|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,252.06 |
| Rate for Payer: Aetna Commercial |
$2,026.85
|
| Rate for Payer: Aetna Commercial |
$3,040.28
|
| Rate for Payer: ASR ASR |
$3,276.75
|
| Rate for Payer: ASR ASR |
$2,184.50
|
| Rate for Payer: ASR Commercial |
$3,276.75
|
| Rate for Payer: ASR Commercial |
$2,184.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,752.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,835.20
|
| Rate for Payer: BCN Commercial |
$2,619.03
|
| Rate for Payer: BCN Commercial |
$1,746.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$3,175.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Healthscope Commercial |
$2,252.06
|
| Rate for Payer: Healthscope Commercial |
$3,378.09
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.50
|
| Rate for Payer: Mclaren Commercial |
$2,026.85
|
| Rate for Payer: Mclaren Commercial |
$3,040.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.72
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$3,378.09
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$3,378.09 |
| Rate for Payer: Aetna Commercial |
$3,040.28
|
| Rate for Payer: Aetna Commercial |
$2,026.85
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: ASR ASR |
$3,276.75
|
| Rate for Payer: ASR ASR |
$2,184.50
|
| Rate for Payer: ASR Commercial |
$2,184.50
|
| Rate for Payer: ASR Commercial |
$3,276.75
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,766.32
|
| Rate for Payer: BCN Commercial |
$1,746.02
|
| Rate for Payer: BCN Commercial |
$2,619.03
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$3,175.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$3,378.09
|
| Rate for Payer: Healthscope Commercial |
$2,252.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Mclaren Commercial |
$2,026.85
|
| Rate for Payer: Mclaren Commercial |
$3,040.28
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,973.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,959.88
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,368.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,578.69
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: VA VA |
$770.53
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$2,899.35
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,899.35 |
| Rate for Payer: Aetna Commercial |
$2,609.41
|
| Rate for Payer: Aetna Commercial |
$1,739.61
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,812.37
|
| Rate for Payer: ASR ASR |
$1,874.91
|
| Rate for Payer: ASR Commercial |
$1,874.91
|
| Rate for Payer: ASR Commercial |
$2,812.37
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,374.28
|
| Rate for Payer: BCN Commercial |
$1,498.58
|
| Rate for Payer: BCN Commercial |
$2,247.87
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$2,725.39
|
| Rate for Payer: Cofinity Commercial |
$1,816.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,899.35
|
| Rate for Payer: Healthscope Commercial |
$1,932.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,874.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,812.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,739.61
|
| Rate for Payer: Mclaren Commercial |
$2,609.41
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Nomi Health Commercial |
$1,584.98
|
| Rate for Payer: Nomi Health Commercial |
$2,377.47
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,540.41
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,032.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.96
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,700.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,551.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,256.38 |
| Max. Negotiated Rate |
$1,932.90 |
| Rate for Payer: Aetna Commercial |
$1,739.61
|
| Rate for Payer: Aetna Commercial |
$2,609.41
|
| Rate for Payer: ASR ASR |
$2,812.37
|
| Rate for Payer: ASR ASR |
$1,874.91
|
| Rate for Payer: ASR Commercial |
$2,812.37
|
| Rate for Payer: ASR Commercial |
$1,874.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,362.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.12
|
| Rate for Payer: BCN Commercial |
$2,247.87
|
| Rate for Payer: BCN Commercial |
$1,498.58
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cofinity Commercial |
$2,725.39
|
| Rate for Payer: Cofinity Commercial |
$1,816.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Healthscope Commercial |
$1,932.90
|
| Rate for Payer: Healthscope Commercial |
$2,899.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,812.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,874.91
|
| Rate for Payer: Mclaren Commercial |
$1,739.61
|
| Rate for Payer: Mclaren Commercial |
$2,609.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Nomi Health Commercial |
$2,377.47
|
| Rate for Payer: Nomi Health Commercial |
$1,584.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,700.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,551.43
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,646.82 |
| Max. Negotiated Rate |
$2,533.57 |
| Rate for Payer: Aetna Commercial |
$2,280.21
|
| Rate for Payer: Aetna Commercial |
$3,420.32
|
| Rate for Payer: ASR ASR |
$3,686.35
|
| Rate for Payer: ASR ASR |
$2,457.56
|
| Rate for Payer: ASR Commercial |
$3,686.35
|
| Rate for Payer: ASR Commercial |
$2,457.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,096.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.61
|
| Rate for Payer: BCN Commercial |
$2,946.42
|
| Rate for Payer: BCN Commercial |
$1,964.28
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$3,572.34
|
| Rate for Payer: Cofinity Commercial |
$2,381.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Healthscope Commercial |
$2,533.57
|
| Rate for Payer: Healthscope Commercial |
$3,800.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,686.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,457.56
|
| Rate for Payer: Mclaren Commercial |
$2,280.21
|
| Rate for Payer: Mclaren Commercial |
$3,420.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,344.32
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$3,800.36
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,800.36 |
| Rate for Payer: Aetna Commercial |
$3,420.32
|
| Rate for Payer: Aetna Commercial |
$2,280.21
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,686.35
