |
| Rate for Payer: Aetna Commercial |
$2,372.35
|
| Rate for Payer: ASR ASR |
$2,556.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,164.63
|
| Rate for Payer: BCN Commercial |
$2,164.63
|
| Rate for Payer: Cash Price |
$2,108.75
|
| Rate for Payer: Cofinity Commercial |
$2,477.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.75
|
| Rate for Payer: Healthscope Commercial |
$2,556.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,635.94
|
| Rate for Payer: Mclaren Commercial |
$2,372.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,240.55
|
| Rate for Payer: Nomi Health Commercial |
$2,161.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,976.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,319.63
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,635.94
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,635.94 |
| Rate for Payer: Aetna Commercial |
$2,372.35
|
| 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 |
$2,556.86
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.33
|
| Rate for Payer: BCN Commercial |
$2,173.33
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,108.75
|
| Rate for Payer: Cash Price |
$2,108.75
|
| Rate for Payer: Cofinity Commercial |
$2,477.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,556.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,635.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,372.35
|
| 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 |
$2,240.55
|
| Rate for Payer: Nomi Health Commercial |
$2,161.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,976.95
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,319.63
|
| 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 UPPER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,336.68
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,752.51 |
| Max. Negotiated Rate |
$2,336.68 |
| Rate for Payer: Aetna Commercial |
$2,103.01
|
| Rate for Payer: Aetna Commercial |
$3,154.53
|
| Rate for Payer: ASR ASR |
$2,266.58
|
| Rate for Payer: ASR ASR |
$3,399.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,878.33
|
| Rate for Payer: BCN Commercial |
$1,918.88
|
| Rate for Payer: BCN Commercial |
$2,878.33
|
| Rate for Payer: Cash Price |
$2,804.02
|
| Rate for Payer: Cash Price |
$1,869.34
|
| Rate for Payer: Cofinity Commercial |
$3,294.73
|
| Rate for Payer: Cofinity Commercial |
$2,196.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,869.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,804.02
|
| Rate for Payer: Healthscope Commercial |
$2,266.58
|
| Rate for Payer: Healthscope Commercial |
$3,399.88
|
| Rate for Payer: Healthscope Whirlpool |
$3,505.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,336.68
|
| Rate for Payer: Mclaren Commercial |
$3,154.53
|
| Rate for Payer: Mclaren Commercial |
$2,103.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,979.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,986.18
|
| Rate for Payer: Nomi Health Commercial |
$2,874.12
|
| Rate for Payer: Nomi Health Commercial |
$1,916.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,752.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,628.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,084.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,056.28
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,336.68
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,336.68 |
| Rate for Payer: Aetna Commercial |
$2,103.01
|
| Rate for Payer: Aetna Commercial |
$3,154.53
|
| 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 |
$2,266.58
|
| Rate for Payer: ASR ASR |
$3,399.88
|
| 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 |
$2,889.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,926.59
|
| Rate for Payer: BCN Commercial |
$2,889.90
|
| Rate for Payer: BCN Commercial |
$1,926.59
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,869.34
|
| Rate for Payer: Cash Price |
$1,869.34
|
| Rate for Payer: Cash Price |
$2,804.02
|
| Rate for Payer: Cash Price |
$2,804.02
|
| Rate for Payer: Cofinity Commercial |
$2,196.48
|
| Rate for Payer: Cofinity Commercial |
$3,294.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,804.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,869.34
|
| 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 |
$2,266.58
|
| Rate for Payer: Healthscope Commercial |
$3,399.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,336.68
|
| Rate for Payer: Healthscope Whirlpool |
$3,505.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$3,154.53
|
| Rate for Payer: Mclaren Commercial |
$2,103.01
|
| 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 |
$1,986.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,979.28
|
| Rate for Payer: Nomi Health Commercial |
$2,874.12
|
| Rate for Payer: Nomi Health Commercial |
$1,916.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,752.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,628.77
|
| 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 |
$1,717.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,717.18
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.74
|
