|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,683.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,060.42 |
| Max. Negotiated Rate |
$1,514.88 |
| Rate for Payer: Aetna Commercial |
$1,430.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.08
|
| Rate for Payer: Cash Price |
$1,346.56
|
| Rate for Payer: Cofinity Commercial |
$1,178.24
|
| Rate for Payer: Cofinity Commercial |
$1,447.55
|
| Rate for Payer: Healthscope Commercial |
$1,514.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.72
|
| Rate for Payer: PHP Commercial |
$1,430.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.24
|
| Rate for Payer: Priority Health SBD |
$1,060.42
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
OP
|
$3,202.09
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$140.80 |
| Max. Negotiated Rate |
$14,847.89 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna Medicare |
$5,085.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,112.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,112.15
|
| Rate for Payer: BCBS Complete |
$2,808.66
|
| Rate for Payer: BCBS MAPPO |
$4,889.72
|
| Rate for Payer: BCBS Trust/PPO |
$150.59
|
| Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Mclaren Medicaid |
$2,674.68
|
| Rate for Payer: Mclaren Medicare |
$4,889.72
|
| Rate for Payer: Meridian Medicaid |
$2,808.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,134.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,623.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PACE Medicare |
$4,645.23
|
| Rate for Payer: PACE SWMI |
$4,889.72
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: PHP Medicare Advantage |
$4,889.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,674.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,847.89
|
| Rate for Payer: Priority Health Medicare |
$4,889.72
|
| Rate for Payer: Priority Health Narrow Network |
$11,878.31
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
| Rate for Payer: UHC Exchange |
$140.80
|
| Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
| Rate for Payer: VA VA |
$4,889.72
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
IP
|
$3,202.09
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,017.32 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,389.80
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,135.57 |
| Max. Negotiated Rate |
$3,050.82 |
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,203.37
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,372.86
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health SBD |
$2,135.57
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$3,389.80
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,340.22 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,203.37
|
| Rate for Payer: BCBS Complete |
$1,355.92
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,372.86
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health SBD |
$2,135.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,474.24
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$1,340.22
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$9,660.92
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,086.38 |
| Max. Negotiated Rate |
$8,694.83 |
| Rate for Payer: Aetna Commercial |
$8,211.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,279.60
|
| Rate for Payer: Cash Price |
$7,728.74
|
| Rate for Payer: Cofinity Commercial |
$6,762.64
|
| Rate for Payer: Cofinity Commercial |
$8,308.39
|
| Rate for Payer: Healthscope Commercial |
$8,694.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.78
|
| Rate for Payer: PHP Commercial |
$8,211.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.64
|
| Rate for Payer: Priority Health SBD |
$6,086.38
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$9,660.92
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$458.75 |
| Max. Negotiated Rate |
$8,694.83 |
| Rate for Payer: Aetna Commercial |
$8,211.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,279.60
|
| Rate for Payer: BCBS Complete |
$3,864.37
|
| Rate for Payer: Cash Price |
$7,728.74
|
| Rate for Payer: Cash Price |
$7,728.74
|
| Rate for Payer: Cofinity Commercial |
$6,762.64
|
| Rate for Payer: Cofinity Commercial |
$8,308.39
|
| Rate for Payer: Healthscope Commercial |
$8,694.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.78
|
| Rate for Payer: PHP Commercial |
$8,211.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.64
|
| Rate for Payer: Priority Health SBD |
$6,086.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.62
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$458.75
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
OP
|
$3,402.31
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$99.28 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,211.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$99.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,381.62
