HC IR PULMONARY
|
Facility
|
OP
|
$1,971.02
|
|
Service Code
|
CPT 75741
|
Hospital Charge Code |
32000195
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$117.49 |
Max. Negotiated Rate |
$8,913.25 |
Rate for Payer: Aetna Commercial |
$1,675.37
|
Rate for Payer: Aetna Medicare |
$2,949.65
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.16
|
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 |
$117.49
|
Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
Rate for Payer: Cash Price |
$1,576.82
|
Rate for Payer: Cash Price |
$1,576.82
|
Rate for Payer: Cofinity Commercial |
$1,379.71
|
Rate for Payer: Cofinity Commercial |
$1,695.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
Rate for Payer: Healthscope Commercial |
$1,773.92
|
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 |
$1,675.37
|
Rate for Payer: PACE Medicare |
$2,694.39
|
Rate for Payer: PACE SWMI |
$2,836.20
|
Rate for Payer: PHP Commercial |
$1,675.37
|
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 |
$1,379.71
|
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 |
$1,241.74
|
Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$140.11
|
Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
Rate for Payer: UHC Exchange |
$127.37
|
Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
Rate for Payer: VA VA |
$2,836.20
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$1,971.02
|
|
Service Code
|
CPT 75741
|
Hospital Charge Code |
32000195
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$1,241.74 |
Max. Negotiated Rate |
$1,773.92 |
Rate for Payer: Aetna Commercial |
$1,675.37
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.16
|
Rate for Payer: Cash Price |
$1,576.82
|
Rate for Payer: Cofinity Commercial |
$1,379.71
|
Rate for Payer: Cofinity Commercial |
$1,695.08
|
Rate for Payer: Healthscope Commercial |
$1,773.92
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,675.37
|
Rate for Payer: PHP Commercial |
$1,675.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,379.71
|
Rate for Payer: Priority Health SBD |
$1,241.74
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,430.91
|
|
Service Code
|
CPT 75743
|
Hospital Charge Code |
32000196
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$119.70 |
Max. Negotiated Rate |
$8,913.25 |
Rate for Payer: Aetna Commercial |
$2,916.27
|
Rate for Payer: Aetna Medicare |
$2,949.65
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,230.09
|
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 |
$119.70
|
Rate for Payer: BCN Medicare Advantage |
$2,836.20
|
Rate for Payer: Cash Price |
$2,744.73
|
Rate for Payer: Cash Price |
$2,744.73
|
Rate for Payer: Cofinity Commercial |
$2,950.58
|
Rate for Payer: Cofinity Commercial |
$2,401.64
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,836.20
|
Rate for Payer: Healthscope Commercial |
$3,087.82
|
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 |
$2,916.27
|
Rate for Payer: PACE Medicare |
$2,694.39
|
Rate for Payer: PACE SWMI |
$2,836.20
|
Rate for Payer: PHP Commercial |
$2,916.27
|
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 |
$2,401.64
|
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 |
$2,161.47
|
Rate for Payer: Railroad Medicare Medicare |
$2,836.20
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$159.20
|
Rate for Payer: UHC Dual Complete DSNP |
$2,836.20
|
Rate for Payer: UHC Exchange |
$144.73
|
Rate for Payer: UHC Medicare Advantage |
$2,921.29
|
Rate for Payer: VA VA |
$2,836.20
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,430.91
|
|
Service Code
|
CPT 75743
|
Hospital Charge Code |
32000196
|
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 IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$121.30
|
|
Service Code
|
CPT 86945
|
Hospital Charge Code |
39000026
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$76.42 |
Max. Negotiated Rate |
$109.17 |
Rate for Payer: Aetna Commercial |
$103.10
|
Rate for Payer: Aetna New Business (MI Preferred) |
$78.84
|
Rate for Payer: Cash Price |
$97.04
|
Rate for Payer: Cofinity Commercial |
$104.32
|
