HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$19,694.46
|
|
Service Code
|
CPT 37231
|
Hospital Charge Code |
36100175
|
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 ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$19,694.46
|
|
Service Code
|
CPT 37231
|
Hospital Charge Code |
36100175
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$699.09 |
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 |
$9,837.16
|
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) |
$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 CATHETER
|
Facility
|
OP
|
$43.86
|
|
Hospital Charge Code |
27200307
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$17.54 |
Max. Negotiated Rate |
$39.47 |
Rate for Payer: Aetna Commercial |
$37.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
Rate for Payer: BCBS Complete |
$17.54
|
Rate for Payer: Cash Price |
$35.09
|
Rate for Payer: Cofinity Commercial |
$30.70
|
Rate for Payer: Cofinity Commercial |
$37.72
|
Rate for Payer: Healthscope Commercial |
$39.47
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
Rate for Payer: PHP Commercial |
$37.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
Rate for Payer: Priority Health SBD |
$27.63
|
|
HC IR CATHETER
|
Facility
|
IP
|
$43.86
|
|
Hospital Charge Code |
27200307
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$27.63 |
Max. Negotiated Rate |
$39.47 |
Rate for Payer: Aetna Commercial |
$37.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
Rate for Payer: Cash Price |
$35.09
|
Rate for Payer: Cofinity Commercial |
$30.70
|
Rate for Payer: Cofinity Commercial |
$37.72
|
Rate for Payer: Healthscope Commercial |
$39.47
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
Rate for Payer: PHP Commercial |
$37.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
Rate for Payer: Priority Health SBD |
$27.63
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$229.50
|
|
Hospital Charge Code |
27200308
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$91.80 |
Max. Negotiated Rate |
$206.55 |
Rate for Payer: Aetna Commercial |
$195.08
|
Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
Rate for Payer: BCBS Complete |
$91.80
|
Rate for Payer: Cash Price |
$183.60
|
Rate for Payer: Cofinity Commercial |
$160.65
|
Rate for Payer: Cofinity Commercial |
$197.37
|
Rate for Payer: Healthscope Commercial |
$206.55
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
Rate for Payer: PHP Commercial |
$195.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
Rate for Payer: Priority Health SBD |
$144.58
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$229.50
|
|
Hospital Charge Code |
27200308
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$144.58 |
Max. Negotiated Rate |
$206.55 |
Rate for Payer: Aetna Commercial |
$195.08
|
Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
Rate for Payer: Cash Price |
$183.60
|
Rate for Payer: Cofinity Commercial |
$160.65
|
Rate for Payer: Cofinity Commercial |
$197.37
|
Rate for Payer: Healthscope Commercial |
$206.55
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
Rate for Payer: PHP Commercial |
$195.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
Rate for Payer: Priority Health SBD |
$144.58
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$544.76
|
|
Service Code
|
CPT 36598
|
Hospital Charge Code |
36100145
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$343.20 |
Max. Negotiated Rate |
$490.28 |
Rate for Payer: Aetna Commercial |
$463.05
|
Rate for Payer: Aetna New Business (MI Preferred) |
$354.09
|
Rate for Payer: Cash Price |
$435.81
|
Rate for Payer: Cofinity Commercial |
$381.33
|
Rate for Payer: Cofinity Commercial |
$468.49
|
Rate for Payer: Healthscope Commercial |
$490.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
Rate for Payer: PHP Commercial |
$463.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