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$2,143.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$124.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
IP
|
$3,402.31
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,143.46 |
| Max. Negotiated Rate |
$3,062.08 |
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,211.50
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,381.62
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health SBD |
$2,143.46
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
IP
|
$4,035.36
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,542.28 |
| Max. Negotiated Rate |
$3,631.82 |
| Rate for Payer: Aetna Commercial |
$3,430.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,622.98
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cofinity Commercial |
$3,470.41
|
| Rate for Payer: Cofinity Commercial |
$2,824.75
|
| Rate for Payer: Healthscope Commercial |
$3,631.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,430.06
|
| Rate for Payer: PHP Commercial |
$3,430.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,824.75
|
| Rate for Payer: Priority Health SBD |
$2,542.28
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
OP
|
$4,035.36
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$14,847.89 |
| Rate for Payer: Aetna Commercial |
$3,430.06
|
| Rate for Payer: Aetna Medicare |
$5,085.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,622.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,112.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,112.15
|
| Rate for Payer: BCBS Complete |
$2,808.66
|
| Rate for Payer: BCBS MAPPO |
$4,889.72
|
| Rate for Payer: BCBS Trust/PPO |
$112.52
|
| Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cofinity Commercial |
$3,470.41
|
| Rate for Payer: Cofinity Commercial |
$2,824.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
| Rate for Payer: Healthscope Commercial |
$3,631.82
|
| Rate for Payer: Mclaren Medicaid |
$2,674.68
|
| Rate for Payer: Mclaren Medicare |
$4,889.72
|
| Rate for Payer: Meridian Medicaid |
$2,808.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,134.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,623.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,430.06
|
| Rate for Payer: PACE Medicare |
$4,645.23
|
| Rate for Payer: PACE SWMI |
$4,889.72
|
| Rate for Payer: PHP Commercial |
$3,430.06
|
| Rate for Payer: PHP Medicare Advantage |
$4,889.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,674.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,824.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,847.89
|
| Rate for Payer: Priority Health Medicare |
$4,889.72
|
| Rate for Payer: Priority Health Narrow Network |
$11,878.31
|
| Rate for Payer: Priority Health SBD |
$2,542.28
|
| Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
| Rate for Payer: UHC Exchange |
$118.53
|
| Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
| Rate for Payer: VA VA |
$4,889.72
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
OP
|
$3,712.59
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.18 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$3,155.70
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,413.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$114.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,970.07
|
| Rate for Payer: Cash Price |
$2,970.07
|
| Rate for Payer: Cofinity Commercial |
$2,598.81
|
| Rate for Payer: Cofinity Commercial |
$3,192.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$3,341.33
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,155.70
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$3,155.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,598.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$2,338.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$147.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
IP
|
$3,712.59
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,338.93 |
| Max. Negotiated Rate |
$3,341.33 |
| Rate for Payer: Aetna Commercial |
$3,155.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,413.18
|
| Rate for Payer: Cash Price |
$2,970.07
|
| Rate for Payer: Cofinity Commercial |
$2,598.81
|
| Rate for Payer: Cofinity Commercial |
$3,192.83
|
| Rate for Payer: Healthscope Commercial |
$3,341.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,155.70
|
| Rate for Payer: PHP Commercial |
$3,155.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,598.81
|
| Rate for Payer: Priority Health SBD |
$2,338.93
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
IP
|
$3,111.90
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,960.50 |
| Max. Negotiated Rate |
$2,800.71 |
| Rate for Payer: Aetna Commercial |
$2,645.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,022.74