Rate for Payer: Cofinity Commercial |
$84.91
|
Rate for Payer: Healthscope Commercial |
$109.17
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.10
|
Rate for Payer: PHP Commercial |
$103.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$84.91
|
Rate for Payer: Priority Health SBD |
$76.42
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$121.30
|
|
Service Code
|
CPT 86945
|
Hospital Charge Code |
39000026
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$7.27 |
Max. Negotiated Rate |
$109.17 |
Rate for Payer: Aetna Commercial |
$103.10
|
Rate for Payer: Aetna Medicare |
$37.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$78.84
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.60
|
Rate for Payer: Amish Plain Church Group Commercial |
$44.60
|
Rate for Payer: BCBS Complete |
$20.49
|
Rate for Payer: BCBS MAPPO |
$35.68
|
Rate for Payer: BCBS Trust/PPO |
$7.27
|
Rate for Payer: BCN Medicare Advantage |
$35.68
|
Rate for Payer: Cash Price |
$97.04
|
Rate for Payer: Cash Price |
$97.04
|
Rate for Payer: Cofinity Commercial |
$84.91
|
Rate for Payer: Cofinity Commercial |
$104.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.68
|
Rate for Payer: Healthscope Commercial |
$109.17
|
Rate for Payer: Mclaren Medicaid |
$19.52
|
Rate for Payer: Mclaren Medicare |
$35.68
|
Rate for Payer: Meridian Medicaid |
$20.49
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.46
|
Rate for Payer: MI Amish Medical Board Commercial |
$41.03
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.10
|
Rate for Payer: PACE Medicare |
$33.90
|
Rate for Payer: PACE SWMI |
$35.68
|
Rate for Payer: PHP Commercial |
$103.10
|
Rate for Payer: PHP Medicare Advantage |
$35.68
|
Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
Rate for Payer: Priority Health Cigna Priority Health |
$84.91
|
Rate for Payer: Priority Health Medicare |
$35.68
|
Rate for Payer: Priority Health SBD |
$76.42
|
Rate for Payer: Railroad Medicare Medicare |
$35.68
|
Rate for Payer: UHC Core |
$17.92
|
Rate for Payer: UHC Dual Complete DSNP |
$35.68
|
Rate for Payer: UHC Medicare Advantage |
$36.75
|
Rate for Payer: VA VA |
$35.68
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,417.12
|
|
Service Code
|
CPT 75893
|
Hospital Charge Code |
32000209
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$103.14 |
Max. Negotiated Rate |
$14,847.89 |
Rate for Payer: Aetna Commercial |
$2,904.55
|
Rate for Payer: Aetna Medicare |
$5,085.31
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,221.13
|
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 |
$130.73
|
Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
Rate for Payer: Cash Price |
$2,733.70
|
Rate for Payer: Cash Price |
$2,733.70
|
Rate for Payer: Cofinity Commercial |
$2,938.72
|
Rate for Payer: Cofinity Commercial |
$2,391.98
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
Rate for Payer: Healthscope Commercial |
$3,075.41
|
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 |
$2,904.55
|
Rate for Payer: PACE Medicare |
$4,645.23
|
Rate for Payer: PACE SWMI |
$4,889.72
|
Rate for Payer: PHP Commercial |
$2,904.55
|
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 |
$2,391.98
|
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 |
$2,152.79
|
Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$113.45
|
Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
Rate for Payer: UHC Exchange |
$103.14
|
Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
Rate for Payer: VA VA |
$4,889.72
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,417.12
|
|
Service Code
|
CPT 75893
|
Hospital Charge Code |
32000209
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$2,152.79 |
Max. Negotiated Rate |
$3,075.41 |
Rate for Payer: Aetna Commercial |
$2,904.55
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,221.13
|
Rate for Payer: Cash Price |
$2,733.70
|
Rate for Payer: Cofinity Commercial |
$2,391.98
|
Rate for Payer: Cofinity Commercial |
$2,938.72
|
Rate for Payer: Healthscope Commercial |
$3,075.41
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,904.55
|
Rate for Payer: PHP Commercial |
