|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,175.98 |
| Max. Negotiated Rate |
$1,809.20 |
| Rate for Payer: Aetna Commercial |
$1,628.28
|
| Rate for Payer: ASR ASR |
$1,754.92
|
| Rate for Payer: ASR Commercial |
$1,754.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,474.32
|
| Rate for Payer: BCN Commercial |
$1,402.67
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,700.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Healthscope Commercial |
$1,809.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,754.92
|
| Rate for Payer: Mclaren Commercial |
$1,628.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,592.10
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,809.20 |
| Rate for Payer: Aetna Commercial |
$1,628.28
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,754.92
|
| Rate for Payer: ASR Commercial |
$1,754.92
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.55
|
| Rate for Payer: BCN Commercial |
$1,402.67
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,700.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,809.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,754.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,628.28
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,312.12
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.70
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,592.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,984.32 |
| Max. Negotiated Rate |
$3,052.80 |
| Rate for Payer: Aetna Commercial |
$2,747.52
|
| Rate for Payer: ASR ASR |
$2,961.22
|
| Rate for Payer: ASR Commercial |
$2,961.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,487.73
|
| Rate for Payer: BCN Commercial |
$2,366.84
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,869.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$3,052.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,961.22
|
| Rate for Payer: Mclaren Commercial |
$2,747.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.46
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,052.80 |
| Rate for Payer: Aetna Commercial |
$2,747.52
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,961.22
|
| Rate for Payer: ASR Commercial |
$2,961.22
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.94
|
| Rate for Payer: BCN Commercial |
$2,366.84
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,869.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,052.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,961.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,747.52
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.33
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,728.26
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,412.55 |
| Rate for Payer: Aetna Commercial |
$1,271.30
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,370.17
|
| Rate for Payer: ASR Commercial |
$1,370.17
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.74
|
| Rate for Payer: BCN Commercial |
$1,095.15
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,327.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,412.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,271.30
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.68
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$990.20
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$918.16 |
| Max. Negotiated Rate |
$1,412.55 |
| Rate for Payer: Aetna Commercial |
$1,271.30
|
| Rate for Payer: ASR ASR |
$1,370.17
|
| Rate for Payer: ASR Commercial |
$1,370.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.09
|
| Rate for Payer: BCN Commercial |
$1,095.15
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,327.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Healthscope Commercial |
$1,412.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.17
|
| Rate for Payer: Mclaren Commercial |
$1,271.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.04
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,207.65 |
| Max. Negotiated Rate |
$1,857.93 |
| Rate for Payer: Aetna Commercial |
$1,672.14
|
| Rate for Payer: ASR ASR |
$1,802.19
|
| Rate for Payer: ASR Commercial |
$1,802.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,514.03
|
| Rate for Payer: BCN Commercial |
$1,440.45
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,746.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Healthscope Commercial |
$1,857.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,802.19
|
| Rate for Payer: Mclaren Commercial |
$1,672.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: Nomi Health Commercial |
$1,523.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,634.98
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$743.17 |
| Max. Negotiated Rate |
$1,857.93 |
| Rate for Payer: Aetna Commercial |
$1,672.14
|
| Rate for Payer: Aetna Medicare |
$928.96
|
| Rate for Payer: ASR ASR |
$1,802.19
|
| Rate for Payer: ASR Commercial |
$1,802.19
|
| Rate for Payer: BCBS Complete |
$743.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,521.46
|
| Rate for Payer: BCN Commercial |
$1,440.45
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,746.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Healthscope Commercial |
$1,857.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,802.19
|
| Rate for Payer: Mclaren Commercial |
$1,672.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: Nomi Health Commercial |
$1,523.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,627.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,302.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,634.98
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$619.30 |
| Max. Negotiated Rate |
$1,548.26 |
| Rate for Payer: Aetna Commercial |
$1,393.43
|
| Rate for Payer: Aetna Medicare |
$774.13
|
| Rate for Payer: ASR ASR |
$1,501.81
|
| Rate for Payer: ASR Commercial |
$1,501.81
|
| Rate for Payer: BCBS Complete |
$619.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.87
|
| Rate for Payer: BCN Commercial |
$1,200.37
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,455.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Healthscope Commercial |
