|
HC MR PELVIS WO W CON
|
Facility
|
OP
|
$3,049.16
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,049.16 |
| Rate for Payer: Aetna Commercial |
$2,744.24
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,957.69
|
| Rate for Payer: ASR Commercial |
$2,957.69
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,496.96
|
| Rate for Payer: BCN Commercial |
$2,364.01
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,439.33
|
| Rate for Payer: Cash Price |
$2,439.33
|
| Rate for Payer: Cofinity Commercial |
$2,866.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,439.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,049.16
|
| Rate for Payer: Healthscope Whirlpool |
$2,957.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,744.24
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,591.79
|
| Rate for Payer: Nomi Health Commercial |
$2,500.31
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,257.52
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,806.02
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,683.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR PELVIS WO W CON
|
Facility
|
IP
|
$3,049.16
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,981.95 |
| Max. Negotiated Rate |
$3,049.16 |
| Rate for Payer: Aetna Commercial |
$2,744.24
|
| Rate for Payer: ASR ASR |
$2,957.69
|
| Rate for Payer: ASR Commercial |
$2,957.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,484.76
|
| Rate for Payer: BCN Commercial |
$2,364.01
|
| Rate for Payer: Cash Price |
$2,439.33
|
| Rate for Payer: Cofinity Commercial |
$2,866.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,439.33
|
| Rate for Payer: Healthscope Commercial |
$3,049.16
|
| Rate for Payer: Healthscope Whirlpool |
$2,957.69
|
| Rate for Payer: Mclaren Commercial |
$2,744.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,591.79
|
| Rate for Payer: Nomi Health Commercial |
$2,500.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,683.26
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
OP
|
$1,900.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,900.16 |
| Rate for Payer: Aetna Commercial |
$1,710.14
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$1,843.16
|
| Rate for Payer: ASR Commercial |
$1,843.16
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.04
|
| Rate for Payer: BCN Commercial |
$1,473.19
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,786.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$1,900.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,843.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$1,710.14
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: Nomi Health Commercial |
$1,558.13
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,664.92
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,332.01
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,672.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
IP
|
$1,900.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,235.10 |
| Max. Negotiated Rate |
$1,900.16 |
| Rate for Payer: Aetna Commercial |
$1,710.14
|
| Rate for Payer: ASR ASR |
$1,843.16
|
| Rate for Payer: ASR Commercial |
$1,843.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.44
|
| Rate for Payer: BCN Commercial |
$1,473.19
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,786.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Healthscope Commercial |
$1,900.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,843.16
|
| Rate for Payer: Mclaren Commercial |
$1,710.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: Nomi Health Commercial |
$1,558.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,672.14
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
OP
|
$2,322.34
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,322.34 |
| Rate for Payer: Aetna Commercial |
$2,090.11
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,252.67
|
| Rate for Payer: ASR Commercial |
$2,252.67
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.76
|
| Rate for Payer: BCN Commercial |
$1,800.51
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,857.87
|
| Rate for Payer: Cash Price |
$1,857.87
|
| Rate for Payer: Cofinity Commercial |
$2,183.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,857.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,322.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,252.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,090.11
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,973.99
|
| Rate for Payer: Nomi Health Commercial |
$1,904.32
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,817.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,454.21
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,043.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
IP
|
$2,322.34
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,509.52 |
| Max. Negotiated Rate |
$2,322.34 |
| Rate for Payer: Aetna Commercial |
$2,090.11
|
| Rate for Payer: ASR ASR |
$2,252.67
|
| Rate for Payer: ASR Commercial |
$2,252.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,892.47
|
| Rate for Payer: BCN Commercial |
$1,800.51
|
| Rate for Payer: Cash Price |
$1,857.87
|
| Rate for Payer: Cofinity Commercial |
$2,183.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,857.87
|
| Rate for Payer: Healthscope Commercial |
$2,322.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,252.67
|
| Rate for Payer: Mclaren Commercial |
$2,090.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,973.99
|
| Rate for Payer: Nomi Health Commercial |
$1,904.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,043.66
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$754.49 |
| Max. Negotiated Rate |
$1,160.76 |
| Rate for Payer: Aetna Commercial |
$1,044.68
|
| Rate for Payer: ASR ASR |
$1,125.94
|
| Rate for Payer: ASR Commercial |
$1,125.94
|
| Rate for Payer: BCBS Trust/PPO |
$945.90
|
| Rate for Payer: BCN Commercial |
$899.94
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$1,091.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Healthscope Commercial |
$1,160.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,125.94
|
| Rate for Payer: Mclaren Commercial |
$1,044.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.65
|
| Rate for Payer: Nomi Health Commercial |
$951.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.47
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,817.76 |
| Rate for Payer: Aetna Commercial |
$1,044.68
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$1,125.94
|
| Rate for Payer: ASR Commercial |
