|
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 LTD
|
Facility
|
OP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,915.20 |
| Rate for Payer: Aetna Commercial |
$2,623.68
|
| 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 |
$2,827.74
|
| Rate for Payer: ASR Commercial |
$2,827.74
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,387.26
|
| Rate for Payer: BCN Commercial |
$2,260.15
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,915.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,827.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,623.68
|
| 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 |
$2,477.92
|
| Rate for Payer: Nomi Health Commercial |
$2,390.46
|
| 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 |
$1,894.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,058.77
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,647.02
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,565.38
|
| 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 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
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,817.76 |
| Rate for Payer: Aetna Commercial |
$1,030.00
|
| 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 |
$1,110.11
|
| Rate for Payer: ASR Commercial |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$937.18
|
| Rate for Payer: BCN Commercial |
$887.28
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,144.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$1,030.00
|
| 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 |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| 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 |
$743.89
|
| 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 |
$1,007.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR 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 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 |
$126.94 |
| Max. Negotiated Rate |
$1,935.87 |
| Rate for Payer: Aetna Commercial |
$1,742.28
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,877.79
|
| Rate for Payer: ASR Commercial |
$1,877.79
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.28
|
| Rate for Payer: BCN Commercial |
$1,500.88
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,935.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,877.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,742.28
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: Nomi Health Commercial |
$1,587.41
|
| 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 |
$1,258.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.53
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,246.02
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,703.57
|
| 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 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 |
$126.94 |
| Max. Negotiated Rate |
$1,557.53 |
| Rate for Payer: Aetna Commercial |
$640.00
|
| 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 |
$689.78
|
| Rate for Payer: ASR Commercial |
$689.78
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$582.33
|
| Rate for Payer: BCN Commercial |
$551.32
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$711.11
|
| Rate for Payer: Healthscope Whirlpool |
$689.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$640.00
|
| 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 |
$604.44
|
| Rate for Payer: Nomi Health Commercial |
$583.11
|
| 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 |
$462.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.53
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,246.02
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.78
|
| 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 THORACIC WO W CON
|
Facility
|
OP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,639.81 |
| Rate for Payer: Aetna Commercial |
$2,375.83
|
| 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 |
$2,560.62
|
| Rate for Payer: ASR Commercial |
$2,560.62
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,161.74
|
| Rate for Payer: BCN Commercial |
$2,046.64
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,111.85
|
| 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: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,639.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,560.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,375.83
|
| 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 |
$2,243.84
|
| Rate for Payer: Nomi Health Commercial |
$2,164.64
|
| 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 |
$1,715.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,077.98
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,662.38
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,323.03
|
| 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 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
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
IP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$600.92 |
| Max. Negotiated Rate |
$924.50 |
| Rate for Payer: Aetna Commercial |
$832.05
|
| Rate for Payer: ASR ASR |
$896.76
|
| Rate for Payer: ASR Commercial |
$896.76
|
| Rate for Payer: BCBS Trust/PPO |
$753.38
|
| Rate for Payer: BCN Commercial |
$716.76
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$869.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Healthscope Commercial |
$924.50
|
| Rate for Payer: Healthscope Whirlpool |
$896.76
|
| Rate for Payer: Mclaren Commercial |
$832.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.82
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.56
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
OP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,077.98 |
| Rate for Payer: Aetna Commercial |
$832.05
|
| 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 |
$896.76
|
| Rate for Payer: ASR Commercial |
$896.76
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$757.07
|
| Rate for Payer: BCN Commercial |
$716.76
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$869.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$924.50
|
| Rate for Payer: Healthscope Whirlpool |
$896.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$832.05
|
| 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 |
$785.82
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| 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 |
$600.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,077.98
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,662.38
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.56
|
| 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 TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.50
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,347.38 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,689.21
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,679.76 |
| Max. Negotiated Rate |
$2,584.25 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| Rate for Payer: ASR ASR |
$2,506.72
|
| Rate for Payer: ASR Commercial |
$2,506.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,105.91
|
| Rate for Payer: BCN Commercial |
$2,003.57
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,429.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Healthscope Commercial |
$2,584.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,506.72
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.14
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,584.25 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| 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 |
$2,506.72
|
| Rate for Payer: ASR Commercial |
$2,506.72
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,116.24
|
| Rate for Payer: BCN Commercial |
$2,003.57
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,429.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,584.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,506.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| 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 |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| 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 |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.14
|
| 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 UPPER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,489.06 |
| Max. Negotiated Rate |