$1,548.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,501.81
|
| Rate for Payer: Mclaren Commercial |
$1,393.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: Nomi Health Commercial |
$1,269.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,356.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,362.47
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,006.37 |
| Max. Negotiated Rate |
$1,548.26 |
| Rate for Payer: Aetna Commercial |
$1,393.43
|
| Rate for Payer: ASR ASR |
$1,501.81
|
| Rate for Payer: ASR Commercial |
$1,501.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.68
|
| Rate for Payer: BCN Commercial |
$1,200.37
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,455.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Healthscope Commercial |
$1,548.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,501.81
|
| Rate for Payer: Mclaren Commercial |
$1,393.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: Nomi Health Commercial |
$1,269.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,362.47
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
OP
|
$2,365.89
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$946.36 |
| Max. Negotiated Rate |
$2,365.89 |
| Rate for Payer: Aetna Commercial |
$2,129.30
|
| Rate for Payer: Aetna Medicare |
$1,182.94
|
| Rate for Payer: ASR ASR |
$2,294.91
|
| Rate for Payer: ASR Commercial |
$2,294.91
|
| Rate for Payer: BCBS Complete |
$946.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,937.43
|
| Rate for Payer: BCN Commercial |
$1,834.27
|
| Rate for Payer: Cash Price |
$1,892.71
|
| Rate for Payer: Cofinity Commercial |
$2,223.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.71
|
| Rate for Payer: Healthscope Commercial |
$2,365.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,294.91
|
| Rate for Payer: Mclaren Commercial |
$2,129.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.01
|
| Rate for Payer: Nomi Health Commercial |
$1,940.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,072.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,658.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,081.98
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
IP
|
$2,365.89
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,537.83 |
| Max. Negotiated Rate |
$2,365.89 |
| Rate for Payer: Aetna Commercial |
$2,129.30
|
| Rate for Payer: ASR ASR |
$2,294.91
|
| Rate for Payer: ASR Commercial |
$2,294.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.96
|
| Rate for Payer: BCN Commercial |
$1,834.27
|
| Rate for Payer: Cash Price |
$1,892.71
|
| Rate for Payer: Cofinity Commercial |
$2,223.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.71
|
| Rate for Payer: Healthscope Commercial |
$2,365.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,294.91
|
| Rate for Payer: Mclaren Commercial |
$2,129.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.01
|
| Rate for Payer: Nomi Health Commercial |
$1,940.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,081.98
|
|
|
HC MR BRAIN W CON
|
Facility
|
IP
|
$2,487.28
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,616.73 |
| Max. Negotiated Rate |
$2,487.28 |
| Rate for Payer: Aetna Commercial |
$2,238.55
|
| Rate for Payer: ASR ASR |
$2,412.66
|
| Rate for Payer: ASR Commercial |
$2,412.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.88
|
| Rate for Payer: BCN Commercial |
$1,928.39
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cofinity Commercial |
$2,338.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,989.82
|
| Rate for Payer: Healthscope Commercial |
$2,487.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.66
|
| Rate for Payer: Mclaren Commercial |
$2,238.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,114.19
|
| Rate for Payer: Nomi Health Commercial |
$2,039.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,616.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,188.81
|
|
|
HC MR BRAIN W CON
|
Facility
|
OP
|
$2,487.28
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,487.28 |
| Rate for Payer: Aetna Commercial |
$2,238.55
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,412.66
|
| Rate for Payer: ASR Commercial |
$2,412.66
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.83
|
| Rate for Payer: BCN Commercial |
$1,928.39
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cofinity Commercial |
$2,338.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,989.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,487.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,238.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,114.19
|
| Rate for Payer: Nomi Health Commercial |
$2,039.57
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,616.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,188.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR BRAIN WO CON
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.50
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.68
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,220.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,347.38 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,689.21
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
OP
|
$3,165.73
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,165.73 |
| Rate for Payer: Aetna Commercial |
$2,849.16
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$3,070.76
|
| Rate for Payer: ASR Commercial |
$3,070.76
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,592.42
|
| Rate for Payer: BCN Commercial |
$2,454.39
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,532.58
|
| Rate for Payer: Cash Price |
$2,532.58
|
| Rate for Payer: Cofinity Commercial |
$2,975.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,165.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,070.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,849.16
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.87
|
| Rate for Payer: Nomi Health Commercial |
$2,595.90
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,107.09
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,685.67
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
IP
|
$3,165.73