| 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 |
$3,084.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,056.28
|
| 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 UPPER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$2,035.12
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,035.12 |
| Rate for Payer: Aetna Commercial |
$1,831.61
|
| Rate for Payer: Aetna Commercial |
$2,747.42
|
| 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 |
$1,974.07
|
| Rate for Payer: ASR ASR |
$2,961.11
|
| 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 |
$2,516.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.96
|
| Rate for Payer: BCN Commercial |
$2,516.94
|
| Rate for Payer: BCN Commercial |
$1,677.96
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cash Price |
$2,442.15
|
| Rate for Payer: Cash Price |
$2,442.15
|
| Rate for Payer: Cofinity Commercial |
$1,913.01
|
| Rate for Payer: Cofinity Commercial |
$2,869.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| 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 |
$1,974.07
|
| Rate for Payer: Healthscope Commercial |
$2,961.11
|
| Rate for Payer: Healthscope Whirlpool |
$2,035.12
|
| Rate for Payer: Healthscope Whirlpool |
$3,052.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$2,747.42
|
| Rate for Payer: Mclaren Commercial |
$1,831.61
|
| 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 |
$1,729.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.79
|
| Rate for Payer: Nomi Health Commercial |
$2,503.21
|
| Rate for Payer: Nomi Health Commercial |
$1,668.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,289.52
|
| 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 |
$2,686.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,790.91
|
| 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 UPPER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$2,035.12
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,526.34 |
| Max. Negotiated Rate |
$2,035.12 |
| Rate for Payer: Aetna Commercial |
$1,831.61
|
| Rate for Payer: Aetna Commercial |
$2,747.42
|
| Rate for Payer: ASR ASR |
$1,974.07
|
| Rate for Payer: ASR ASR |
$2,961.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,506.87
|
| Rate for Payer: BCN Commercial |
$1,671.24
|
| Rate for Payer: BCN Commercial |
$2,506.87
|
| Rate for Payer: Cash Price |
$2,442.15
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cofinity Commercial |
$2,869.53
|
| Rate for Payer: Cofinity Commercial |
$1,913.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.15
|
| Rate for Payer: Healthscope Commercial |
$1,974.07
|
| Rate for Payer: Healthscope Commercial |
$2,961.11
|
| Rate for Payer: Healthscope Whirlpool |
$3,052.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,035.12
|
| Rate for Payer: Mclaren Commercial |
$2,747.42
|
| Rate for Payer: Mclaren Commercial |
$1,831.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,729.85
|
| Rate for Payer: Nomi Health Commercial |
$2,503.21
|
| Rate for Payer: Nomi Health Commercial |
$1,668.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,289.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,790.91
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,508.56
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,508.56 |
| Rate for Payer: Aetna Commercial |
$2,257.70
|
| Rate for Payer: Aetna Commercial |
$3,386.55
|
| 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 |
$2,433.30
|
| Rate for Payer: ASR ASR |
$3,649.95
|
| 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 |
$3,102.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.31
|
| Rate for Payer: BCN Commercial |
$3,102.45
|
| Rate for Payer: BCN Commercial |
$2,068.31
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,006.85
|
| Rate for Payer: Cash Price |
$2,006.85
|
| Rate for Payer: Cash Price |
$3,010.26
|
| Rate for Payer: Cash Price |
$3,010.26
|
| Rate for Payer: Cofinity Commercial |
$2,358.05
|
| Rate for Payer: Cofinity Commercial |
$3,537.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,010.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,006.85
|
| 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 |
$2,433.30
|
| Rate for Payer: Healthscope Commercial |
$3,649.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,508.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,762.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$3,386.55
|
| Rate for Payer: Mclaren Commercial |
$2,257.70
|
| 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 |
$2,132.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,198.41
|
| Rate for Payer: Nomi Health Commercial |
$3,085.52
|
| Rate for Payer: Nomi Health Commercial |
$2,057.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,881.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,822.12
|
| 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 |
$1,866.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| 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 |
$347.62
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,311.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,207.53
|
| 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
|
|
