|
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 |
$186.69 |
| Max. Negotiated Rate |
$2,639.81 |
| Rate for Payer: Aetna Commercial |
$2,375.83
|
| 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 |
$2,560.62
|
| Rate for Payer: ASR Commercial |
$2,560.62
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,161.74
|
| Rate for Payer: BCN Commercial |
$2,046.64
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,639.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,560.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,375.83
|
| 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 |
$2,243.84
|
| Rate for Payer: Nomi Health Commercial |
$2,164.64
|
| 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 |
$1,715.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,313.00
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,850.51
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,323.03
|
| 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 W LTD
|
Facility
|
OP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$924.50 |
| Rate for Payer: Aetna Commercial |
$832.05
|
| 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 |
$896.76
|
| Rate for Payer: ASR Commercial |
$896.76
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$757.07
|
| Rate for Payer: BCN Commercial |
$716.76
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$924.50
|
| Rate for Payer: Healthscope Whirlpool |
$896.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$832.05
|
| 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 |
$785.83
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| 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 |
$600.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$810.05
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$648.07
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.56
|
| 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 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 |
$785.83
|
| 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 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 TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,072.90 |
| Rate for Payer: Aetna Commercial |
$1,865.61
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,010.71
|
| Rate for Payer: ASR Commercial |
$2,010.71
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.50
|
| Rate for Payer: BCN Commercial |
$1,607.12
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,948.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,865.61
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,816.27
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,453.10
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR 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 |
$2,119.09
|
| 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 |
$186.69 |
| Max. Negotiated Rate |
$2,584.25 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| 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 |
$2,506.72
|
| Rate for Payer: ASR Commercial |
$2,506.72
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,116.24
|
| Rate for Payer: BCN Commercial |
$2,003.57
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,584.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,506.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| 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 |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.09
|
| 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 |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,264.32
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,811.56
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.14
|
| 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 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 |
$2,233.59
|
| 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 |
$413.00 |
| 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 |
$770.53
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: ASR ASR |
$3,333.21
|
| 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 |
$433.65
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,813.99
|
| Rate for Payer: BCN Commercial |
$1,776.10
|
| Rate for Payer: BCN Commercial |
$2,664.16
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.12
|
| Rate for Payer: Cofinity Commercial |
$2,153.41
|
| 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 |
$770.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$3,436.30
|
| Rate for Payer: Healthscope Commercial |
$2,290.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,222.13
|
| Rate for Payer: Healthscope Whirlpool |
$3,333.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Mclaren Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Commercial |
$3,092.67
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,010.89
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,408.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.89
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,023.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: VA VA |
$770.53
|
|
|
HC MR 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 |
$126.36 |
| 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 |
$235.74
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,903.05
|
| 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 |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.83
|
| Rate for Payer: BCN Commercial |
$1,546.89
|
| Rate for Payer: BCN Commercial |
$2,320.34
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$2,813.26
|
| Rate for Payer: Cofinity Commercial |
$1,875.51
|
| 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 |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,992.83
|
| Rate for Payer: Healthscope Commercial |
$1,995.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,903.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Commercial |
$2,693.55
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,748.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,622.32
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,097.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,398.65
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR 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 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 |
$186.69 |
| 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 |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,578.38
|
| 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 |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.96
|
| Rate for Payer: BCN Commercial |
$1,906.75
|
| Rate for Payer: BCN Commercial |
$2,860.12
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cofinity Commercial |
$3,467.71
|
| Rate for Payer: Cofinity Commercial |
$2,311.81
|
| 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 |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,689.05
|
| Rate for Payer: Healthscope Commercial |
$2,459.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,385.59
|
| Rate for Payer: Healthscope Whirlpool |
$3,578.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,213.43
|
| Rate for Payer: Mclaren Commercial |
$3,320.14
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Nomi Health Commercial |
$2,016.68
|
| Rate for Payer: Nomi Health Commercial |
$3,025.02
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,154.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,232.35
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,586.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,724.02
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,246.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR 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 |
$413.00 |
| Max. Negotiated Rate |
$2,512.46 |