$2,904.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,391.98
|
Rate for Payer: Priority Health SBD |
$2,152.79
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$10,807.38
|
|
Service Code
|
CPT 37224
|
Hospital Charge Code |
36100168
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$423.71 |
Max. Negotiated Rate |
$15,432.16 |
Rate for Payer: Aetna Commercial |
$9,186.27
|
Rate for Payer: Aetna Medicare |
$5,289.19
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,024.80
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,357.20
|
Rate for Payer: Amish Plain Church Group Commercial |
$6,357.20
|
Rate for Payer: BCBS Complete |
$2,921.26
|
Rate for Payer: BCBS MAPPO |
$5,085.76
|
Rate for Payer: BCBS Trust/PPO |
$3,701.02
|
Rate for Payer: BCN Medicare Advantage |
$5,085.76
|
Rate for Payer: Cash Price |
$8,645.90
|
Rate for Payer: Cash Price |
$8,645.90
|
Rate for Payer: Cofinity Commercial |
$9,294.35
|
Rate for Payer: Cofinity Commercial |
$7,565.17
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,085.76
|
Rate for Payer: Healthscope Commercial |
$9,726.64
|
Rate for Payer: Mclaren Medicaid |
$2,781.91
|
Rate for Payer: Mclaren Medicare |
$5,085.76
|
Rate for Payer: Meridian Medicaid |
$2,921.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,340.05
|
Rate for Payer: MI Amish Medical Board Commercial |
$5,848.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,186.27
|
Rate for Payer: PACE Medicare |
$4,831.47
|
Rate for Payer: PACE SWMI |
$5,085.76
|
Rate for Payer: PHP Commercial |
$9,186.27
|
Rate for Payer: PHP Medicare Advantage |
$5,085.76
|
Rate for Payer: Priority Health Choice Medicaid |
$2,781.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,565.17
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,432.16
|
Rate for Payer: Priority Health Medicare |
$5,085.76
|
Rate for Payer: Priority Health Narrow Network |
$12,345.73
|
Rate for Payer: Priority Health SBD |
$6,808.65
|
Rate for Payer: Railroad Medicare Medicare |
$5,085.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$466.08
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Dual Complete DSNP |
$5,085.76
|
Rate for Payer: UHC Exchange |
$423.71
|
Rate for Payer: UHC Medicare Advantage |
$5,238.33
|
Rate for Payer: VA VA |
$5,085.76
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$10,807.38
|
|
Service Code
|
CPT 37224
|
Hospital Charge Code |
36100168
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$6,808.65 |
Max. Negotiated Rate |
$9,726.64 |
Rate for Payer: Aetna Commercial |
$9,186.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,024.80
|
Rate for Payer: Cash Price |
$8,645.90
|
Rate for Payer: Cofinity Commercial |
$7,565.17
|
Rate for Payer: Cofinity Commercial |
$9,294.35
|
Rate for Payer: Healthscope Commercial |
$9,726.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,186.27
|
Rate for Payer: PHP Commercial |
$9,186.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,565.17
|
Rate for Payer: Priority Health SBD |
$6,808.65
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$10,896.68
|
|
Service Code
|
CPT 37220
|
Hospital Charge Code |
36100164
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$6,864.91 |
Max. Negotiated Rate |
$9,807.01 |
Rate for Payer: Aetna Commercial |
$9,262.18
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,082.84
|
Rate for Payer: Cash Price |
$8,717.34
|
Rate for Payer: Cofinity Commercial |
$7,627.68
|
Rate for Payer: Cofinity Commercial |
$9,371.14
|
Rate for Payer: Healthscope Commercial |
$9,807.01
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,262.18
|
Rate for Payer: PHP Commercial |
$9,262.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,627.68
|
Rate for Payer: Priority Health SBD |
$6,864.91
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$10,896.68
|
|
Service Code
|
CPT 37220
|
Hospital Charge Code |
36100164
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$381.14 |
Max. Negotiated Rate |
$15,432.16 |
Rate for Payer: Aetna Commercial |
$9,262.18
|
Rate for Payer: Aetna Medicare |
$5,289.19