$1,125.94
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$950.55
|
| Rate for Payer: BCN Commercial |
$899.94
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$1,091.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,160.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,125.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,044.68
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.65
|
| Rate for Payer: Nomi Health Commercial |
$951.82
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,817.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,454.21
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,288.04 |
| Rate for Payer: Aetna Commercial |
$2,059.24
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,219.40
|
| Rate for Payer: ASR Commercial |
$2,219.40
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,873.68
|
| Rate for Payer: BCN Commercial |
$1,773.92
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$2,150.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,288.04
|
| Rate for Payer: Healthscope Whirlpool |
$2,219.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$2,059.24
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.01
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.41
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,013.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,487.23 |
| Max. Negotiated Rate |
$2,288.04 |
| Rate for Payer: Aetna Commercial |
$2,059.24
|
| Rate for Payer: ASR ASR |
$2,219.40
|
| Rate for Payer: ASR Commercial |
$2,219.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,864.52
|
| Rate for Payer: BCN Commercial |
$1,773.92
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$2,150.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,288.04
|
| Rate for Payer: Healthscope Whirlpool |
$2,219.40
|
| Rate for Payer: Mclaren Commercial |
$2,059.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,013.48
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,563.01 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,110.11
|
| Rate for Payer: ASR Commercial |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$937.18
|
| Rate for Payer: BCN Commercial |
$887.28
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$1,075.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,144.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.01
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.41
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$743.89 |
| Max. Negotiated Rate |
$1,144.44 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| Rate for Payer: ASR ASR |
$1,110.11
|
| Rate for Payer: ASR Commercial |
$1,110.11
|
| Rate for Payer: BCBS Trust/PPO |
$932.60
|
| Rate for Payer: BCN Commercial |
$887.28
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$1,075.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,144.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.11
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,771.89
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,801.73 |
| Max. Negotiated Rate |
$2,771.89 |
| Rate for Payer: Aetna Commercial |
$2,494.70
|
| Rate for Payer: ASR ASR |
$2,688.73
|
| Rate for Payer: ASR Commercial |
$2,688.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,258.81
|
| Rate for Payer: BCN Commercial |
$2,149.05
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cofinity Commercial |
$2,605.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.51
|
| Rate for Payer: Healthscope Commercial |
$2,771.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,688.73
|
| Rate for Payer: Mclaren Commercial |
$2,494.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.11
|
| Rate for Payer: Nomi Health Commercial |
$2,272.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.26
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,771.89
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,771.89 |
| Rate for Payer: Aetna Commercial |
$2,494.70
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,688.73
|
| Rate for Payer: ASR Commercial |
$2,688.73
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,269.90
|
| Rate for Payer: BCN Commercial |
$2,149.05
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cofinity Commercial |
$2,605.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,771.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,688.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,494.70
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.11
|
| Rate for Payer: Nomi Health Commercial |
$2,272.95
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,107.09
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,685.67
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$888.92
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$577.80 |
| Max. Negotiated Rate |
$888.92 |
| Rate for Payer: Aetna Commercial |
$800.03
|
| Rate for Payer: ASR ASR |
$862.25
|
| Rate for Payer: ASR Commercial |
$862.25
|
| Rate for Payer: BCBS Trust/PPO |
$724.38
|
| Rate for Payer: BCN Commercial |
$689.18
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cofinity Commercial |
$835.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$711.14
|
| Rate for Payer: Healthscope Commercial |
$888.92
|
| Rate for Payer: Healthscope Whirlpool |
$862.25
|
| Rate for Payer: Mclaren Commercial |
$800.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.58
|
| Rate for Payer: Nomi Health Commercial |
$728.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$782.25
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$888.92
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,107.09 |
| Rate for Payer: Aetna Commercial |
$800.03
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$862.25
|
| Rate for Payer: ASR Commercial |
$862.25
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$727.94
|
| Rate for Payer: BCN Commercial |
$689.18
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cofinity Commercial |
$835.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$711.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$888.92
|
| Rate for Payer: Healthscope Whirlpool |
$862.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$800.03
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.58
|
| Rate for Payer: Nomi Health Commercial |
$728.91
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,107.09
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,685.67
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$782.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,458.07 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| Rate for Payer: ASR ASR |