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cofinity Commercial |
$2,178.33
|
| Rate for Payer: Cofinity Commercial |
$2,676.23
|
| Rate for Payer: Healthscope Commercial |
$2,800.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.12
|
| Rate for Payer: PHP Commercial |
$2,645.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.33
|
| Rate for Payer: Priority Health SBD |
$1,960.50
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
OP
|
$3,111.90
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.59 |
| Max. Negotiated Rate |
$8,913.25 |
| Rate for Payer: Aetna Commercial |
$2,645.12
|
| Rate for Payer: Aetna Medicare |
$2,949.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,022.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,545.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,545.25
|
| Rate for Payer: BCBS Complete |
$1,629.11
|
| Rate for Payer: BCBS MAPPO |
$2,836.20
|
| Rate for Payer: BCBS Trust/PPO |
$118.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cofinity Commercial |
$2,178.33
|
| Rate for Payer: Cofinity Commercial |
$2,676.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
| Rate for Payer: Healthscope Commercial |
$2,800.71
|
| Rate for Payer: Mclaren Medicaid |
$1,551.40
|
| Rate for Payer: Mclaren Medicare |
$2,836.20
|
| Rate for Payer: Meridian Medicaid |
$1,629.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,978.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,261.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.12
|
| Rate for Payer: PACE Medicare |
$2,694.39
|
| Rate for Payer: PACE SWMI |
$2,836.20
|
| Rate for Payer: PHP Commercial |
$2,645.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,836.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,913.25
|
| Rate for Payer: Priority Health Medicare |
$2,836.20
|
| Rate for Payer: Priority Health Narrow Network |
$7,130.60
|
| Rate for Payer: Priority Health SBD |
$1,960.50
|
| Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
| Rate for Payer: UHC Exchange |
$159.79
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
| Rate for Payer: VA VA |
$2,836.20
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$19,641.83
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,374.35 |
| Max. Negotiated Rate |
$17,677.65 |
| Rate for Payer: Aetna Commercial |
$16,695.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,767.19
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cofinity Commercial |
$13,749.28
|
| Rate for Payer: Cofinity Commercial |
$16,891.97
|
| Rate for Payer: Healthscope Commercial |
$17,677.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,695.56
|
| Rate for Payer: PHP Commercial |
$16,695.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,749.28
|
| Rate for Payer: Priority Health SBD |
$12,374.35
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$19,641.83
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$699.09 |
| Max. Negotiated Rate |
$51,507.72 |
| Rate for Payer: Aetna Commercial |
$16,695.56
|
| Rate for Payer: Aetna Medicare |
$16,226.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,767.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,503.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,503.28
|
| Rate for Payer: BCBS Complete |
$8,962.14
|
| Rate for Payer: BCBS MAPPO |
$15,602.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,837.16
|
| Rate for Payer: BCN Medicare Advantage |
$15,602.62
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cofinity Commercial |
$13,749.28
|
| Rate for Payer: Cofinity Commercial |
$16,891.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,602.62
|
| Rate for Payer: Healthscope Commercial |
$17,677.65
|
| Rate for Payer: Mclaren Medicaid |
$8,534.63
|
| Rate for Payer: Mclaren Medicare |
$15,602.62
|
| Rate for Payer: Meridian Medicaid |
$8,962.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,382.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,943.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,695.56
|
| Rate for Payer: PACE Medicare |
$14,822.49
|
| Rate for Payer: PACE SWMI |
$15,602.62
|
| Rate for Payer: PHP Commercial |
$16,695.56
|
| Rate for Payer: PHP Medicare Advantage |
$15,602.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,534.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,749.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51,507.72
|
| Rate for Payer: Priority Health Medicare |
$15,602.62
|
| Rate for Payer: Priority Health Narrow Network |
$41,206.18
|
| Rate for Payer: Priority Health SBD |
$12,374.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15,602.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.00
|
| Rate for Payer: UHC Core |
$11,194.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,602.62
|
| Rate for Payer: UHC Exchange |
$699.09
|
| Rate for Payer: UHC Medicare Advantage |
$16,070.70