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,082.84
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,357.20
|
Rate for Payer: Amish Plain Church Group Commercial |
$6,357.20
|
Rate for Payer: BCBS Complete |
$2,921.26
|
Rate for Payer: BCBS MAPPO |
$5,085.76
|
Rate for Payer: BCBS Trust/PPO |
$1,984.61
|
Rate for Payer: BCN Medicare Advantage |
$5,085.76
|
Rate for Payer: Cash Price |
$8,717.34
|
Rate for Payer: Cash Price |
$8,717.34
|
Rate for Payer: Cofinity Commercial |
$9,371.14
|
Rate for Payer: Cofinity Commercial |
$7,627.68
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,085.76
|
Rate for Payer: Healthscope Commercial |
$9,807.01
|
Rate for Payer: Mclaren Medicaid |
$2,781.91
|
Rate for Payer: Mclaren Medicare |
$5,085.76
|
Rate for Payer: Meridian Medicaid |
$2,921.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,340.05
|
Rate for Payer: MI Amish Medical Board Commercial |
$5,848.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,262.18
|
Rate for Payer: PACE Medicare |
$4,831.47
|
Rate for Payer: PACE SWMI |
$5,085.76
|
Rate for Payer: PHP Commercial |
$9,262.18
|
Rate for Payer: PHP Medicare Advantage |
$5,085.76
|
Rate for Payer: Priority Health Choice Medicaid |
$2,781.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,627.68
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,432.16
|
Rate for Payer: Priority Health Medicare |
$5,085.76
|
Rate for Payer: Priority Health Narrow Network |
$12,345.73
|
Rate for Payer: Priority Health SBD |
$6,864.91
|
Rate for Payer: Railroad Medicare Medicare |
$5,085.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$419.25
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Dual Complete DSNP |
$5,085.76
|
Rate for Payer: UHC Exchange |
$381.14
|
Rate for Payer: UHC Medicare Advantage |
$5,238.33
|
Rate for Payer: VA VA |
$5,085.76
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,081.27
|
|
Service Code
|
CPT 37222
|
Hospital Charge Code |
36100166
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$176.16 |
Max. Negotiated Rate |
$7,632.00 |
Rate for Payer: Aetna Commercial |
$6,019.08
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,602.83
|
Rate for Payer: BCBS Complete |
$2,832.51
|
Rate for Payer: BCBS Trust/PPO |
$1,714.66
|
Rate for Payer: Cash Price |
$5,665.02
|
Rate for Payer: Cash Price |
$5,665.02
|
Rate for Payer: Cofinity Commercial |
$4,956.89
|
Rate for Payer: Cofinity Commercial |
$6,089.89
|
Rate for Payer: Healthscope Commercial |
$6,373.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
Rate for Payer: PHP Commercial |
$6,019.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
Rate for Payer: Priority Health SBD |
$4,461.20
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$193.78
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Exchange |
$176.16
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,081.27
|
|
Service Code
|
CPT 37222
|
Hospital Charge Code |
36100166
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$4,461.20 |
Max. Negotiated Rate |
$6,373.14 |
Rate for Payer: Aetna Commercial |
$6,019.08
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,602.83
|
Rate for Payer: Cash Price |
$5,665.02
|
Rate for Payer: Cofinity Commercial |
$4,956.89
|
Rate for Payer: Cofinity Commercial |
$6,089.89
|
Rate for Payer: Healthscope Commercial |
$6,373.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
Rate for Payer: PHP Commercial |
$6,019.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
Rate for Payer: Priority Health SBD |
$4,461.20
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,174.50
|
|
Service Code
|
CPT 37221
|
Hospital Charge Code |
36100165
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$7,669.94 |
Max. Negotiated Rate |
$10,957.05 |
Rate for Payer: Aetna Commercial |
$10,348.32
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,913.42
|
Rate for Payer: Cash Price |
$9,739.60
|
Rate for Payer: Cofinity Commercial |
$10,470.07
|
Rate for Payer: Cofinity Commercial |
$8,522.15
|
Rate for Payer: Healthscope Commercial |
$10,957.05
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
