|
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 LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,144.44 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| 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 |
$1,110.11
|
| Rate for Payer: ASR Commercial |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$937.18
|
| Rate for Payer: BCN Commercial |
$887.28
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| 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 |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,144.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| 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 |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| 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 |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.76
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$802.25
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
| 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 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 |
$186.69 |
| Max. Negotiated Rate |
$2,771.89 |
| Rate for Payer: Aetna Commercial |
$2,494.70
|
| 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 |
$2,688.73
|
| Rate for Payer: ASR Commercial |
$2,688.73
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,269.90
|
| Rate for Payer: BCN Commercial |
$2,149.05
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,771.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,688.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,494.70
|
| 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 |
$2,356.11
|
| Rate for Payer: Nomi Health Commercial |
$2,272.95
|
| 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 |
$1,801.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,428.73
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.09
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.26
|
| 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 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 |
$186.69 |
| Max. Negotiated Rate |
$888.92 |
| Rate for Payer: Aetna Commercial |
$800.03
|
| 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 |
$862.25
|
| Rate for Payer: ASR Commercial |
$862.25
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$727.94
|
| Rate for Payer: BCN Commercial |
$689.18
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$888.92
|
| Rate for Payer: Healthscope Whirlpool |
$862.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$800.03
|
| 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 |
$755.58
|
| Rate for Payer: Nomi Health Commercial |
$728.91
|
| 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 |
$577.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.87
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$623.13
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$782.25
|
| 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 SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| 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 |
$2,175.88
|
| Rate for Payer: ASR Commercial |
$2,175.88
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,836.94
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| 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 |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| 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 |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.47
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,572.47
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
| 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 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 LTD
|
Facility
|
OP
|
$817.75
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$817.75 |
| Rate for Payer: Aetna Commercial |
$735.98
|
| 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 |
$793.22
|
| Rate for Payer: ASR Commercial |
$793.22
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$669.66
|
| Rate for Payer: BCN Commercial |
$634.00
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$817.75
|
| Rate for Payer: Healthscope Whirlpool |
$793.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$735.98
|
| 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 |
$695.09
|
| Rate for Payer: Nomi Health Commercial |
$670.55
|
| 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 |
$531.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.51
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$573.24
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$719.62
|
| 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 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 |
$670.55
|
| 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
|
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 CON
|
Facility
|
OP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,280.24 |
| Rate for Payer: Aetna Commercial |
$2,052.22
|
| 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 |
$2,211.83
|
| Rate for Payer: ASR Commercial |
$2,211.83
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.29
|
| Rate for Payer: BCN Commercial |
$1,767.87
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| 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 |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,280.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$2,052.22
|
| 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 |
$1,938.20
|
| Rate for Payer: Nomi Health Commercial |
$1,869.80
|
| 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 |
$1,482.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,997.95
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,598.45
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,006.61
|
| 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 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 |
$126.36 |
| Max. Negotiated Rate |
$2,088.08 |
| Rate for Payer: Aetna Commercial |
$1,879.27
|
| 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 |
$2,025.44
|
| Rate for Payer: ASR Commercial |
$2,025.44
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.93
|
| Rate for Payer: BCN Commercial |
$1,618.89
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| 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 |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,088.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,025.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,879.27
|
| 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 |
$1,774.87
|
| Rate for Payer: Nomi Health Commercial |
$1,712.23
|
| 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 |
$1,357.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,829.58
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,463.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,837.51
|
| 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 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
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,183.47 |
| Rate for Payer: Aetna Commercial |
$2,865.12
|
| 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 |
$3,087.97
|
| Rate for Payer: ASR Commercial |
$3,087.97
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,606.94
|
| Rate for Payer: BCN Commercial |
$2,468.14
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,546.78
|
| 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: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,183.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,087.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,865.12