Rate for Payer: Priority Health SBD |
$343.20
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$544.76
|
|
Service Code
|
CPT 36598
|
Hospital Charge Code |
36100145
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$34.05 |
Max. Negotiated Rate |
$878.00 |
Rate for Payer: Aetna Commercial |
$463.05
|
Rate for Payer: Aetna Medicare |
$198.35
|
Rate for Payer: Aetna New Business (MI Preferred) |
$354.09
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.40
|
Rate for Payer: Amish Plain Church Group Commercial |
$238.40
|
Rate for Payer: BCBS Complete |
$109.55
|
Rate for Payer: BCBS MAPPO |
$190.72
|
Rate for Payer: BCBS Trust/PPO |
$129.13
|
Rate for Payer: BCN Medicare Advantage |
$190.72
|
Rate for Payer: Cash Price |
$435.81
|
Rate for Payer: Cash Price |
$435.81
|
Rate for Payer: Cofinity Commercial |
$381.33
|
Rate for Payer: Cofinity Commercial |
$468.49
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.72
|
Rate for Payer: Healthscope Commercial |
$490.28
|
Rate for Payer: Mclaren Medicaid |
$104.32
|
Rate for Payer: Mclaren Medicare |
$190.72
|
Rate for Payer: Meridian Medicaid |
$109.55
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.26
|
Rate for Payer: MI Amish Medical Board Commercial |
$219.33
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
Rate for Payer: PACE Medicare |
$181.18
|
Rate for Payer: PACE SWMI |
$190.72
|
Rate for Payer: PHP Commercial |
$463.05
|
Rate for Payer: PHP Medicare Advantage |
$190.72
|
Rate for Payer: Priority Health Choice Medicaid |
$104.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.40
|
Rate for Payer: Priority Health Medicare |
$190.72
|
Rate for Payer: Priority Health Narrow Network |
$495.52
|
Rate for Payer: Priority Health SBD |
$343.20
|
Rate for Payer: Railroad Medicare Medicare |
$190.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$37.46
|
Rate for Payer: UHC Core |
$878.00
|
Rate for Payer: UHC Dual Complete DSNP |
$190.72
|
Rate for Payer: UHC Exchange |
$34.05
|
Rate for Payer: UHC Medicare Advantage |
$196.44
|
Rate for Payer: VA VA |
$190.72
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,490.95
|
|
Service Code
|
CPT 51040
|
Hospital Charge Code |
36100398
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,199.30 |
Max. Negotiated Rate |
$3,141.86 |
Rate for Payer: Aetna Commercial |
$2,967.31
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.12
|
Rate for Payer: Cash Price |
$2,792.76
|
Rate for Payer: Cofinity Commercial |
$2,443.66
|
Rate for Payer: Cofinity Commercial |
$3,002.22
|
Rate for Payer: Healthscope Commercial |
$3,141.86
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,967.31
|
Rate for Payer: PHP Commercial |
$2,967.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,443.66
|
Rate for Payer: Priority Health SBD |
$2,199.30
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,490.95
|
|
Service Code
|
CPT 51040
|
Hospital Charge Code |
36100398
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$288.15 |
Max. Negotiated Rate |
$5,561.92 |
Rate for Payer: Aetna Commercial |
$2,967.31
|
Rate for Payer: Aetna Medicare |
$1,884.83
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.12
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,265.42
|
Rate for Payer: Amish Plain Church Group Commercial |
$2,265.42
|
Rate for Payer: BCBS Complete |
$1,041.01
|
Rate for Payer: BCBS MAPPO |
$1,812.34
|
Rate for Payer: BCBS Trust/PPO |
$925.69
|
Rate for Payer: BCN Medicare Advantage |
$1,812.34
|
Rate for Payer: Cash Price |
$2,792.76
|
Rate for Payer: Cash Price |
$2,792.76
|
Rate for Payer: Cofinity Commercial |
$3,002.22
|
Rate for Payer: Cofinity Commercial |
$2,443.66
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,812.34
|
Rate for Payer: Healthscope Commercial |
$3,141.86
|
Rate for Payer: Mclaren Medicaid |
$991.35
|
Rate for Payer: Mclaren Medicare |
$1,812.34
|