Rate for Payer: PHP Commercial |
$10,348.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
Rate for Payer: Priority Health SBD |
$7,669.94
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,174.50
|
|
Service Code
|
CPT 37221
|
Hospital Charge Code |
36100165
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$469.55 |
Max. Negotiated Rate |
$31,275.01 |
Rate for Payer: Aetna Commercial |
$10,348.32
|
Rate for Payer: Aetna Medicare |
$10,180.30
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,913.42
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,235.94
|
Rate for Payer: Amish Plain Church Group Commercial |
$12,235.94
|
Rate for Payer: BCBS Complete |
$5,622.66
|
Rate for Payer: BCBS MAPPO |
$9,788.75
|
Rate for Payer: BCBS Trust/PPO |
$4,767.59
|
Rate for Payer: BCN Medicare Advantage |
$9,788.75
|
Rate for Payer: Cash Price |
$9,739.60
|
Rate for Payer: Cash Price |
$9,739.60
|
Rate for Payer: Cofinity Commercial |
$8,522.15
|
Rate for Payer: Cofinity Commercial |
$10,470.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,788.75
|
Rate for Payer: Healthscope Commercial |
$10,957.05
|
Rate for Payer: Mclaren Medicaid |
$5,354.45
|
Rate for Payer: Mclaren Medicare |
$9,788.75
|
Rate for Payer: Meridian Medicaid |
$5,622.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,278.19
|
Rate for Payer: MI Amish Medical Board Commercial |
$11,257.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
Rate for Payer: PACE Medicare |
$9,299.31
|
Rate for Payer: PACE SWMI |
$9,788.75
|
Rate for Payer: PHP Commercial |
$10,348.32
|
Rate for Payer: PHP Medicare Advantage |
$9,788.75
|
Rate for Payer: Priority Health Choice Medicaid |
$5,354.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,275.01
|
Rate for Payer: Priority Health Medicare |
$9,788.75
|
Rate for Payer: Priority Health Narrow Network |
$25,020.01
|
Rate for Payer: Priority Health SBD |
$7,669.94
|
Rate for Payer: Railroad Medicare Medicare |
$9,788.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$516.50
|
Rate for Payer: UHC Core |
$8,819.00
|
Rate for Payer: UHC Dual Complete DSNP |
$9,788.75
|
Rate for Payer: UHC Exchange |
$469.55
|
Rate for Payer: UHC Medicare Advantage |
$10,082.41
|
Rate for Payer: VA VA |
$9,788.75
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,437.71
|
|
Service Code
|
CPT 37228
|
Hospital Charge Code |
36100172
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$8,465.76 |
Max. Negotiated Rate |
$12,093.94 |
Rate for Payer: Aetna Commercial |
$11,422.05
|
Rate for Payer: Aetna New Business (MI Preferred) |
$8,734.51
|
Rate for Payer: Cash Price |
$10,750.17
|
Rate for Payer: Cofinity Commercial |
$11,556.43
|
Rate for Payer: Cofinity Commercial |
$9,406.40
|
Rate for Payer: Healthscope Commercial |
$12,093.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
Rate for Payer: PHP Commercial |
$11,422.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
Rate for Payer: Priority Health SBD |
$8,465.76
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,437.71
|
|
Service Code
|
CPT 37228
|
Hospital Charge Code |
36100172
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$515.07 |
Max. Negotiated Rate |
$31,275.01 |
Rate for Payer: Aetna Commercial |
$11,422.05
|
Rate for Payer: Aetna Medicare |
$10,180.30
|
Rate for Payer: Aetna New Business (MI Preferred) |
$8,734.51
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,235.94
|
Rate for Payer: Amish Plain Church Group Commercial |
$12,235.94
|
Rate for Payer: BCBS Complete |
$5,622.66
|
Rate for Payer: BCBS MAPPO |
$9,788.75
|
Rate for Payer: BCBS Trust/PPO |
$3,845.00
|
Rate for Payer: BCN Medicare Advantage |
$9,788.75
|
Rate for Payer: Cash Price |
$10,750.17
|
Rate for Payer: Cash Price |
$10,750.17
|
Rate for Payer: Cofinity Commercial |
$11,556.43
|
Rate for Payer: Cofinity Commercial |
$9,406.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,788.75
|
Rate for Payer: Healthscope Commercial |
$12,093.94
|
Rate for Payer: Mclaren Medicaid |
$5,354.45
|
Rate for Payer: Mclaren Medicare |
$9,788.75
|
Rate for Payer: Meridian Medicaid |