|
| Rate for Payer: VA VA |
$15,602.62
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$16,997.42
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,708.37 |
| Max. Negotiated Rate |
$15,297.68 |
| Rate for Payer: Aetna Commercial |
$14,447.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,048.32
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cofinity Commercial |
$11,898.19
|
| Rate for Payer: Cofinity Commercial |
$14,617.78
|
| Rate for Payer: Healthscope Commercial |
$15,297.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,447.81
|
| Rate for Payer: PHP Commercial |
$14,447.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,898.19
|
| Rate for Payer: Priority Health SBD |
$10,708.37
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$16,997.42
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.08 |
| Max. Negotiated Rate |
$31,275.01 |
| Rate for Payer: Aetna Commercial |
$14,447.81
|
| Rate for Payer: Aetna Medicare |
$16,226.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,048.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,503.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,503.28
|
| Rate for Payer: BCBS Complete |
$8,962.14
|
| Rate for Payer: BCBS MAPPO |
$15,602.62
|
| Rate for Payer: BCBS Trust/PPO |
$6,207.78
|
| Rate for Payer: BCN Medicare Advantage |
$15,602.62
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cofinity Commercial |
$14,617.78
|
| Rate for Payer: Cofinity Commercial |
$11,898.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,602.62
|
| Rate for Payer: Healthscope Commercial |
$15,297.68
|
| Rate for Payer: Mclaren Medicaid |
$8,534.63
|
| Rate for Payer: Mclaren Medicare |
$15,602.62
|
| Rate for Payer: Meridian Medicaid |
$8,962.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,382.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,943.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,447.81
|
| Rate for Payer: PACE Medicare |
$14,822.49
|
| Rate for Payer: PACE SWMI |
$15,602.62
|
| Rate for Payer: PHP Commercial |
$14,447.81
|
| Rate for Payer: PHP Medicare Advantage |
$15,602.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,534.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,898.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,275.01
|
| Rate for Payer: Priority Health Medicare |
$15,602.62
|
| Rate for Payer: Priority Health Narrow Network |
$25,020.01
|
| Rate for Payer: Priority Health SBD |
$10,708.37
|
| Rate for Payer: Railroad Medicare Medicare |
$15,602.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.09
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,602.62
|
| Rate for Payer: UHC Exchange |
$570.08
|
| Rate for Payer: UHC Medicare Advantage |
$16,070.70
|
| Rate for Payer: VA VA |
$15,602.62
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
IP
|
$19,694.46
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,407.51 |
| Max. Negotiated Rate |
$17,725.01 |
| Rate for Payer: Aetna Commercial |
$16,740.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,801.40
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$13,786.12
|
| Rate for Payer: Cofinity Commercial |
$16,937.24
|
| Rate for Payer: Healthscope Commercial |
$17,725.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: PHP Commercial |
$16,740.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: Priority Health SBD |
$12,407.51
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$19,694.46
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$682.06 |
| Max. Negotiated Rate |
$51,507.72 |
| Rate for Payer: Aetna Commercial |
$16,740.29
|
| Rate for Payer: Aetna Medicare |
$16,226.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,801.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,503.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,503.28
|
| Rate for Payer: BCBS Complete |
$8,962.14
|
| Rate for Payer: BCBS MAPPO |
$15,602.62
|
| Rate for Payer: BCBS Trust/PPO |
$8,704.23
|
| Rate for Payer: BCN Medicare Advantage |
$15,602.62
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$16,937.24
|
| Rate for Payer: Cofinity Commercial |
$13,786.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,602.62
|
| Rate for Payer: Healthscope Commercial |
$17,725.01
|
| Rate for Payer: Mclaren Medicaid |
$8,534.63
|
| Rate for Payer: Mclaren Medicare |
$15,602.62
|
| Rate for Payer: Meridian Medicaid |
$8,962.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,382.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,943.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: PACE Medicare |
$14,822.49
|
| Rate for Payer: PACE SWMI |
$15,602.62
|
| Rate for Payer: PHP Commercial |
$16,740.29
|
| Rate for Payer: PHP Medicare Advantage |
$15,602.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,534.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51,507.72
|