Rate for Payer: Meridian Medicaid |
$1,041.01
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,902.96
|
Rate for Payer: MI Amish Medical Board Commercial |
$2,084.19
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,967.31
|
Rate for Payer: PACE Medicare |
$1,721.72
|
Rate for Payer: PACE SWMI |
$1,812.34
|
Rate for Payer: PHP Commercial |
$2,967.31
|
Rate for Payer: PHP Medicare Advantage |
$1,812.34
|
Rate for Payer: Priority Health Choice Medicaid |
$991.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,443.66
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,561.92
|
Rate for Payer: Priority Health Medicare |
$1,812.34
|
Rate for Payer: Priority Health Narrow Network |
$4,449.54
|
Rate for Payer: Priority Health SBD |
$2,199.30
|
Rate for Payer: Railroad Medicare Medicare |
$1,812.34
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$316.96
|
Rate for Payer: UHC Core |
$4,155.00
|
Rate for Payer: UHC Dual Complete DSNP |
$1,812.34
|
Rate for Payer: UHC Exchange |
$288.15
|
Rate for Payer: UHC Medicare Advantage |
$1,866.71
|
Rate for Payer: VA VA |
$1,812.34
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,507.98
|
|
Service Code
|
CPT 72285
|
Hospital Charge Code |
32000057
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$1,580.03 |
Max. Negotiated Rate |
$2,257.18 |
Rate for Payer: Aetna Commercial |
$2,131.78
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.19
|
Rate for Payer: Cash Price |
$2,006.38
|
Rate for Payer: Cofinity Commercial |
$1,755.59
|
Rate for Payer: Cofinity Commercial |
$2,156.86
|
Rate for Payer: Healthscope Commercial |
$2,257.18
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,131.78
|
Rate for Payer: PHP Commercial |
$2,131.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,755.59
|
Rate for Payer: Priority Health SBD |
$1,580.03
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,507.98
|
|
Service Code
|
CPT 72285
|
Hospital Charge Code |
32000057
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$121.90 |
Max. Negotiated Rate |
$5,389.95 |
Rate for Payer: Aetna Commercial |
$2,131.78
|
Rate for Payer: Aetna Medicare |
$1,786.71
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.19
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,147.49
|
Rate for Payer: Amish Plain Church Group Commercial |
$2,147.49
|
Rate for Payer: BCBS Complete |
$986.81
|
Rate for Payer: BCBS MAPPO |
$1,717.99
|
Rate for Payer: BCBS Trust/PPO |
$121.90
|
Rate for Payer: BCN Medicare Advantage |
$1,717.99
|
Rate for Payer: Cash Price |
$2,006.38
|
Rate for Payer: Cash Price |
$2,006.38
|
Rate for Payer: Cofinity Commercial |
$2,156.86
|
Rate for Payer: Cofinity Commercial |
$1,755.59
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,717.99
|
Rate for Payer: Healthscope Commercial |
$2,257.18
|
Rate for Payer: Mclaren Medicaid |
$939.74
|
Rate for Payer: Mclaren Medicare |
$1,717.99
|
Rate for Payer: Meridian Medicaid |
$986.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,803.89
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,975.69
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,131.78
|
Rate for Payer: PACE Medicare |
$1,632.09
|
Rate for Payer: PACE SWMI |
$1,717.99
|
Rate for Payer: PHP Commercial |
$2,131.78
|
Rate for Payer: PHP Medicare Advantage |
$1,717.99
|
Rate for Payer: Priority Health Choice Medicaid |
$939.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,755.59
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,389.95
|
Rate for Payer: Priority Health Medicare |
$1,717.99
|
Rate for Payer: Priority Health Narrow Network |
$4,311.96
|
Rate for Payer: Priority Health SBD |
$1,580.03
|
Rate for Payer: Railroad Medicare Medicare |
$1,717.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$142.64
|
Rate for Payer: UHC Dual Complete DSNP |
$1,717.99
|
Rate for Payer: UHC Exchange |
$129.67
|
Rate for Payer: UHC Medicare Advantage |