$5,622.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,278.19
|
Rate for Payer: MI Amish Medical Board Commercial |
$11,257.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
Rate for Payer: PACE Medicare |
$9,299.31
|
Rate for Payer: PACE SWMI |
$9,788.75
|
Rate for Payer: PHP Commercial |
$11,422.05
|
Rate for Payer: PHP Medicare Advantage |
$9,788.75
|
Rate for Payer: Priority Health Choice Medicaid |
$5,354.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,275.01
|
Rate for Payer: Priority Health Medicare |
$9,788.75
|
Rate for Payer: Priority Health Narrow Network |
$25,020.01
|
Rate for Payer: Priority Health SBD |
$8,465.76
|
Rate for Payer: Railroad Medicare Medicare |
$9,788.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$566.58
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Dual Complete DSNP |
$9,788.75
|
Rate for Payer: UHC Exchange |
$515.07
|
Rate for Payer: UHC Medicare Advantage |
$10,082.41
|
Rate for Payer: VA VA |
$9,788.75
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,435.33
|
|
Service Code
|
CPT 37232
|
Hospital Charge Code |
36100176
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$4,684.26 |
Max. Negotiated Rate |
$6,691.80 |
Rate for Payer: Aetna Commercial |
$6,320.03
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,832.96
|
Rate for Payer: Cash Price |
$5,948.26
|
Rate for Payer: Cofinity Commercial |
$5,204.73
|
Rate for Payer: Cofinity Commercial |
$6,394.38
|
Rate for Payer: Healthscope Commercial |
$6,691.80
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
Rate for Payer: PHP Commercial |
$6,320.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
Rate for Payer: Priority Health SBD |
$4,684.26
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,435.33
|
|
Service Code
|
CPT 37232
|
Hospital Charge Code |
36100176
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$189.59 |
Max. Negotiated Rate |
$7,632.00 |
Rate for Payer: Aetna Commercial |
$6,320.03
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,832.96
|
Rate for Payer: BCBS Complete |
$2,974.13
|
Rate for Payer: BCBS Trust/PPO |
$2,368.12
|
Rate for Payer: Cash Price |
$5,948.26
|
Rate for Payer: Cash Price |
$5,948.26
|
Rate for Payer: Cofinity Commercial |
$6,394.38
|
Rate for Payer: Cofinity Commercial |
$5,204.73
|
Rate for Payer: Healthscope Commercial |
$6,691.80
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
Rate for Payer: PHP Commercial |
$6,320.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
Rate for Payer: Priority Health SBD |
$4,684.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$208.55
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Exchange |
$189.59
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,133.54
|
|
Service Code
|
CPT 37223
|
Hospital Charge Code |
36100167
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$7,644.13 |
Max. Negotiated Rate |
$10,920.19 |
Rate for Payer: Aetna Commercial |
$10,313.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,886.80
|
Rate for Payer: Cash Price |
$9,706.83
|
Rate for Payer: Cofinity Commercial |
$8,493.48
|
Rate for Payer: Cofinity Commercial |
$10,434.84
|
Rate for Payer: Healthscope Commercial |
$10,920.19
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
Rate for Payer: PHP Commercial |
$10,313.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
Rate for Payer: Priority Health SBD |
$7,644.13
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,133.54
|
|
Service Code
|
CPT 37223
|
Hospital Charge Code |
36100167
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$201.70 |
Max. Negotiated Rate |
$10,920.19 |
Rate for Payer: Aetna Commercial |
$10,313.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,886.80
|
Rate for Payer: BCBS Complete |
$4,853.42
|
Rate for Payer: BCBS Trust/PPO |
$5,082.71
|
Rate for Payer: Cash Price |
$9,706.83
|
Rate for Payer: Cash Price |
$9,706.83
|
Rate for Payer: Cofinity Commercial |
$8,493.48
|
Rate for Payer: Cofinity Commercial |
$10,434.84
|
Rate for Payer: Healthscope Commercial |
$10,920.19
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
