|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,174.14 |
| Max. Negotiated Rate |
$18,391.82 |
| Rate for Payer: Aetna Commercial |
$17,370.06
|
| Rate for Payer: Aetna Medicare |
$10,217.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,282.98
|
| Rate for Payer: BCBS Complete |
$8,174.14
|
| Rate for Payer: BCBS Trust/PPO |
$12,975.11
|
| Rate for Payer: BCN Commercial |
$12,975.11
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Advantage |
$14,304.75
|
| Rate for Payer: Cofinity Commercial |
$17,574.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Healthscope Commercial |
$18,391.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,348.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: PHP Commercial |
$17,370.06
|
| Rate for Payer: Priority Health SBD |
$12,874.28
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,874.28 |
| Max. Negotiated Rate |
$18,391.82 |
| Rate for Payer: Aetna Commercial |
$17,370.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,282.98
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Advantage |
$14,304.75
|
| Rate for Payer: Cofinity Commercial |
$17,574.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Healthscope Commercial |
$18,391.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: PHP Commercial |
$17,370.06
|
| Rate for Payer: Priority Health SBD |
$12,874.28
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,073.65 |
| Max. Negotiated Rate |
$15,915.71 |
| Rate for Payer: Aetna Commercial |
$15,031.50
|
| Rate for Payer: Aetna Medicare |
$8,842.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,494.68
|
| Rate for Payer: BCBS Complete |
$7,073.65
|
| Rate for Payer: BCBS Trust/PPO |
$8,187.99
|
| Rate for Payer: BCN Commercial |
$8,187.99
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Advantage |
$12,378.88
|
| Rate for Payer: Cofinity Commercial |
$15,208.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Healthscope Commercial |
$15,915.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,147.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: PHP Commercial |
$15,031.50
|
| Rate for Payer: Priority Health SBD |
$11,141.00
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,141.00 |
| Max. Negotiated Rate |
$15,915.71 |
| Rate for Payer: Aetna Commercial |
$15,031.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,494.68
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Advantage |
$12,378.88
|
| Rate for Payer: Cofinity Commercial |
$15,208.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Healthscope Commercial |
$15,915.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: PHP Commercial |
$15,031.50
|
| Rate for Payer: Priority Health SBD |
$11,141.00
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,908.78 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,318.58
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Advantage |
$14,343.08
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health SBD |
$12,908.78
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,196.05 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna Medicare |
$10,245.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,318.58
|
| Rate for Payer: BCBS Complete |
$8,196.05
|
| Rate for Payer: BCBS Trust/PPO |
$11,480.78
|
| Rate for Payer: BCN Commercial |
$11,480.78
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Advantage |
$14,343.08
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,392.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health SBD |
$12,908.78
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,111.23 |
| Max. Negotiated Rate |
$20,158.89 |
| Rate for Payer: Aetna Commercial |
$19,038.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,559.20
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Advantage |
$15,679.14
|
| Rate for Payer: Cofinity Commercial |
$19,262.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Healthscope Commercial |
$20,158.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: PHP Commercial |
$19,038.95
|
| Rate for Payer: Priority Health SBD |
$14,111.23
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,959.51 |
| Max. Negotiated Rate |
$20,158.89 |
| Rate for Payer: Aetna Commercial |
$19,038.95
|
| Rate for Payer: Aetna Medicare |
$11,199.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,559.20
|
| Rate for Payer: BCBS Complete |
$8,959.51
|
| Rate for Payer: BCBS Trust/PPO |
$9,363.38
|
| Rate for Payer: BCN Commercial |
$9,363.38
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Advantage |
$15,679.14
|
| Rate for Payer: Cofinity Commercial |
$19,262.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Healthscope Commercial |
$20,158.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,919.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: PHP Commercial |
$19,038.95
|
| Rate for Payer: Priority Health SBD |
$14,111.23
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,775.55 |
| Max. Negotiated Rate |
$8,735.42 |
| Rate for Payer: Aetna Commercial |
$8,250.12
|
| Rate for Payer: Aetna Medicare |
$4,853.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,308.91
|
| Rate for Payer: BCBS Complete |
$3,882.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,775.55
|
| Rate for Payer: BCN Commercial |
$3,775.55
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Advantage |
$6,794.21
|
| Rate for Payer: Cofinity Commercial |
$8,347.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Healthscope Commercial |
$8,735.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,764.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: PHP Commercial |
$8,250.12
|
| Rate for Payer: Priority Health SBD |
$6,114.79
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,114.79 |
| Max. Negotiated Rate |
$8,735.42 |
| Rate for Payer: Aetna Commercial |
$8,250.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,308.91
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Advantage |
$6,794.21
|
| Rate for Payer: Cofinity Commercial |
$8,347.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Healthscope Commercial |
$8,735.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: PHP Commercial |
$8,250.12
|
| Rate for Payer: Priority Health SBD |
$6,114.79
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,196.05 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna Medicare |
$10,245.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,318.58
|
| Rate for Payer: BCBS Complete |
$8,196.05
|
| Rate for Payer: BCBS Trust/PPO |
$12,975.11
|
| Rate for Payer: BCN Commercial |
$12,975.11
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Advantage |
$14,343.08
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,392.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health SBD |
$12,908.78
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,908.78 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,318.58
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Advantage |
$14,343.08
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health SBD |
$12,908.78
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.75 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.66
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Advantage |
$31.94
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health SBD |
$28.75
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna Medicare |