$1,769.53
|
Rate for Payer: VA VA |
$1,717.99
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,871.60
|
|
Service Code
|
CPT 72295
|
Hospital Charge Code |
32000277
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$109.37 |
Max. Negotiated Rate |
$5,389.95 |
Rate for Payer: Aetna Commercial |
$2,440.86
|
Rate for Payer: Aetna Medicare |
$1,786.71
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.54
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,147.49
|
Rate for Payer: Amish Plain Church Group Commercial |
$2,147.49
|
Rate for Payer: BCBS Complete |
$986.81
|
Rate for Payer: BCBS MAPPO |
$1,717.99
|
Rate for Payer: BCBS Trust/PPO |
$118.59
|
Rate for Payer: BCN Medicare Advantage |
$1,717.99
|
Rate for Payer: Cash Price |
$2,297.28
|
Rate for Payer: Cash Price |
$2,297.28
|
Rate for Payer: Cofinity Commercial |
$2,469.58
|
Rate for Payer: Cofinity Commercial |
$2,010.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,717.99
|
Rate for Payer: Healthscope Commercial |
$2,584.44
|
Rate for Payer: Mclaren Medicaid |
$939.74
|
Rate for Payer: Mclaren Medicare |
$1,717.99
|
Rate for Payer: Meridian Medicaid |
$986.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,803.89
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,975.69
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,440.86
|
Rate for Payer: PACE Medicare |
$1,632.09
|
Rate for Payer: PACE SWMI |
$1,717.99
|
Rate for Payer: PHP Commercial |
$2,440.86
|
Rate for Payer: PHP Medicare Advantage |
$1,717.99
|
Rate for Payer: Priority Health Choice Medicaid |
$939.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,010.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,389.95
|
Rate for Payer: Priority Health Medicare |
$1,717.99
|
Rate for Payer: Priority Health Narrow Network |
$4,311.96
|
Rate for Payer: Priority Health SBD |
$1,809.11
|
Rate for Payer: Railroad Medicare Medicare |
$1,717.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$120.31
|
Rate for Payer: UHC Dual Complete DSNP |
$1,717.99
|
Rate for Payer: UHC Exchange |
$109.37
|
Rate for Payer: UHC Medicare Advantage |
$1,769.53
|
Rate for Payer: VA VA |
$1,717.99
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,871.60
|
|
Service Code
|
CPT 72295
|
Hospital Charge Code |
32000277
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$1,809.11 |
Max. Negotiated Rate |
$2,584.44 |
Rate for Payer: Aetna Commercial |
$2,440.86
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.54
|
Rate for Payer: Cash Price |
$2,297.28
|
Rate for Payer: Cofinity Commercial |
$2,010.12
|
Rate for Payer: Cofinity Commercial |
$2,469.58
|
Rate for Payer: Healthscope Commercial |
$2,584.44
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,440.86
|
Rate for Payer: PHP Commercial |
$2,440.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,010.12
|
Rate for Payer: Priority Health SBD |
$1,809.11
|
|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,430.91
|
|
Service Code
|
CPT 75894
|
Hospital Charge Code |
32000210
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$1,372.36 |
Max. Negotiated Rate |
$3,087.82 |
Rate for Payer: Aetna Commercial |
$2,916.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,230.09
|
Rate for Payer: BCBS Complete |
$1,372.36
|
Rate for Payer: BCBS Trust/PPO |
$1,522.41
|
Rate for Payer: Cash Price |
$2,744.73
|
Rate for Payer: Cash Price |
$2,744.73
|
Rate for Payer: Cofinity Commercial |
$2,401.64
|
Rate for Payer: Cofinity Commercial |
$2,950.58
|
Rate for Payer: Healthscope Commercial |
$3,087.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,916.27
|
Rate for Payer: PHP Commercial |
$2,916.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,401.64
|
Rate for Payer: Priority Health SBD |
$2,161.47
|
|
HC IR EMBOLIZATION
|
Facility
|
IP
|
$3,430.91
|
|
Service Code
|
CPT 75894
|
Hospital Charge Code |
32000210