|
| Rate for Payer: ASR ASR |
$2,457.56
|
| Rate for Payer: ASR Commercial |
$2,457.56
|
| Rate for Payer: ASR Commercial |
$3,686.35
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,112.11
|
| Rate for Payer: BCN Commercial |
$1,964.28
|
| Rate for Payer: BCN Commercial |
$2,946.42
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$3,572.34
|
| Rate for Payer: Cofinity Commercial |
$2,381.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,533.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,457.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,686.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,280.21
|
| Rate for Payer: Mclaren Commercial |
$3,420.32
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,219.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,329.88
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,664.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,776.03
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,344.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$2,392.92 |
| Rate for Payer: Aetna Commercial |
$2,153.63
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: ASR ASR |
$2,321.13
|
| Rate for Payer: ASR Commercial |
$2,321.13
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.56
|
| Rate for Payer: BCN Commercial |
$1,855.23
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,249.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$2,392.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,321.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Mclaren Commercial |
$2,153.63
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,096.68
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,677.44
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,105.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: VA VA |
$770.53
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,555.40 |
| Max. Negotiated Rate |
$2,392.92 |
| Rate for Payer: Aetna Commercial |
$2,153.63
|
| Rate for Payer: ASR ASR |
$2,321.13
|
| Rate for Payer: ASR Commercial |
$2,321.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.99
|
| Rate for Payer: BCN Commercial |
$1,855.23
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,249.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Healthscope Commercial |
$2,392.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,321.13
|
| Rate for Payer: Mclaren Commercial |
$2,153.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,105.77
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,281.51 |
| Max. Negotiated Rate |
$1,971.56 |
| Rate for Payer: Aetna Commercial |
$1,774.40
|
| Rate for Payer: ASR ASR |
$1,912.41
|
| Rate for Payer: ASR Commercial |
$1,912.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.62
|
| Rate for Payer: BCN Commercial |
$1,528.55
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,853.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Healthscope Commercial |
$1,971.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,912.41
|
| Rate for Payer: Mclaren Commercial |
$1,774.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.97
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,971.56 |
| Rate for Payer: Aetna Commercial |
$1,774.40
|
| 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 |
$1,912.41
|
| Rate for Payer: ASR Commercial |
$1,912.41
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.51
|
| Rate for Payer: BCN Commercial |
$1,528.55
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,853.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,971.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,912.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,774.40
|
| 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 |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| 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 |
$1,281.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,727.48
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,382.06
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.97
|
| 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 LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,955.86 |
| Rate for Payer: Aetna Commercial |
$2,660.27
|
| 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 |
$2,867.18
|
| Rate for Payer: ASR Commercial |
$2,867.18
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,420.55
|
| Rate for Payer: BCN Commercial |
$2,291.68
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,778.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,955.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,867.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,660.27
|
| 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 |
$2,512.48
|
| Rate for Payer: Nomi Health Commercial |
$2,423.81
|
| 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 |
$1,921.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,589.92
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,072.06
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,601.16
|
| 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 LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,921.31 |
| Max. Negotiated Rate |
$2,955.86 |
| Rate for Payer: Aetna Commercial |
$2,660.27
|
| Rate for Payer: ASR ASR |
$2,867.18
|
| Rate for Payer: ASR Commercial |
$2,867.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,408.73
|
| Rate for Payer: BCN Commercial |
$2,291.68
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,778.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Healthscope Commercial |
$2,955.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,867.18
|
| Rate for Payer: Mclaren Commercial |
$2,660.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.48
|
| Rate for Payer: Nomi Health Commercial |
$2,423.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,601.16
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,871.91
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| 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 |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.10
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| 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 |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| 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 |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,012.72