|
| 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 |
$2,705.95
|
| Rate for Payer: Nomi Health Commercial |
$2,610.45
|
| 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 |
$2,069.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,789.36
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,231.61
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,801.45
|
| 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 SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,915.20 |
| Rate for Payer: Aetna Commercial |
$2,623.68
|
| 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 |
$2,827.74
|
| Rate for Payer: ASR Commercial |
$2,827.74
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,387.26
|
| Rate for Payer: BCN Commercial |
$2,260.15
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,740.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,915.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,827.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,623.68
|
| 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 |
$2,477.92
|
| Rate for Payer: Nomi Health Commercial |
$2,390.46
|
| 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 |
$1,894.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,554.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,043.56
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,565.38
|
| 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 SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,894.88 |
| Max. Negotiated Rate |
$2,915.20 |
| Rate for Payer: Aetna Commercial |
$2,623.68
|
| Rate for Payer: ASR ASR |
$2,827.74
|
| Rate for Payer: ASR Commercial |
$2,827.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,375.60
|
| Rate for Payer: BCN Commercial |
$2,260.15
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,740.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Healthscope Commercial |
$2,915.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,827.74
|
| Rate for Payer: Mclaren Commercial |
$2,623.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.92
|
| Rate for Payer: Nomi Health Commercial |
$2,390.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,565.38
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
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 THORACIC W LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,144.44 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,110.11
|
| Rate for Payer: ASR Commercial |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$937.18
|
| Rate for Payer: BCN Commercial |
$887.28
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,144.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| 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 |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| 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 |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.76
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$802.25
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,258.32 |
| Max. Negotiated Rate |
$1,935.87 |
| Rate for Payer: Aetna Commercial |
$1,742.28
|
| Rate for Payer: ASR ASR |
$1,877.79
|
| Rate for Payer: ASR Commercial |
$1,877.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.54
|
| Rate for Payer: BCN Commercial |
$1,500.88
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cofinity Commercial |
$1,819.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.70
|
| Rate for Payer: Healthscope Commercial |
$1,935.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,877.79
|
| Rate for Payer: Mclaren Commercial |
$1,742.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: Nomi Health Commercial |
$1,587.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,703.57
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,935.87 |
| Rate for Payer: Aetna Commercial |
$1,742.28
|
| 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 |
$1,877.79
|
| Rate for Payer: ASR Commercial |
$1,877.79
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.28
|
| Rate for Payer: BCN Commercial |
$1,500.88
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cofinity Commercial |
$1,819.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,935.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,877.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,742.28
|
| 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 |
$1,645.49
|
| Rate for Payer: Nomi Health Commercial |
$1,587.41
|
| 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 |
$1,258.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,696.21
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,357.04
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,703.57
|
| 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 SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$462.22 |
| Max. Negotiated Rate |
$711.11 |
| Rate for Payer: Aetna Commercial |
$640.00
|
| Rate for Payer: ASR ASR |
$689.78
|
| Rate for Payer: ASR Commercial |
$689.78
|
| Rate for Payer: BCBS Trust/PPO |
$579.48
|
| Rate for Payer: BCN Commercial |
$551.32
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$668.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Healthscope Commercial |
$711.11
|
| Rate for Payer: Healthscope Whirlpool |
$689.78
|
| Rate for Payer: Mclaren Commercial |
$640.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.44
|
| Rate for Payer: Nomi Health Commercial |
$583.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.78
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
OP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$711.11 |
| Rate for Payer: Aetna Commercial |
$640.00
|
| 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 |
$689.78
|
| Rate for Payer: ASR Commercial |
$689.78
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$582.33
|
| Rate for Payer: BCN Commercial |
$551.32
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$668.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$711.11
|
| Rate for Payer: Healthscope Whirlpool |
$689.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$640.00
|
| 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 |
$604.44
|
| Rate for Payer: Nomi Health Commercial |
$583.11
|
| 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 |
$462.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$623.07
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$498.49
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.78
|
| 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 SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,715.88 |
| Max. Negotiated Rate |
$2,639.81 |
| Rate for Payer: Aetna Commercial |
$2,375.83
|
| Rate for Payer: ASR ASR |
$2,560.62
|
| Rate for Payer: ASR Commercial |
$2,560.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.18
|
| Rate for Payer: BCN Commercial |
$2,046.64
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cofinity Commercial |
$2,481.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.85
|
| Rate for Payer: Healthscope Commercial |
$2,639.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,560.62
|
| Rate for Payer: Mclaren Commercial |
$2,375.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.84
|
| Rate for Payer: Nomi Health Commercial |
$2,164.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,323.03
|
|