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$2,161.47 |
Max. Negotiated Rate |
$3,087.82 |
Rate for Payer: Aetna Commercial |
$2,916.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,230.09
|
Rate for Payer: Cash Price |
$2,744.73
|
Rate for Payer: Cofinity Commercial |
$2,401.64
|
Rate for Payer: Cofinity Commercial |
$2,950.58
|
Rate for Payer: Healthscope Commercial |
$3,087.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,916.27
|
Rate for Payer: PHP Commercial |
$2,916.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,401.64
|
Rate for Payer: Priority Health SBD |
$2,161.47
|
|
HC IR ERCP
|
Facility
|
IP
|
$800.65
|
|
Service Code
|
CPT 74330
|
Hospital Charge Code |
32000155
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$504.41 |
Max. Negotiated Rate |
$720.58 |
Rate for Payer: Aetna Commercial |
$680.55
|
Rate for Payer: Aetna New Business (MI Preferred) |
$520.42
|
Rate for Payer: Cash Price |
$640.52
|
Rate for Payer: Cofinity Commercial |
$560.46
|
Rate for Payer: Cofinity Commercial |
$688.56
|
Rate for Payer: Healthscope Commercial |
$720.58
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.55
|
Rate for Payer: PHP Commercial |
$680.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$560.46
|
Rate for Payer: Priority Health SBD |
$504.41
|
|
HC IR ERCP
|
Facility
|
OP
|
$800.65
|
|
Service Code
|
CPT 74330
|
Hospital Charge Code |
32000155
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$122.45 |
Max. Negotiated Rate |
$720.58 |
Rate for Payer: Aetna Commercial |
$680.55
|
Rate for Payer: Aetna New Business (MI Preferred) |
$520.42
|
Rate for Payer: BCBS Complete |
$320.26
|
Rate for Payer: BCBS Trust/PPO |
$122.45
|
Rate for Payer: Cash Price |
$640.52
|
Rate for Payer: Cash Price |
$640.52
|
Rate for Payer: Cofinity Commercial |
$560.46
|
Rate for Payer: Cofinity Commercial |
$688.56
|
Rate for Payer: Healthscope Commercial |
$720.58
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.55
|
Rate for Payer: PHP Commercial |
$680.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$560.46
|
Rate for Payer: Priority Health SBD |
$504.41
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
IP
|
$616.61
|
|
Service Code
|
CPT 75901
|
Hospital Charge Code |
32000275
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$388.46 |
Max. Negotiated Rate |
$554.95 |
Rate for Payer: Aetna Commercial |
$524.12
|
Rate for Payer: Aetna New Business (MI Preferred) |
$400.80
|
Rate for Payer: Cash Price |
$493.29
|
Rate for Payer: Cofinity Commercial |
$431.63
|
Rate for Payer: Cofinity Commercial |
$530.28
|
Rate for Payer: Healthscope Commercial |
$554.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$524.12
|
Rate for Payer: PHP Commercial |
$524.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$431.63
|
Rate for Payer: Priority Health SBD |
$388.46
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
OP
|
$616.61
|
|
Service Code
|
CPT 75901
|
Hospital Charge Code |
32000275
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$223.32 |
Max. Negotiated Rate |
$554.95 |
Rate for Payer: Aetna Commercial |
$524.12
|
Rate for Payer: Aetna New Business (MI Preferred) |
$400.80
|
Rate for Payer: BCBS Complete |
$246.64
|
Rate for Payer: BCBS Trust/PPO |
$345.85
|
Rate for Payer: Cash Price |
$493.29
|
Rate for Payer: Cash Price |
$493.29
|
Rate for Payer: Cofinity Commercial |
$431.63
|
Rate for Payer: Cofinity Commercial |
$530.28
|
Rate for Payer: Healthscope Commercial |
$554.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$524.12
|
Rate for Payer: PHP Commercial |
$524.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$431.63
|
Rate for Payer: Priority Health SBD |
$388.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$245.65
|
Rate for Payer: UHC Exchange |
$223.32
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
IP
|
$300.42
|
|
Service Code
|
CPT 77001
|