$2,290.86 |
| Rate for Payer: Aetna Commercial |
$2,061.77
|
| Rate for Payer: Aetna Commercial |
$3,092.67
|
| Rate for Payer: ASR ASR |
$3,333.21
|
| Rate for Payer: ASR ASR |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$3,333.21
|
| Rate for Payer: ASR Commercial |
$2,222.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,800.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.82
|
| Rate for Payer: BCN Commercial |
$2,664.16
|
| Rate for Payer: BCN Commercial |
$1,776.10
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$3,230.12
|
| Rate for Payer: Cofinity Commercial |
$2,153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Healthscope Commercial |
$2,290.86
|
| Rate for Payer: Healthscope Commercial |
$3,436.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,333.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,222.13
|
| Rate for Payer: Mclaren Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Commercial |
$3,092.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,023.94
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$3,436.30 |
| Rate for Payer: Aetna Commercial |
$3,092.67
|
| Rate for Payer: Aetna Commercial |
$2,061.77
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$3,333.21
|
| Rate for Payer: ASR ASR |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$3,333.21
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,813.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.99
|
| Rate for Payer: BCN Commercial |
$1,776.10
|
| Rate for Payer: BCN Commercial |
$2,664.16
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$2,153.41
|
| Rate for Payer: Cofinity Commercial |
$3,230.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,290.86
|
| Rate for Payer: Healthscope Commercial |
$3,436.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,222.13
|
| Rate for Payer: Healthscope Whirlpool |
$3,333.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Commercial |
$3,092.67
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.53
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,246.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,246.02
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,023.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,296.89 |
| Max. Negotiated Rate |
$1,995.22 |
| Rate for Payer: Aetna Commercial |
$1,795.70
|
| Rate for Payer: Aetna Commercial |
$2,693.55
|
| Rate for Payer: ASR ASR |
$2,903.05
|
| Rate for Payer: ASR ASR |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$2,903.05
|
| Rate for Payer: ASR Commercial |
$1,935.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,438.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.90
|
| Rate for Payer: BCN Commercial |
$2,320.34
|
| Rate for Payer: BCN Commercial |
$1,546.89
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,813.26
|
| Rate for Payer: Cofinity Commercial |
$1,875.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$1,995.22
|
| Rate for Payer: Healthscope Commercial |
$2,992.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,903.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.36
|
| Rate for Payer: Mclaren Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Commercial |
$2,693.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.69
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,992.83 |
| Rate for Payer: Aetna Commercial |
$2,693.55
|
| Rate for Payer: Aetna Commercial |
$1,795.70
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,903.05
|
| Rate for Payer: ASR ASR |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$2,903.05
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.89
|
| Rate for Payer: BCN Commercial |
$1,546.89
|
| Rate for Payer: BCN Commercial |
$2,320.34
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,875.51
|
| Rate for Payer: Cofinity Commercial |
$2,813.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,995.22
|
| Rate for Payer: Healthscope Commercial |
$2,992.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,903.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Commercial |
$2,693.55
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.88
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,334.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,334.30
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,598.59 |
| Max. Negotiated Rate |
$2,459.37 |
| Rate for Payer: Aetna Commercial |
$2,213.43
|
| Rate for Payer: Aetna Commercial |
$3,320.14
|
| Rate for Payer: ASR ASR |
$3,578.38
|
| Rate for Payer: ASR ASR |
$2,385.59
|
| Rate for Payer: ASR Commercial |
$3,578.38
|
| Rate for Payer: ASR Commercial |
$2,385.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,006.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,004.14
|
| Rate for Payer: BCN Commercial |
$2,860.12
|
| Rate for Payer: BCN Commercial |
$1,906.75
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$3,467.71
|
| Rate for Payer: Cofinity Commercial |
$2,311.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Healthscope Commercial |
$2,459.37
|
| Rate for Payer: Healthscope Commercial |
$3,689.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,578.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,385.59
|
| Rate for Payer: Mclaren Commercial |
$2,213.43
|
| Rate for Payer: Mclaren Commercial |
$3,320.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Nomi Health Commercial |
$3,025.02
|
| Rate for Payer: Nomi Health Commercial |
$2,016.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,246.36
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$3,689.05
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,689.05 |
| Rate for Payer: Aetna Commercial |
$3,320.14
|
| Rate for Payer: Aetna Commercial |
$2,213.43
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$3,578.38
|
| Rate for Payer: ASR ASR |
$2,385.59
|
| Rate for Payer: ASR Commercial |
$2,385.59
|
| Rate for Payer: ASR Commercial |
$3,578.38
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.98
|
| Rate for Payer: BCN Commercial |
$1,906.75
|
| Rate for Payer: BCN Commercial |
$2,860.12
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cofinity Commercial |
$2,311.81
|
| Rate for Payer: Cofinity Commercial |
$3,467.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,459.37
|
| Rate for Payer: Healthscope Commercial |
$3,689.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,385.59
|
| Rate for Payer: Healthscope Whirlpool |
$3,578.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,213.43
|
| Rate for Payer: Mclaren Commercial |
$3,320.14
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Nomi Health Commercial |
$3,025.02
|
| Rate for Payer: Nomi Health Commercial |
$2,016.68
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,246.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,633.10 |
| Max. Negotiated Rate |
$2,512.46 |
| Rate for Payer: Aetna Commercial |
$2,261.21
|
| Rate for Payer: ASR ASR |
$2,437.09
|
| Rate for Payer: ASR Commercial |
$2,437.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.40
|
| Rate for Payer: BCN Commercial |
$1,947.91
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$2,361.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Healthscope Commercial |
$2,512.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,437.09
|
| Rate for Payer: Mclaren Commercial |
$2,261.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: Nomi Health Commercial |
$2,060.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,210.96
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$2,512.46 |
| Rate for Payer: Aetna Commercial |
$2,261.21
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$2,437.09
|
| Rate for Payer: ASR Commercial |
$2,437.09
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.45
|
| Rate for Payer: BCN Commercial |
$1,947.91
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$2,361.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,512.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,437.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$2,261.21
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: Nomi Health Commercial |
$2,060.22
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.53
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,246.02
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,210.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