$22.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.66
|
| Rate for Payer: BCBS Complete |
$18.25
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Advantage |
$31.94
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health SBD |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.66
|
| Rate for Payer: UHC Core |
$23.77
|
| Rate for Payer: UHC Exchange |
$17.93
|
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.43 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.20
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Advantage |
$167.14
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health SBD |
$150.43
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna Medicare |
$119.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.20
|
| Rate for Payer: BCBS Complete |
$95.51
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Advantage |
$167.14
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health SBD |
$150.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.20
|
| Rate for Payer: UHC Core |
$124.40
|
| Rate for Payer: UHC Exchange |
$93.84
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.07 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.40
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Advantage |
$396.74
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: Priority Health SBD |
$357.07
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$685.39 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna Medicare |
$220.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$264.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$264.93
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$211.94
|
| Rate for Payer: BCBS Trust/PPO |
$170.32
|
| Rate for Payer: BCN Commercial |
$170.32
|
| Rate for Payer: BCN Medicare Advantage |
$211.94
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Advantage |
$396.74
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.94
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Mclaren Medicare |
$211.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.54
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$635.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PACE Medicare |
$201.34
|
| Rate for Payer: PACE SWMI |
$211.94
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: PHP Medicare Advantage |
$211.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$685.39
|
| Rate for Payer: Priority Health Medicare |
$211.94
|
| Rate for Payer: Priority Health SBD |
$357.07
|
| Rate for Payer: Priority Health Tiered Network |
$548.31
|
| Rate for Payer: Railroad Medicare Medicare |
$211.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.94
|
| Rate for Payer: UHC Medicaid |
$110.84
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$211.94
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Commercial |
$3,087.19
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,360.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.97
|
| Rate for Payer: BCN Commercial |
$1,220.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Advantage |
$2,542.39
|
| Rate for Payer: Cofinity Commercial |
$3,123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,268.79
|
| Rate for Payer: Mclaren Medicaid |
$1,089.34
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$3,087.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,288.15
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,288.15 |
| Max. Negotiated Rate |
$3,268.79 |
| Rate for Payer: Aetna Commercial |
$3,087.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,360.79
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Advantage |
$2,542.39
|
| Rate for Payer: Cofinity Commercial |
$3,123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Healthscope Commercial |
$3,268.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: PHP Commercial |
$3,087.19
|
| Rate for Payer: Priority Health SBD |
$2,288.15
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,643.86 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$2,217.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,696.05
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Advantage |
$1,826.51
|
| Rate for Payer: Cofinity Commercial |
$2,244.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Healthscope Commercial |
$2,348.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: PHP Commercial |
$2,217.91
|
| Rate for Payer: Priority Health SBD |
$1,643.86
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Commercial |
$2,217.91
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,696.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$173.39
|
| Rate for Payer: BCN Commercial |
$173.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Advantage |
$1,826.51
|
| Rate for Payer: Cofinity Commercial |
$2,244.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,348.37
|
| Rate for Payer: Mclaren Medicaid |
$1,017.60
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,217.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,643.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,696.05
|
| Rate for Payer: UHC Core |
$1,359.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Exchange |
$1,025.45
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,882.19 |
| Max. Negotiated Rate |
$2,688.85 |
| Rate for Payer: Aetna Commercial |
$2,539.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.95
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Advantage |
$2,091.33
|
| Rate for Payer: Cofinity Commercial |
$2,569.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Healthscope Commercial |
$2,688.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: PHP Commercial |
$2,539.47
|
| Rate for Payer: Priority Health SBD |
$1,882.19
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.03 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Commercial |
$2,539.47
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$162.03
|
| Rate for Payer: BCN Commercial |
$162.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Advantage |
$2,091.33
|
| Rate for Payer: Cofinity Commercial |
$2,569.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,688.85
|
| Rate for Payer: Mclaren Medicaid |
$1,017.60
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,539.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,882.19
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,941.95
|
| Rate for Payer: UHC Core |
$1,556.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Exchange |
$1,174.13
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,402.82 |
| Max. Negotiated Rate |
$3,212.57 |
| Rate for Payer: Aetna Commercial |
$3,034.09
|
| Rate for Payer: Aetna Medicare |
$1,784.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.19
|
| Rate for Payer: BCBS Complete |
$1,427.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,099.56
|
| Rate for Payer: BCN Commercial |
$2,099.56
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Advantage |
$2,498.66
|
| Rate for Payer: Cofinity Commercial |
$3,069.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,212.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,855.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: PHP Commercial |
$3,034.09
|
| Rate for Payer: Priority Health SBD |
$2,248.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,320.19
|
| Rate for Payer: UHC Core |
$1,859.72
|
| Rate for Payer: UHC Exchange |
$1,402.82
|
|