Hospital Charge Code |
32000245
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$189.26 |
Max. Negotiated Rate |
$270.38 |
Rate for Payer: Aetna Commercial |
$255.36
|
Rate for Payer: Aetna New Business (MI Preferred) |
$195.27
|
Rate for Payer: Cash Price |
$240.34
|
Rate for Payer: Cofinity Commercial |
$210.29
|
Rate for Payer: Cofinity Commercial |
$258.36
|
Rate for Payer: Healthscope Commercial |
$270.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
Rate for Payer: PHP Commercial |
$255.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
Rate for Payer: Priority Health SBD |
$189.26
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
OP
|
$300.42
|
|
Service Code
|
CPT 77001
|
Hospital Charge Code |
32000245
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$96.92 |
Max. Negotiated Rate |
$270.38 |
Rate for Payer: Aetna Commercial |
$255.36
|
Rate for Payer: Aetna New Business (MI Preferred) |
$195.27
|
Rate for Payer: BCBS Complete |
$120.17
|
Rate for Payer: BCBS Trust/PPO |
$137.35
|
Rate for Payer: Cash Price |
$240.34
|
Rate for Payer: Cash Price |
$240.34
|
Rate for Payer: Cofinity Commercial |
$210.29
|
Rate for Payer: Cofinity Commercial |
$258.36
|
Rate for Payer: Healthscope Commercial |
$270.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
Rate for Payer: PHP Commercial |
$255.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
Rate for Payer: Priority Health SBD |
$189.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$106.61
|
Rate for Payer: UHC Exchange |
$96.92
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
IP
|
$550.58
|
|
Service Code
|
CPT 77003
|
Hospital Charge Code |
32000247
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$346.87 |
Max. Negotiated Rate |
$495.52 |
Rate for Payer: Aetna Commercial |
$467.99
|
Rate for Payer: Aetna New Business (MI Preferred) |
$357.88
|
Rate for Payer: Cash Price |
$440.46
|
Rate for Payer: Cofinity Commercial |
$385.41
|
Rate for Payer: Cofinity Commercial |
$473.50
|
Rate for Payer: Healthscope Commercial |
$495.52
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
Rate for Payer: PHP Commercial |
$467.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
Rate for Payer: Priority Health SBD |
$346.87
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
OP
|
$550.58
|
|
Service Code
|
CPT 77003
|
Hospital Charge Code |
32000247
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$103.47 |
Max. Negotiated Rate |
$495.52 |
Rate for Payer: Aetna Commercial |
$467.99
|
Rate for Payer: Aetna New Business (MI Preferred) |
$357.88
|
Rate for Payer: BCBS Complete |
$220.23
|
Rate for Payer: BCBS Trust/PPO |
$128.52
|
Rate for Payer: Cash Price |
$440.46
|
Rate for Payer: Cash Price |
$440.46
|
Rate for Payer: Cofinity Commercial |
$385.41
|
Rate for Payer: Cofinity Commercial |
$473.50
|
Rate for Payer: Healthscope Commercial |
$495.52
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
Rate for Payer: PHP Commercial |
$467.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
Rate for Payer: Priority Health SBD |
$346.87
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$113.82
|
Rate for Payer: UHC Exchange |
$103.47
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
IP
|
$550.58
|
|
Service Code
|
CPT 76000
|
Hospital Charge Code |
32000231
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$346.87 |
Max. Negotiated Rate |
$495.52 |
Rate for Payer: Aetna Commercial |
$467.99
|
Rate for Payer: Aetna New Business (MI Preferred) |
$357.88
|
Rate for Payer: Cash Price |
$440.46
|
Rate for Payer: Cofinity Commercial |
$385.41
|
Rate for Payer: Cofinity Commercial |
$473.50
|
Rate for Payer: Healthscope Commercial |
$495.52
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
Rate for Payer: PHP Commercial |
$467.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
Rate for Payer: Priority Health SBD |
$346.87
|
|