| Rate for Payer: Aetna Commercial |
$2,261.21
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: ASR ASR |
$2,437.09
|
| Rate for Payer: ASR Commercial |
$2,437.09
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.45
|
| Rate for Payer: BCN Commercial |
$1,947.91
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| 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 |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$2,512.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,437.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Mclaren Commercial |
$2,261.21
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: Nomi Health Commercial |
$2,060.22
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.42
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,761.23
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,210.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: VA VA |
$770.53
|
|
|
HC MR 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 WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,871.91
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.10
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,012.72
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.27
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,463.20 |
| Rate for Payer: Aetna Commercial |
$2,216.88
|
| 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 |
$2,389.30
|
| Rate for Payer: ASR Commercial |
$2,389.30
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.11
|
| Rate for Payer: BCN Commercial |
$1,909.72
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,315.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,463.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,389.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,216.88
|
| 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 |
$2,093.72
|
| Rate for Payer: Nomi Health Commercial |
$2,019.82
|
| 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 |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,158.26
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,726.70
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,167.62
|
| 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 UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,601.08 |
| Max. Negotiated Rate |
$2,463.20 |
| Rate for Payer: Aetna Commercial |
$2,216.88
|
| Rate for Payer: ASR ASR |
$2,389.30
|
| Rate for Payer: ASR Commercial |
$2,389.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.26
|
| Rate for Payer: BCN Commercial |
$1,909.72
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,315.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Healthscope Commercial |
$2,463.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,389.30
|
| Rate for Payer: Mclaren Commercial |
$2,216.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,093.72
|
| Rate for Payer: Nomi Health Commercial |
$2,019.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,167.62
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.10
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,012.72
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.27
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,297.10 |
| Rate for Payer: Aetna Commercial |
$2,067.39
|
| Rate for Payer: ASR ASR |
$2,228.19
|
| Rate for Payer: ASR Commercial |
$2,228.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,871.91
|
| Rate for Payer: BCN Commercial |
$1,780.94
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$2,159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,297.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,228.19
|
| Rate for Payer: Mclaren Commercial |
$2,067.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,021.45
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,584.25 |
| Rate for Payer: Aetna Commercial |
$2,325.82
|
| 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 |
$2,506.72
|
| Rate for Payer: ASR Commercial |
$2,506.72
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,116.24
|
| Rate for Payer: BCN Commercial |
$2,003.57
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,584.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,506.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,325.82
|
| 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 |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.09
|
| 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 |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,264.32
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,811.56
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,274.14
|
| 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 UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
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 |
$2,119.09
|
| 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 NO JOINT W CON
|
Facility
|
IP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,513.96 |
| Max. Negotiated Rate |
$2,329.17 |
| Rate for Payer: Aetna Commercial |
$2,096.25
|
| Rate for Payer: Aetna Commercial |
$3,144.38
|
| Rate for Payer: ASR ASR |
$3,388.94
|
| Rate for Payer: ASR ASR |
$2,259.29
|
| Rate for Payer: ASR Commercial |
$3,388.94
|
| Rate for Payer: ASR Commercial |
$2,259.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,847.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.04
|
| Rate for Payer: BCN Commercial |
$2,708.70
|
| Rate for Payer: BCN Commercial |
$1,805.81
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$3,284.12
|
| Rate for Payer: Cofinity Commercial |
$2,189.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Healthscope Commercial |
$2,329.17
|
| Rate for Payer: Healthscope Commercial |
$3,493.75
|
| Rate for Payer: Healthscope Whirlpool |
$3,388.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,259.29
|
| Rate for Payer: Mclaren Commercial |
$2,096.25
|
| Rate for Payer: Mclaren Commercial |
$3,144.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Nomi Health Commercial |
$2,864.88
|
| Rate for Payer: Nomi Health Commercial |
$1,909.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,049.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,074.50
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,493.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,493.75 |
| Rate for Payer: Aetna Commercial |
$3,144.38
|
| Rate for Payer: Aetna Commercial |
$2,096.25
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,388.94
|
| Rate for Payer: ASR ASR |
$2,259.29
|
| Rate for Payer: ASR Commercial |
$2,259.29
|
| Rate for Payer: ASR Commercial |
$3,388.94
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,907.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,861.03
|
| Rate for Payer: BCN Commercial |
$1,805.81
|
| Rate for Payer: BCN Commercial |
$2,708.70
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cofinity Commercial |
$3,284.12
|
| Rate for Payer: Cofinity Commercial |
$2,189.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,493.75
|
| Rate for Payer: Healthscope Commercial |
$2,329.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,259.29
|
| Rate for Payer: Healthscope Whirlpool |
$3,388.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,096.25
|
| Rate for Payer: Mclaren Commercial |
$3,144.38
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Nomi Health Commercial |
$1,909.92
|
| Rate for Payer: Nomi Health Commercial |
$2,864.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,040.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,061.22
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,449.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.75
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,049.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,074.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
