|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$169.51
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$144.08
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$95.73
|
| Rate for Payer: BCN Commercial |
$95.73
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cofinity Advantage |
$118.66
|
| Rate for Payer: Cofinity Commercial |
$145.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$152.56
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.08
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.13
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$144.08
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$106.79
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.18
|
| Rate for Payer: UHC Core |
$88.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$66.62
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$928.95 |
| Max. Negotiated Rate |
$1,327.08 |
| Rate for Payer: Aetna Commercial |
$1,253.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Advantage |
$1,032.17
|
| Rate for Payer: Cofinity Commercial |
$1,268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Healthscope Commercial |
$1,327.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: PHP Commercial |
$1,253.35
|
| Rate for Payer: Priority Health SBD |
$928.95
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$928.95 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna Commercial |
$1,253.35
|
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.94
|
| Rate for Payer: BCN Commercial |
$1,435.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Advantage |
$1,032.17
|
| Rate for Payer: Cofinity Commercial |
$1,268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,327.08
|
| Rate for Payer: Mclaren Medicaid |
$999.98
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$2,007.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$1,253.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,183.25
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health SBD |
$928.95
|
| Rate for Payer: Priority Health Tiered Network |
$4,946.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.08 |
| Max. Negotiated Rate |
$557.28 |
| Rate for Payer: Aetna Commercial |
$329.40
|
| Rate for Payer: Aetna Medicare |
$193.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.89
|
| Rate for Payer: BCBS Complete |
$155.01
|
| Rate for Payer: BCBS Trust/PPO |
$557.28
|
| Rate for Payer: BCN Commercial |
$557.28
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Advantage |
$271.27
|
| Rate for Payer: Cofinity Commercial |
$333.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$348.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: PHP Commercial |
$329.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.35
|
| Rate for Payer: Priority Health SBD |
$244.14
|
| Rate for Payer: Priority Health Tiered Network |
$117.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.89
|
| Rate for Payer: UHC Core |
$201.90
|
| Rate for Payer: UHC Exchange |
$152.30
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$244.14 |
| Max. Negotiated Rate |
$348.78 |
| Rate for Payer: Aetna Commercial |
$329.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.89
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Advantage |
$271.27
|
| Rate for Payer: Cofinity Commercial |
$333.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$348.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: PHP Commercial |
$329.40
|
| Rate for Payer: Priority Health SBD |
$244.14
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,635.76 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,020.40 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,456.16
|
| Rate for Payer: BCN Commercial |
$2,456.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,687.69
|
| Rate for Payer: UHC Core |
$1,352.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,020.40
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.83 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$493.83
|
| Rate for Payer: BCN Commercial |
$493.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,635.76 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,903.75 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.01
|
| Rate for Payer: BCN Commercial |
$2,170.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,903.75 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,460.54 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.54
|
| Rate for Payer: BCN Commercial |
$1,460.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,806.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$819.28 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna Commercial |
$1,535.14
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$819.28
|
| Rate for Payer: BCN Commercial |
$819.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cofinity Advantage |
$1,264.23
|
| Rate for Payer: Cofinity Commercial |
$1,553.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,625.44
|
| Rate for Payer: Mclaren Medicaid |
$820.32
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.14
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,354.54
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,535.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,137.81
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,806.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,137.81 |
| Max. Negotiated Rate |
$1,625.44 |
| Rate for Payer: Aetna Commercial |
$1,535.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.93
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cofinity Advantage |
$1,264.23
|
| Rate for Payer: Cofinity Commercial |
$1,553.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.84
|
| Rate for Payer: Healthscope Commercial |
$1,625.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,354.54
|
| Rate for Payer: PHP Commercial |
$1,535.14
|
| Rate for Payer: Priority Health SBD |
$1,137.81
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,675.08
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,055.30 |
| Max. Negotiated Rate |
$1,507.57 |
| Rate for Payer: Aetna Commercial |
$1,423.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cofinity Advantage |
$1,172.56
|
| Rate for Payer: Cofinity Commercial |
$1,440.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,340.06
|
| Rate for Payer: Healthscope Commercial |
$1,507.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,423.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.31
|
| Rate for Payer: PHP Commercial |
$1,423.82
|
| Rate for Payer: Priority Health SBD |
$1,055.30
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,675.08
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.83 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna Commercial |
$1,423.82
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$493.83
|
| Rate for Payer: BCN Commercial |
$493.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cofinity Advantage |
$1,172.56
|
| Rate for Payer: Cofinity Commercial |
$1,440.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,340.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,507.57
|
| Rate for Payer: Mclaren Medicaid |
$820.32
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,423.82
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.31