$2,175.88
|
| Rate for Payer: ASR Commercial |
$2,175.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.97
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$2,108.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,175.88
|
| Rate for Payer: ASR Commercial |
$2,175.88
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,836.94
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$2,108.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.07
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,380.86
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$817.75
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,726.07 |
| Rate for Payer: Aetna Commercial |
$735.98
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$793.22
|
| Rate for Payer: ASR Commercial |
$793.22
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$669.66
|
| Rate for Payer: BCN Commercial |
$634.00
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cofinity Commercial |
$768.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$817.75
|
| Rate for Payer: Healthscope Whirlpool |
$793.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$735.98
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.09
|
| Rate for Payer: Nomi Health Commercial |
$670.56
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.07
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,380.86
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$719.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$817.75
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$531.54 |
| Max. Negotiated Rate |
$817.75 |
| Rate for Payer: Aetna Commercial |
$735.98
|
| Rate for Payer: ASR ASR |
$793.22
|
| Rate for Payer: ASR Commercial |
$793.22
|
| Rate for Payer: BCBS Trust/PPO |
$666.38
|
| Rate for Payer: BCN Commercial |
$634.00
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cofinity Commercial |
$768.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.20
|
| Rate for Payer: Healthscope Commercial |
$817.75
|
| Rate for Payer: Healthscope Whirlpool |
$793.22
|
| Rate for Payer: Mclaren Commercial |
$735.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.09
|
| Rate for Payer: Nomi Health Commercial |
$670.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$719.62
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,280.24 |
| Rate for Payer: Aetna Commercial |
$2,052.22
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,211.83
|
| Rate for Payer: ASR Commercial |
$2,211.83
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.29
|
| Rate for Payer: BCN Commercial |
$1,767.87
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cofinity Commercial |
$2,143.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,824.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,280.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$2,052.22
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,938.20
|
| Rate for Payer: Nomi Health Commercial |
$1,869.80
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,550.94
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.75
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,006.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,482.16 |
| Max. Negotiated Rate |
$2,280.24 |
| Rate for Payer: Aetna Commercial |
$2,052.22
|
| Rate for Payer: ASR ASR |
$2,211.83
|
| Rate for Payer: ASR Commercial |
$2,211.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.17
|
| Rate for Payer: BCN Commercial |
$1,767.87
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cofinity Commercial |
$2,143.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,824.19
|
| Rate for Payer: Healthscope Commercial |
$2,280.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.83
|
| Rate for Payer: Mclaren Commercial |
$2,052.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,938.20
|
| Rate for Payer: Nomi Health Commercial |
$1,869.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,006.61
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,088.08
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,357.25 |
| Max. Negotiated Rate |
$2,088.08 |
| Rate for Payer: Aetna Commercial |
$1,879.27
|
| Rate for Payer: ASR ASR |
$2,025.44
|
| Rate for Payer: ASR Commercial |
$2,025.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.58
|
| Rate for Payer: BCN Commercial |
$1,618.89
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cofinity Commercial |
$1,962.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.46
|
| Rate for Payer: Healthscope Commercial |
$2,088.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,025.44
|
| Rate for Payer: Mclaren Commercial |
$1,879.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.87
|
| Rate for Payer: Nomi Health Commercial |
$1,712.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,837.51
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,088.08
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,088.08 |
| Rate for Payer: Aetna Commercial |
$1,879.27
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,025.44
|
| Rate for Payer: ASR Commercial |
$2,025.44
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.93
|
| Rate for Payer: BCN Commercial |
$1,618.89
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cofinity Commercial |
$1,962.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,088.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,025.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,879.27
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.87
|
| Rate for Payer: Nomi Health Commercial |
$1,712.23
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,550.94
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.75
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,837.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,069.26 |
| Max. Negotiated Rate |
$3,183.47 |
| Rate for Payer: Aetna Commercial |
$2,865.12
|
| Rate for Payer: ASR ASR |
$3,087.97
|
| Rate for Payer: ASR Commercial |
$3,087.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,594.21
|
| Rate for Payer: BCN Commercial |
$2,468.14
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Commercial |
$2,992.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Healthscope Commercial |
$3,183.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,087.97
|
| Rate for Payer: Mclaren Commercial |
$2,865.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.95
|
| Rate for Payer: Nomi Health Commercial |
$2,610.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,801.45
|
|