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.27
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
| 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 LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
IP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,053.06 |
| Max. Negotiated Rate |
$3,158.55 |
| Rate for Payer: Aetna Commercial |
$2,842.70
|
| Rate for Payer: ASR ASR |
$3,063.79
|
| Rate for Payer: ASR Commercial |
$3,063.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,573.90
|
| Rate for Payer: BCN Commercial |
$2,448.82
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,969.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Healthscope Commercial |
$3,158.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,063.79
|
| Rate for Payer: Mclaren Commercial |
$2,842.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: Nomi Health Commercial |
$2,590.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.52
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
OP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,158.55 |
| Rate for Payer: Aetna Commercial |
$2,842.70
|
| 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 |
$3,063.79
|
| Rate for Payer: ASR Commercial |
$3,063.79
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,586.54
|
| Rate for Payer: BCN Commercial |
$2,448.82
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,969.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,158.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,063.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,842.70
|
| 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 |
$2,684.77
|
| Rate for Payer: Nomi Health Commercial |
$2,590.01
|
| 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 |
$2,053.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,767.52
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,214.14
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.52
|
| 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 LOWER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,364.71
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.06 |
| Max. Negotiated Rate |
$2,364.71 |
| Rate for Payer: Aetna Commercial |
$2,128.24
|
| Rate for Payer: Aetna Commercial |
$3,192.36
|
| Rate for Payer: ASR ASR |
$3,440.66
|
| Rate for Payer: ASR ASR |
$2,293.77
|
| Rate for Payer: ASR Commercial |
$3,440.66
|
| Rate for Payer: ASR Commercial |
$2,293.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.00
|
| Rate for Payer: BCN Commercial |
$2,750.04
|
| Rate for Payer: BCN Commercial |
$1,833.36
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$3,334.25
|
| Rate for Payer: Cofinity Commercial |
$2,222.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Healthscope Commercial |
$2,364.71
|
| Rate for Payer: Healthscope Commercial |
$3,547.07
|
| Rate for Payer: Healthscope Whirlpool |
$3,440.66
|
| Rate for Payer: Healthscope Whirlpool |
$2,293.77
|
| Rate for Payer: Mclaren Commercial |
$2,128.24
|
| Rate for Payer: Mclaren Commercial |
$3,192.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: Nomi Health Commercial |
$2,908.60
|
| Rate for Payer: Nomi Health Commercial |
$1,939.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,080.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,121.42
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,547.07
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,547.07 |
| Rate for Payer: Aetna Commercial |
$3,192.36
|
| Rate for Payer: Aetna Commercial |
$2,128.24
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,440.66
|
| Rate for Payer: ASR ASR |
$2,293.77
|
| Rate for Payer: ASR Commercial |
$2,293.77
|
| Rate for Payer: ASR Commercial |
$3,440.66
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,936.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.70
|
| Rate for Payer: BCN Commercial |
$1,833.36
|
| Rate for Payer: BCN Commercial |
$2,750.04
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cofinity Commercial |
$3,334.25
|
| Rate for Payer: Cofinity Commercial |
$2,222.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,547.07
|
| Rate for Payer: Healthscope Commercial |
$2,364.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,293.77
|
| Rate for Payer: Healthscope Whirlpool |
$3,440.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,128.24
|
| Rate for Payer: Mclaren Commercial |
$3,192.36
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: Nomi Health Commercial |
$1,939.06
|
| Rate for Payer: Nomi Health Commercial |
$2,908.60
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,071.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,107.94
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,486.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,657.66
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,080.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,121.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$3,199.38
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$3,199.38 |
| Rate for Payer: Aetna Commercial |
$2,879.44
|
| Rate for Payer: Aetna Commercial |
$1,919.63
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$3,103.40
|
| Rate for Payer: ASR ASR |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$3,103.40
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,619.97
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| Rate for Payer: BCN Commercial |
$2,480.48
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$3,007.42
|
| Rate for Payer: Cofinity Commercial |
$2,004.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$3,199.38
|
| Rate for Payer: Healthscope Commercial |
$2,132.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.93
|
| Rate for Payer: Healthscope Whirlpool |
$3,103.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Commercial |
$2,879.44
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: Nomi Health Commercial |
$2,623.49
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,868.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,803.30
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,242.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.18