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,423.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,055.30
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,642.07
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,034.50 |
| Max. Negotiated Rate |
$1,477.86 |
| Rate for Payer: Aetna Commercial |
$1,395.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.35
|
| Rate for Payer: Cash Price |
$1,313.66
|
| Rate for Payer: Cofinity Advantage |
$1,149.45
|
| Rate for Payer: Cofinity Commercial |
$1,412.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.66
|
| Rate for Payer: Healthscope Commercial |
$1,477.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,231.55
|
| Rate for Payer: PHP Commercial |
$1,395.76
|
| Rate for Payer: Priority Health SBD |
$1,034.50
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,642.07
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$642.31 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna Commercial |
$1,395.76
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$642.31
|
| Rate for Payer: BCN Commercial |
$642.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,313.66
|
| Rate for Payer: Cash Price |
$1,313.66
|
| Rate for Payer: Cash Price |
$1,313.66
|
| Rate for Payer: Cofinity Advantage |
$1,149.45
|
| Rate for Payer: Cofinity Commercial |
$1,412.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,477.86
|
| Rate for Payer: Mclaren Medicaid |
$820.32
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.76
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,231.55
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,395.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,034.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.35
|
| Rate for Payer: UHC Core |
$855.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$645.33
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,678.61
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,023.77 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna Commercial |
$3,126.82
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.77
|
| Rate for Payer: BCN Commercial |
$2,023.77
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$2,942.89
|
| Rate for Payer: Cash Price |
$2,942.89
|
| Rate for Payer: Cash Price |
$2,942.89
|
| Rate for Payer: Cofinity Advantage |
$2,575.03
|
| Rate for Payer: Cofinity Commercial |
$3,163.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,942.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,310.75
|
| Rate for Payer: Mclaren Medicaid |
$2,899.76
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,126.82
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,758.96
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$3,126.82
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$2,317.52
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,678.61
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,317.52 |
| Max. Negotiated Rate |
$3,310.75 |
| Rate for Payer: Aetna Commercial |
$3,126.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.10
|
| Rate for Payer: Cash Price |
$2,942.89
|
| Rate for Payer: Cofinity Advantage |
$2,575.03
|
| Rate for Payer: Cofinity Commercial |
$3,163.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,942.89
|
| Rate for Payer: Healthscope Commercial |
$3,310.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,126.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,758.96
|
| Rate for Payer: PHP Commercial |
$3,126.82
|
| Rate for Payer: Priority Health SBD |
$2,317.52
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,351.19
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,317.02 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Commercial |
$2,848.51
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,327.77
|
| Rate for Payer: BCN Commercial |
$2,327.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$2,680.95
|
| Rate for Payer: Cash Price |
$2,680.95
|
| Rate for Payer: Cash Price |
$2,680.95
|
| Rate for Payer: Cofinity Advantage |
$2,345.83
|
| Rate for Payer: Cofinity Commercial |
$2,882.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,680.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,016.07
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,848.51
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,513.39
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$2,848.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$2,111.25
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,178.27
|
| Rate for Payer: UHC Core |
$1,745.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Exchange |
$1,317.02
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,351.19
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,111.25 |
| Max. Negotiated Rate |
$3,016.07 |
| Rate for Payer: Aetna Commercial |
$2,848.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.27
|
| Rate for Payer: Cash Price |
$2,680.95
|
| Rate for Payer: Cofinity Advantage |
$2,345.83
|
| Rate for Payer: Cofinity Commercial |
$2,882.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,680.95
|
| Rate for Payer: Healthscope Commercial |
$3,016.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,848.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,513.39
|
| Rate for Payer: PHP Commercial |
$2,848.51
|
| Rate for Payer: Priority Health SBD |
$2,111.25
|
|
|
HC INSERTION VENTRICULAR ASSIST DEVICE RIGHT HEART
|
Facility
|
OP
|
$3,141.86
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
48100136
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$938.66 |
| Max. Negotiated Rate |
$2,827.67 |
| Rate for Payer: Aetna Commercial |
$2,670.58
|
| Rate for Payer: Aetna Medicare |
$1,570.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,042.21
|
| Rate for Payer: BCBS Complete |
$1,256.74
|
| Rate for Payer: BCBS Trust/PPO |
$938.66
|
| Rate for Payer: BCN Commercial |
$938.66
|
| Rate for Payer: Cash Price |
$2,513.49
|
| Rate for Payer: Cash Price |
$2,513.49
|
| Rate for Payer: Cofinity Advantage |
$2,199.30
|
| Rate for Payer: Cofinity Commercial |
$2,702.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,513.49
|
| Rate for Payer: Healthscope Commercial |
$2,827.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,513.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,670.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,356.39
|
| Rate for Payer: PHP Commercial |
$2,670.58
|
| Rate for Payer: Priority Health SBD |
$1,979.37
|
|
|
HC INSERTION VENTRICULAR ASSIST DEVICE RIGHT HEART
|
Facility
|
IP
|
$3,141.86
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
48100136
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,979.37 |
| Max. Negotiated Rate |
$2,827.67 |
| Rate for Payer: Aetna Commercial |
$2,670.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,042.21
|
| Rate for Payer: Cash Price |
$2,513.49
|
| Rate for Payer: Cofinity Advantage |
$2,199.30
|
| Rate for Payer: Cofinity Commercial |
$2,702.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,513.49
|
| Rate for Payer: Healthscope Commercial |
$2,827.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,670.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,356.39
|
| Rate for Payer: PHP Commercial |
$2,670.58
|
| Rate for Payer: Priority Health SBD |
$1,979.37
|
|
