|
HC IR REVASC IVT W STENT UNILAT COMPLEX INIT VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37260
|
| Hospital Charge Code |
36100639
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,116.72 |
| Max. Negotiated Rate |
$25,881.03 |
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Mclaren Medicaid |
$6,015.90
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,116.72 |
| Max. Negotiated Rate |
$25,881.03 |
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,083.72 |
| Max. Negotiated Rate |
$10,119.60 |
| Rate for Payer: Aetna Commercial |
$9,557.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,308.60
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Advantage |
$7,870.80
|
| Rate for Payer: Cofinity Commercial |
$9,669.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,119.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: PHP Commercial |
$9,557.40
|
| Rate for Payer: Priority Health SBD |
$7,083.72
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,497.60 |
| Max. Negotiated Rate |
$10,119.60 |
| Rate for Payer: Aetna Commercial |
$9,557.40
|
| Rate for Payer: Aetna Medicare |
$5,622.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,308.60
|
| Rate for Payer: BCBS Complete |
$4,497.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,881.60
|
| Rate for Payer: BCN Commercial |
$4,881.60
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Advantage |
$7,870.80
|
| Rate for Payer: Cofinity Commercial |
$9,669.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,119.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,995.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: PHP Commercial |
$9,557.40
|
| Rate for Payer: Priority Health SBD |
$7,083.72
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,142.25 |
| Max. Negotiated Rate |
$10,203.21 |
| Rate for Payer: Aetna Commercial |
$9,636.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,368.98
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Advantage |
$7,935.83
|
| Rate for Payer: Cofinity Commercial |
$9,749.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,203.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: PHP Commercial |
$9,636.36
|
| Rate for Payer: Priority Health SBD |
$7,142.25
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,617.68 |
| Max. Negotiated Rate |
$10,203.21 |
| Rate for Payer: Aetna Commercial |
$9,636.36
|
| Rate for Payer: Aetna Medicare |
$5,668.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,368.98
|
| Rate for Payer: BCBS Complete |
$4,534.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,617.68
|
| Rate for Payer: BCN Commercial |
$2,617.68
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Advantage |
$7,935.83
|
| Rate for Payer: Cofinity Commercial |
$9,749.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,203.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,069.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: PHP Commercial |
$9,636.36
|
| Rate for Payer: Priority Health SBD |
$7,142.25
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,641.44 |
| Max. Negotiated Rate |
$6,630.62 |
| Rate for Payer: Aetna Commercial |
$6,262.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.78
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Advantage |
$5,157.15
|
| Rate for Payer: Cofinity Commercial |
$6,335.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$6,630.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: PHP Commercial |
$6,262.26
|
| Rate for Payer: Priority Health SBD |
$4,641.44
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,261.61 |
| Max. Negotiated Rate |
$6,630.62 |
| Rate for Payer: Aetna Commercial |
$6,262.26
|
| Rate for Payer: Aetna Medicare |
$3,683.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.78
|
| Rate for Payer: BCBS Complete |
$2,946.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,261.61
|
| Rate for Payer: BCN Commercial |
$2,261.61
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Advantage |
$5,157.15
|
| Rate for Payer: Cofinity Commercial |
$6,335.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$6,630.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,893.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: PHP Commercial |
$6,262.26
|
| Rate for Payer: Priority Health SBD |
$4,641.44
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,979.80 |
| Max. Negotiated Rate |
$11,399.72 |
| Rate for Payer: Aetna Commercial |
$10,766.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,233.13
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Advantage |
$8,866.44
|
| Rate for Payer: Cofinity Commercial |
$10,893.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$11,399.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: PHP Commercial |
$10,766.40
|
| Rate for Payer: Priority Health SBD |
$7,979.80
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,066.54 |
| Max. Negotiated Rate |
$11,399.72 |
| Rate for Payer: Aetna Commercial |
$10,766.40
|
| Rate for Payer: Aetna Medicare |
$6,333.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,233.13
|
| Rate for Payer: BCBS Complete |
$5,066.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,288.40
|
| Rate for Payer: BCN Commercial |
$6,288.40
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Advantage |
$8,866.44
|
| Rate for Payer: Cofinity Commercial |
$10,893.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$11,399.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,133.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: PHP Commercial |
$10,766.40
|
| Rate for Payer: Priority Health SBD |
$7,979.80
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,807.77 |
| Max. Negotiated Rate |
$12,582.53 |
| Rate for Payer: Aetna Commercial |
$11,883.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,087.38
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Advantage |
$9,786.41
|
| Rate for Payer: Cofinity Commercial |
$12,023.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$12,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: PHP Commercial |
$11,883.50
|
| Rate for Payer: Priority Health SBD |
$8,807.77
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,071.52 |
| Max. Negotiated Rate |
$12,582.53 |
| Rate for Payer: Aetna Commercial |
$11,883.50
|
| Rate for Payer: Aetna Medicare |
$6,990.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,087.38
|
| Rate for Payer: BCBS Complete |
$5,592.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,071.52
|
| Rate for Payer: BCN Commercial |
$5,071.52
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Advantage |
$9,786.41
|
| Rate for Payer: Cofinity Commercial |
$12,023.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$12,582.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,184.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: PHP Commercial |
$11,883.50
|
| Rate for Payer: Priority Health SBD |
$8,807.77
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,735.72
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,094.29 |
| Max. Negotiated Rate |
$6,962.15 |
| Rate for Payer: Aetna Commercial |
$6,575.36
|
| Rate for Payer: Aetna Medicare |
$3,867.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,028.22
|
| Rate for Payer: BCBS Complete |
$3,094.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,123.53
|
| Rate for Payer: BCN Commercial |
$3,123.53
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cofinity Advantage |