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,057.72 |
| Max. Negotiated Rate |
$3,165.73 |
| Rate for Payer: Aetna Commercial |
$2,849.16
|
| Rate for Payer: ASR ASR |
$3,070.76
|
| Rate for Payer: ASR Commercial |
$3,070.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,579.75
|
| Rate for Payer: BCN Commercial |
$2,454.39
|
| Rate for Payer: Cash Price |
$2,532.58
|
| Rate for Payer: Cofinity Commercial |
$2,975.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.58
|
| Rate for Payer: Healthscope Commercial |
$3,165.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,070.76
|
| Rate for Payer: Mclaren Commercial |
$2,849.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.87
|
| Rate for Payer: Nomi Health Commercial |
$2,595.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.84
|
|
|
HC MR BREAST ABBREVIATED WO W CON
|
Facility
|
OP
|
$289.45
|
|
|
Service Code
|
CPT 77049
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$115.78 |
| Max. Negotiated Rate |
$335.46 |
| Rate for Payer: Aetna Commercial |
$260.50
|
| Rate for Payer: Aetna Medicare |
$144.72
|
| Rate for Payer: ASR ASR |
$280.77
|
| Rate for Payer: ASR Commercial |
$280.77
|
| Rate for Payer: BCBS Complete |
$115.78
|
| Rate for Payer: BCBS Trust/PPO |
$237.03
|
| Rate for Payer: BCCCP Commercial |
$324.98
|
| Rate for Payer: BCN Commercial |
$224.41
|
| Rate for Payer: Cash Price |
$231.56
|
| Rate for Payer: Cash Price |
$231.56
|
| Rate for Payer: Cofinity Commercial |
$272.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.56
|
| Rate for Payer: Healthscope Commercial |
$289.45
|
| Rate for Payer: Healthscope Whirlpool |
$280.77
|
| Rate for Payer: Mclaren Commercial |
$260.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.03
|
| Rate for Payer: Nomi Health Commercial |
$237.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.46
|
| Rate for Payer: Priority Health Narrow Network |
$268.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.72
|
|
|
HC MR BREAST ABBREVIATED WO W CON
|
Facility
|
IP
|
$289.45
|
|
|
Service Code
|
CPT 77049
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$289.45 |
| Rate for Payer: Aetna Commercial |
$260.50
|
| Rate for Payer: ASR ASR |
$280.77
|
| Rate for Payer: ASR Commercial |
$280.77
|
| Rate for Payer: BCBS Trust/PPO |
$235.87
|
| Rate for Payer: BCN Commercial |
$224.41
|
| Rate for Payer: Cash Price |
$231.56
|
| Rate for Payer: Cofinity Commercial |
$272.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.56
|
| Rate for Payer: Healthscope Commercial |
$289.45
|
| Rate for Payer: Healthscope Whirlpool |
$280.77
|
| Rate for Payer: Mclaren Commercial |
$260.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.03
|
| Rate for Payer: Nomi Health Commercial |
$237.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.72
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
IP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$802.44 |
| Max. Negotiated Rate |
$1,234.53 |
| Rate for Payer: Aetna Commercial |
$1,111.08
|
| Rate for Payer: ASR ASR |
$1,197.49
|
| Rate for Payer: ASR Commercial |
$1,197.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.02
|
| Rate for Payer: BCN Commercial |
$957.13
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,160.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Healthscope Commercial |
$1,234.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.49
|
| Rate for Payer: Mclaren Commercial |
$1,111.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.35
|
| Rate for Payer: Nomi Health Commercial |
$1,012.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.39
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
OP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,234.53 |
| Rate for Payer: Aetna Commercial |
$1,111.08
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$1,197.49
|
| Rate for Payer: ASR Commercial |
$1,197.49
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.96
|
| Rate for Payer: BCN Commercial |
$957.13
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,160.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,234.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,111.08
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.35
|
| Rate for Payer: Nomi Health Commercial |
$1,012.31
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,081.70
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$865.41
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,259.22 |
| Rate for Payer: Aetna Commercial |
$1,133.30
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$1,221.44
|
| Rate for Payer: ASR Commercial |
$1,221.44
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.18
|
| Rate for Payer: BCN Commercial |
$976.27
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,183.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,259.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,133.30
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.33
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$882.71
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$818.49 |
| Max. Negotiated Rate |
$1,259.22 |
| Rate for Payer: Aetna Commercial |
$1,133.30
|
| Rate for Payer: ASR ASR |
$1,221.44
|
| Rate for Payer: ASR Commercial |
$1,221.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,026.14
|
| Rate for Payer: BCN Commercial |
$976.27
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,183.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,259.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.44
|
| Rate for Payer: Mclaren Commercial |
$1,133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.11
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,132.92 |
| Rate for Payer: Aetna Commercial |
$1,919.63
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$2,068.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.65
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$2,004.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,132.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,868.86
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.18
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,876.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