Rate for Payer: PHP Commercial |
$10,313.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
Rate for Payer: Priority Health SBD |
$7,644.13
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$221.87
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Exchange |
$201.70
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,312.70
|
|
Service Code
|
CPT 37234
|
Hospital Charge Code |
36100178
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$6,497.00 |
Max. Negotiated Rate |
$9,281.43 |
Rate for Payer: Aetna Commercial |
$8,765.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$6,703.26
|
Rate for Payer: Cash Price |
$8,250.16
|
Rate for Payer: Cofinity Commercial |
$8,868.92
|
Rate for Payer: Cofinity Commercial |
$7,218.89
|
Rate for Payer: Healthscope Commercial |
$9,281.43
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
Rate for Payer: PHP Commercial |
$8,765.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
Rate for Payer: Priority Health SBD |
$6,497.00
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,312.70
|
|
Service Code
|
CPT 37234
|
Hospital Charge Code |
36100178
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$267.85 |
Max. Negotiated Rate |
$9,281.43 |
Rate for Payer: Aetna Commercial |
$8,765.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$6,703.26
|
Rate for Payer: BCBS Complete |
$4,125.08
|
Rate for Payer: BCBS Trust/PPO |
$7,747.28
|
Rate for Payer: Cash Price |
$8,250.16
|
Rate for Payer: Cash Price |
$8,250.16
|
Rate for Payer: Cofinity Commercial |
$8,868.92
|
Rate for Payer: Cofinity Commercial |
$7,218.89
|
Rate for Payer: Healthscope Commercial |
$9,281.43
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
Rate for Payer: PHP Commercial |
$8,765.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
Rate for Payer: Priority Health SBD |
$6,497.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$294.64
|
Rate for Payer: UHC Core |
$7,632.00
|
Rate for Payer: UHC Exchange |
$267.85
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,160.76
|
|
Service Code
|
CPT 37183
|
Hospital Charge Code |
36100148
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$355.27 |
Max. Negotiated Rate |
$15,432.16 |
Rate for Payer: Aetna Commercial |
$9,486.65
|
Rate for Payer: Aetna Medicare |
$5,289.19
|
Rate for Payer: Aetna New Business (MI Preferred) |
$7,254.49
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,357.20
|
Rate for Payer: Amish Plain Church Group Commercial |
$6,357.20
|
Rate for Payer: BCBS Complete |
$2,921.26
|
Rate for Payer: BCBS MAPPO |
$5,085.76
|
Rate for Payer: BCBS Trust/PPO |
$2,511.70
|
Rate for Payer: BCN Medicare Advantage |
$5,085.76
|
Rate for Payer: Cash Price |
$8,928.61
|
Rate for Payer: Cash Price |
$8,928.61
|
Rate for Payer: Cofinity Commercial |
$7,812.53
|
Rate for Payer: Cofinity Commercial |
$9,598.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,085.76
|
Rate for Payer: Healthscope Commercial |
$10,044.68
|
Rate for Payer: Mclaren Medicaid |
$2,781.91
|
Rate for Payer: Mclaren Medicare |
$5,085.76
|
Rate for Payer: Meridian Medicaid |
$2,921.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,340.05
|
Rate for Payer: MI Amish Medical Board Commercial |
$5,848.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
Rate for Payer: PACE Medicare |
$4,831.47
|
Rate for Payer: PACE SWMI |
$5,085.76
|
Rate for Payer: PHP Commercial |
$9,486.65
|
Rate for Payer: PHP Medicare Advantage |
$5,085.76
|
Rate for Payer: Priority Health Choice Medicaid |
$2,781.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,432.16
|
Rate for Payer: Priority Health Medicare |
$5,085.76
|
Rate for Payer: Priority Health Narrow Network |
$12,345.73
|
Rate for Payer: Priority Health SBD |
$7,031.28
|
Rate for Payer: Railroad Medicare Medicare |
$5,085.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$390.80
|
Rate for Payer: UHC Core |
$8,819.00
|
Rate for Payer: UHC Dual Complete DSNP |
$5,085.76
|
Rate for Payer: UHC Exchange |
$355.27
|
Rate for Payer: UHC Medicare Advantage |
$5,238.33
|
Rate for Payer: VA VA |
$5,085.76
|
|