| Rate for Payer: Priority Health Medicare |
$15,602.62
|
| Rate for Payer: Priority Health Narrow Network |
$41,206.18
|
| Rate for Payer: Priority Health SBD |
$12,407.51
|
| Rate for Payer: Railroad Medicare Medicare |
$15,602.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.27
|
| Rate for Payer: UHC Core |
$11,194.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,602.62
|
| Rate for Payer: UHC Exchange |
$682.06
|
| Rate for Payer: UHC Medicare Advantage |
$16,070.70
|
| Rate for Payer: VA VA |
$15,602.62
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$21,529.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,563.27 |
| Max. Negotiated Rate |
$19,376.10 |
| Rate for Payer: Aetna Commercial |
$18,299.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,993.85
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cofinity Commercial |
$15,070.30
|
| Rate for Payer: Cofinity Commercial |
$18,514.94
|
| Rate for Payer: Healthscope Commercial |
$19,376.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,299.65
|
| Rate for Payer: PHP Commercial |
$18,299.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,070.30
|
| Rate for Payer: Priority Health SBD |
$13,563.27
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$21,529.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$659.80 |
| Max. Negotiated Rate |
$51,507.72 |
| Rate for Payer: Aetna Commercial |
$18,299.65
|
| Rate for Payer: Aetna Medicare |
$16,226.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,993.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,503.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,503.28
|
| Rate for Payer: BCBS Complete |
$8,962.14
|
| Rate for Payer: BCBS MAPPO |
$15,602.62
|
| Rate for Payer: BCBS Trust/PPO |
$7,098.91
|
| Rate for Payer: BCN Medicare Advantage |
$15,602.62
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cofinity Commercial |
$18,514.94
|
| Rate for Payer: Cofinity Commercial |
$15,070.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,602.62
|
| Rate for Payer: Healthscope Commercial |
$19,376.10
|
| Rate for Payer: Mclaren Medicaid |
$8,534.63
|
| Rate for Payer: Mclaren Medicare |
$15,602.62
|
| Rate for Payer: Meridian Medicaid |
$8,962.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,382.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,943.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,299.65
|
| Rate for Payer: PACE Medicare |
$14,822.49
|
| Rate for Payer: PACE SWMI |
$15,602.62
|
| Rate for Payer: PHP Commercial |
$18,299.65
|
| Rate for Payer: PHP Medicare Advantage |
$15,602.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,534.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,070.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51,507.72
|
| Rate for Payer: Priority Health Medicare |
$15,602.62
|
| Rate for Payer: Priority Health Narrow Network |
$41,206.18
|
| Rate for Payer: Priority Health SBD |
$13,563.27
|
| Rate for Payer: Railroad Medicare Medicare |
$15,602.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.78
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,602.62
|
| Rate for Payer: UHC Exchange |
$659.80
|
| Rate for Payer: UHC Medicare Advantage |
$16,070.70
|
| Rate for Payer: VA VA |
$15,602.62
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,329.13
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,877.35 |
| Max. Negotiated Rate |
$8,396.22 |
| Rate for Payer: Aetna Commercial |
$7,929.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,063.93
|
| Rate for Payer: Cash Price |
$7,463.30
|
| Rate for Payer: Cofinity Commercial |
$6,530.39
|
| Rate for Payer: Cofinity Commercial |
$8,023.05
|
| Rate for Payer: Healthscope Commercial |
$8,396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,929.76
|
| Rate for Payer: PHP Commercial |
$7,929.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,530.39
|
| Rate for Payer: Priority Health SBD |
$5,877.35
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,329.13
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$306.49 |
| Max. Negotiated Rate |
$8,819.00 |
| Rate for Payer: Aetna Commercial |
$7,929.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,063.93
|
| Rate for Payer: BCBS Complete |
$3,731.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,862.46
|
| Rate for Payer: Cash Price |
$7,463.30
|
| Rate for Payer: Cash Price |
$7,463.30
|
| Rate for Payer: Cofinity Commercial |
$8,023.05
|
| Rate for Payer: Cofinity Commercial |
$6,530.39
|
| Rate for Payer: Healthscope Commercial |
$8,396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,929.76
|
| Rate for Payer: PHP Commercial |
$7,929.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,530.39
|
| Rate for Payer: Priority Health SBD |
$5,877.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.14
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Exchange |
$306.49
|
|