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,876.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,815.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
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: Aetna Commercial |
$2,879.44
|
| Rate for Payer: ASR ASR |
$3,103.40
|
| Rate for Payer: ASR ASR |
$2,068.93
|
| Rate for Payer: ASR Commercial |
$3,103.40
|
| Rate for Payer: ASR Commercial |
$2,068.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,607.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.12
|
| Rate for Payer: BCN Commercial |
$2,480.48
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$3,007.42
|
| Rate for Payer: Cofinity Commercial |
$2,004.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Healthscope Commercial |
$2,132.92
|
| Rate for Payer: Healthscope Commercial |
$3,199.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,103.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.93
|
| Rate for Payer: Mclaren Commercial |
$1,919.63
|
| Rate for Payer: Mclaren Commercial |
$2,879.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$2,623.49
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,876.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,815.45
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,969.31 |
| Max. Negotiated Rate |
$3,029.70 |
| Rate for Payer: Aetna Commercial |
$2,726.73
|
| Rate for Payer: Aetna Commercial |
$4,090.09
|
| Rate for Payer: ASR ASR |
$4,408.21
|
| Rate for Payer: ASR ASR |
$2,938.81
|
| Rate for Payer: ASR Commercial |
$4,408.21
|
| Rate for Payer: ASR Commercial |
$2,938.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,468.90
|
| Rate for Payer: BCN Commercial |
$3,523.39
|
| Rate for Payer: BCN Commercial |
$2,348.93
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$4,271.88
|
| Rate for Payer: Cofinity Commercial |
$2,847.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Healthscope Commercial |
$3,029.70
|
| Rate for Payer: Healthscope Commercial |
$4,544.55
|
| Rate for Payer: Healthscope Whirlpool |
$4,408.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,938.81
|
| Rate for Payer: Mclaren Commercial |
$2,726.73
|
| Rate for Payer: Mclaren Commercial |
$4,090.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: Nomi Health Commercial |
$3,726.53
|
| Rate for Payer: Nomi Health Commercial |
$2,484.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,999.20
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$4,544.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$4,544.55 |
| Rate for Payer: Aetna Commercial |
$4,090.09
|
| Rate for Payer: Aetna Commercial |
$2,726.73
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$4,408.21
|
| Rate for Payer: ASR ASR |
$2,938.81
|
| Rate for Payer: ASR Commercial |
$2,938.81
|
| Rate for Payer: ASR Commercial |
$4,408.21
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,481.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,721.53
|
| Rate for Payer: BCN Commercial |
$2,348.93
|
| Rate for Payer: BCN Commercial |
$3,523.39
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cofinity Commercial |
$4,271.88
|
| Rate for Payer: Cofinity Commercial |
$2,847.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$4,544.55
|
| Rate for Payer: Healthscope Commercial |
$3,029.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,938.81
|
| Rate for Payer: Healthscope Whirlpool |
$4,408.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,726.73
|
| Rate for Payer: Mclaren Commercial |
$4,090.09
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: Nomi Health Commercial |
$2,484.35
|
| Rate for Payer: Nomi Health Commercial |
$3,726.53
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,654.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,981.93
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$3,185.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,123.82
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,999.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,252.06 |
| Rate for Payer: Aetna Commercial |
$2,026.85
|
| Rate for Payer: ASR ASR |
$2,184.50
|
| Rate for Payer: ASR Commercial |
$2,184.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,835.20
|
| Rate for Payer: BCN Commercial |
$1,746.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$2,116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,252.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.50
|
| Rate for Payer: Mclaren Commercial |
$2,026.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.81
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,252.06 |
| Rate for Payer: Aetna Commercial |
$2,026.85
|
| 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 |
$2,184.50
|
| Rate for Payer: ASR Commercial |
$2,184.50
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.21
|
| Rate for Payer: BCN Commercial |
$1,746.02
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$2,116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,252.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,026.85
|
| 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 |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| 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 |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,973.25
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,578.69
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.81
|
| 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 MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna Commercial |
$1,900.26
|
| 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 |
$2,048.06
|
| Rate for Payer: ASR Commercial |
$2,048.06
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.03
|
| Rate for Payer: BCN Commercial |
$1,636.97
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,984.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,048.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,900.26
|
| 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 |
$1,794.69
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| 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 |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,850.01
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,480.09
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,858.03
|
| 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
|
|