$5,415.00
|
| Rate for Payer: Cofinity Commercial |
$6,652.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,188.58
|
| Rate for Payer: Healthscope Commercial |
$6,962.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,188.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,575.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,801.79
|
| Rate for Payer: PHP Commercial |
$6,575.36
|
| Rate for Payer: Priority Health SBD |
$4,873.50
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,735.72
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,873.50 |
| Max. Negotiated Rate |
$6,962.15 |
| Rate for Payer: Aetna Commercial |
$6,575.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,028.22
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cofinity Advantage |
$5,415.00
|
| Rate for Payer: Cofinity Commercial |
$6,652.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,188.58
|
| Rate for Payer: Healthscope Commercial |
$6,962.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,575.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,801.79
|
| Rate for Payer: PHP Commercial |
$6,575.36
|
| Rate for Payer: Priority Health SBD |
$4,873.50
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,623.73
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,952.95 |
| Max. Negotiated Rate |
$11,361.36 |
| Rate for Payer: Aetna Commercial |
$10,730.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,205.42
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cofinity Advantage |
$8,836.61
|
| Rate for Payer: Cofinity Commercial |
$10,856.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,098.98
|
| Rate for Payer: Healthscope Commercial |
$11,361.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,730.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,467.80
|
| Rate for Payer: PHP Commercial |
$10,730.17
|
| Rate for Payer: Priority Health SBD |
$7,952.95
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,623.73
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,049.49 |
| Max. Negotiated Rate |
$11,361.36 |
| Rate for Payer: Aetna Commercial |
$10,730.17
|
| Rate for Payer: Aetna Medicare |
$6,311.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,205.42
|
| Rate for Payer: BCBS Complete |
$5,049.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,704.03
|
| Rate for Payer: BCN Commercial |
$6,704.03
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cofinity Advantage |
$8,836.61
|
| Rate for Payer: Cofinity Commercial |
$10,856.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,098.98
|
| Rate for Payer: Healthscope Commercial |
$11,361.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,098.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,730.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,467.80
|
| Rate for Payer: PHP Commercial |
$10,730.17
|
| Rate for Payer: Priority Health SBD |
$7,952.95
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,729.33
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,759.48 |
| Max. Negotiated Rate |
$9,656.40 |
| Rate for Payer: Aetna Commercial |
$9,119.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,974.06
|
| Rate for Payer: Cash Price |
$8,583.46
|
| Rate for Payer: Cofinity Advantage |
$7,510.53
|
| Rate for Payer: Cofinity Commercial |
$9,227.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,583.46
|
| Rate for Payer: Healthscope Commercial |
$9,656.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,119.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,047.00
|
| Rate for Payer: PHP Commercial |
$9,119.93
|
| Rate for Payer: Priority Health SBD |
$6,759.48
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,729.33
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,291.73 |
| Max. Negotiated Rate |
$10,218.58 |
| Rate for Payer: Aetna Commercial |
$9,119.93
|
| Rate for Payer: Aetna Medicare |
$5,364.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,974.06
|
| Rate for Payer: BCBS Complete |
$4,291.73
|
| Rate for Payer: BCBS Trust/PPO |
$10,218.58
|
| Rate for Payer: BCN Commercial |
$10,218.58
|
| Rate for Payer: Cash Price |
$8,583.46
|
| Rate for Payer: Cash Price |
$8,583.46
|
| Rate for Payer: Cofinity Advantage |
$7,510.53
|
| Rate for Payer: Cofinity Commercial |
$9,227.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,583.46
|
| Rate for Payer: Healthscope Commercial |
$9,656.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,583.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,119.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,047.00
|
| Rate for Payer: PHP Commercial |
$9,119.93
|
| Rate for Payer: Priority Health SBD |
$6,759.48
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,611.66
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna Commercial |
$9,869.91
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,547.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.90
|
| Rate for Payer: BCN Commercial |
$3,312.90
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$9,289.33
|
| Rate for Payer: Cash Price |
$9,289.33
|
| Rate for Payer: Cash Price |
$9,289.33
|
| Rate for Payer: Cofinity Advantage |
$8,128.16
|
| Rate for Payer: Cofinity Commercial |
$9,986.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,289.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$10,450.49
|
| Rate for Payer: Mclaren Medicaid |
$2,965.99
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,869.91
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,708.75
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$9,869.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$7,315.35
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,611.66
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,315.35 |
| Max. Negotiated Rate |
$10,450.49 |
| Rate for Payer: Aetna Commercial |
$9,869.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,547.58
|
| Rate for Payer: Cash Price |
$9,289.33
|
| Rate for Payer: Cofinity Advantage |
$8,128.16
|
| Rate for Payer: Cofinity Commercial |
$9,986.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,289.33
|
| Rate for Payer: Healthscope Commercial |
$10,450.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,869.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,708.75
|
| Rate for Payer: PHP Commercial |
$9,869.91
|
| Rate for Payer: Priority Health SBD |
$7,315.35
|
|
|
HC IR REVSC FPVT W ANGIO UNILAT COMPLEX INIT
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37265
|
| Hospital Charge Code |
36100643
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,931.98 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
|
|
HC IR REVSC FPVT W ANGIO UNILAT COMPLEX INIT
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37265
|
| Hospital Charge Code |
36100643
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Mclaren Medicaid |
$2,965.99
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC IR REVSC FPVT W ANGIO UNILAT SF INIT VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37263
|
| Hospital Charge Code |
36100642
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,931.98 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
|
|
HC IR REVSC FPVT W ANGIO UNILAT SF INIT VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37263
|
| Hospital Charge Code |
36100642
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Mclaren Medicaid |
$2,965.99
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
