|
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
|
OP
|
$2,487.28
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,487.28 |
| Rate for Payer: Aetna Commercial |
$2,238.55
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$2,412.66
|
| Rate for Payer: ASR Commercial |
$2,412.66
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.83
|
| Rate for Payer: BCN Commercial |
$1,928.39
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,487.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,238.55
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,616.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,179.35
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,743.58
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,188.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
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 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 CON
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.50
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| 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 |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,816.27
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,453.10
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
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 |
$186.69 |
| Max. Negotiated Rate |
$3,165.73 |
| Rate for Payer: Aetna Commercial |
$2,849.16
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,070.76
|
| Rate for Payer: ASR Commercial |
$3,070.76
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,592.42
|
| Rate for Payer: BCN Commercial |
$2,454.39
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,165.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,070.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,849.16
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,773.81
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,219.18
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
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
|
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 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 |
$289.45 |
| 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: 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: Priority Health HMO/PPO/Tiered Network |
$253.62
|
| Rate for Payer: Priority Health Narrow Network |
$202.90
|
| 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 |
$186.69 |
| Max. Negotiated Rate |
$1,234.53 |
| Rate for Payer: Aetna Commercial |
$1,111.08
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,197.49
|
| Rate for Payer: ASR Commercial |
$1,197.49
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.96
|
| Rate for Payer: BCN Commercial |
$957.13
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,234.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,111.08
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| 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 |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$865.41
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
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 SCREEN WO W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,259.22 |
| Rate for Payer: Aetna Commercial |
$1,133.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,221.44
|
| Rate for Payer: ASR Commercial |
$1,221.44
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.18
|
| Rate for Payer: BCN Commercial |
$976.27
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,259.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,133.30
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| 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 |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$882.71
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,386.40 |
| Max. Negotiated Rate |
$2,132.92 |
| Rate for Payer: Aetna Commercial |
$1,919.63
|
| Rate for Payer: ASR ASR |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$2,068.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.12
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| 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: Healthscope Commercial |
$2,132.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.93
|
| Rate for Payer: Mclaren Commercial |
$1,919.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,876.97
|
|
|
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 |
$186.69 |
| Max. Negotiated Rate |
$2,132.92 |
| Rate for Payer: Aetna Commercial |
$1,919.63
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$2,068.93
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.65
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,132.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| 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 |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.18
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,876.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,414.13 |
| Max. Negotiated Rate |
$2,175.58 |
| Rate for Payer: Aetna Commercial |
$1,958.02
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: ASR Commercial |
$2,110.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,772.88
|
| Rate for Payer: BCN Commercial |
$1,686.73
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$2,175.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,110.31
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$870.23 |
| Max. Negotiated Rate |
$2,175.58 |
| Rate for Payer: Aetna Commercial |
$1,958.02
|
| Rate for Payer: Aetna Medicare |
$1,087.79
|
| Rate for Payer: ASR ASR |
$2,110.31
|
| Rate for Payer: ASR Commercial |
$2,110.31
|
| Rate for Payer: BCBS Complete |
$870.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.58
|
| Rate for Payer: BCN Commercial |
$1,686.73
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$2,045.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$2,175.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,110.31
|
| Rate for Payer: Mclaren Commercial |
$1,958.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,906.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,525.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.51
|
|
|
HC MR BREAST CAD
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC MR BREAST CAD
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$908.41
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$590.47 |
| Max. Negotiated Rate |
$908.41 |
| Rate for Payer: Aetna Commercial |
$817.57
|
| Rate for Payer: ASR ASR |
$881.16
|
| Rate for Payer: ASR Commercial |
$881.16
|
| Rate for Payer: BCBS Trust/PPO |
$740.26
|
| Rate for Payer: BCN Commercial |
$704.29
|
| Rate for Payer: Cash Price |
$726.73
|
| Rate for Payer: Cofinity Commercial |
$853.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.73
|
| Rate for Payer: Healthscope Commercial |
$908.41
|
| Rate for Payer: Healthscope Whirlpool |
$881.16
|
| Rate for Payer: Mclaren Commercial |
$817.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.15
|
| Rate for Payer: Nomi Health Commercial |
$744.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.40
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
OP
|
$908.41
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$908.41 |
| Rate for Payer: Aetna Commercial |
$817.57
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$881.16
|
| Rate for Payer: ASR Commercial |
$881.16
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$743.90
|
| Rate for Payer: BCN Commercial |
$704.29
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$726.73
|
| Rate for Payer: Cash Price |
$726.73
|
| Rate for Payer: Cofinity Commercial |
$853.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$908.41
|
| Rate for Payer: Healthscope Whirlpool |
$881.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$817.57
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.15
|
| Rate for Payer: Nomi Health Commercial |
$744.90
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.95
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$636.80
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,234.53 |
| Rate for Payer: Aetna Commercial |
$1,111.08
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,197.49
|
| Rate for Payer: ASR Commercial |
$1,197.49
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.96
|
| Rate for Payer: BCN Commercial |
$957.13
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,234.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,111.08
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| 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 |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| 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 |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$865.41
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
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 UNI WO W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,020.09 |
| Max. Negotiated Rate |
$1,569.37 |
| Rate for Payer: Aetna Commercial |
$1,412.43
|
| Rate for Payer: Aetna Commercial |
$2,118.64
|
| Rate for Payer: ASR ASR |
$2,283.43
|
| Rate for Payer: ASR ASR |
$1,522.29
|
| Rate for Payer: ASR Commercial |
$2,283.43
|
| Rate for Payer: ASR Commercial |
$1,522.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,278.88
|
| Rate for Payer: BCN Commercial |
$1,825.09
|
| Rate for Payer: BCN Commercial |
$1,216.73
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,212.81
|
| Rate for Payer: Cofinity Commercial |
$1,475.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Healthscope Commercial |
$1,569.37
|
| Rate for Payer: Healthscope Commercial |
$2,354.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,283.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,522.29
|
| Rate for Payer: Mclaren Commercial |
$1,412.43
|
| Rate for Payer: Mclaren Commercial |
$2,118.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: Nomi Health Commercial |
$1,930.32
|
| Rate for Payer: Nomi Health Commercial |
$1,286.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,071.56
|
|
