|
HC IR REVSC FPVT W ATHERECT UNILAT COMPLEX INIT
|
Facility
|
OP
|
$45,664.30
|
|
|
Service Code
|
CPT 37273
|
| Hospital Charge Code |
36100645
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna Commercial |
$38,814.65
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,681.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cofinity Advantage |
$31,965.01
|
| Rate for Payer: Cofinity Commercial |
$39,271.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,531.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$41,097.87
|
| Rate for Payer: Mclaren Medicaid |
$9,552.97
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,814.65
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34,248.22
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$38,814.65
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$28,768.51
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC IR REVSC FPVT W ATHERECT UNILAT COMPLEX INIT
|
Facility
|
IP
|
$45,664.30
|
|
|
Service Code
|
CPT 37273
|
| Hospital Charge Code |
36100645
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28,768.51 |
| Max. Negotiated Rate |
$41,097.87 |
| Rate for Payer: Aetna Commercial |
$38,814.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,681.79
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cofinity Advantage |
$31,965.01
|
| Rate for Payer: Cofinity Commercial |
$39,271.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,531.44
|
| Rate for Payer: Healthscope Commercial |
$41,097.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,814.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34,248.22
|
| Rate for Payer: PHP Commercial |
$38,814.65
|
| Rate for Payer: Priority Health SBD |
$28,768.51
|
|
|
HC IR REVSC FPVT W ATHERECT UNILAT SF INIT VESSEL
|
Facility
|
IP
|
$45,664.30
|
|
|
Service Code
|
CPT 37271
|
| Hospital Charge Code |
36100644
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28,768.51 |
| Max. Negotiated Rate |
$41,097.87 |
| Rate for Payer: Aetna Commercial |
$38,814.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,681.79
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cofinity Advantage |
$31,965.01
|
| Rate for Payer: Cofinity Commercial |
$39,271.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,531.44
|
| Rate for Payer: Healthscope Commercial |
$41,097.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,814.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34,248.22
|
| Rate for Payer: PHP Commercial |
$38,814.65
|
| Rate for Payer: Priority Health SBD |
$28,768.51
|
|
|
HC IR REVSC FPVT W ATHERECT UNILAT SF INIT VESSEL
|
Facility
|
OP
|
$45,664.30
|
|
|
Service Code
|
CPT 37271
|
| Hospital Charge Code |
36100644
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna Commercial |
$38,814.65
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,681.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cash Price |
$36,531.44
|
| Rate for Payer: Cofinity Advantage |
$31,965.01
|
| Rate for Payer: Cofinity Commercial |
$39,271.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,531.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$41,097.87
|
| Rate for Payer: Mclaren Medicaid |
$9,552.97
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,814.65
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34,248.22
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$38,814.65
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$28,768.51
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC IR REVSC IVT W ANGIO UNILAT COMPLEX EA ADD
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37257
|
| Hospital Charge Code |
36100641
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,889.16 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna Medicare |
$3,611.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Advantage |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,778.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,417.18
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
|
|
HC IR REVSC IVT W ANGIO UNILAT COMPLEX EA ADD
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37257
|
| Hospital Charge Code |
36100641
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,550.43 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Advantage |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,417.18
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
|
|
HC IR REVSC IVT W ANGIO UNILAT SF EA ADD
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37255
|
| Hospital Charge Code |
36100640
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,550.43 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Advantage |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,417.18
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
|
|
HC IR REVSC IVT W ANGIO UNILAT SF EA ADD
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37255
|
| Hospital Charge Code |
36100640
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,889.16 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna Medicare |
$3,611.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Advantage |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,778.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,417.18
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
|
|
HC IR REVSC TPVT W ANGIO UNILAT COMPLEX EA ADD
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37283
|
| Hospital Charge Code |
36100649
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,777.95 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Advantage |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,688.03
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
|
|
HC IR REVSC TPVT W ANGIO UNILAT COMPLEX EA ADD
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37283
|
| Hospital Charge Code |
36100649
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,033.62 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna Medicare |
$3,792.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Advantage |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,067.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,688.03
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
|
|
HC IR REVSC TPVT W ANGIO UNILAT COMPLEX INIT
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37282
|
| Hospital Charge Code |
36100647
|
|
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 REVSC TPVT W ANGIO UNILAT COMPLEX INIT
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37282
|
| Hospital Charge Code |
36100647
|
|
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 REVSC TPVT W ANGIO UNILAT SF EA ADD
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37281
|
| Hospital Charge Code |
36100648
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,033.62 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna Medicare |
$3,792.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Advantage |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,067.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,688.03
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
|
|
HC IR REVSC TPVT W ANGIO UNILAT SF EA ADD
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37281
|
| Hospital Charge Code |
36100648
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,777.95 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Advantage |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,688.03
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
|
|
HC IR REVSC TPVT W ANGIO UNILAT SF INIT VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37280
|
| Hospital Charge Code |
36100646
|
|
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 REVSC TPVT W ANGIO UNILAT SF INIT VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37280
|
| Hospital Charge Code |
36100646
|
|
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 REVSC TPVT W STENT UNILAT SF EA ADD
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37285
|
| Hospital Charge Code |
36100650
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,207.58 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,415.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
|
|
HC IR REVSC TPVT W STENT UNILAT SF EA ADD
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37285
|
| Hospital Charge Code |
36100650
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,626.94 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
|
|
HC IR REVSC TPVT W STEN UNILAT COMPLEX EA ADD
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37287
|
| Hospital Charge Code |
36100651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,626.94 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
|
|
HC IR REVSC TPVT W STEN UNILAT COMPLEX EA ADD
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37287
|
| Hospital Charge Code |
36100651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,207.58 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,415.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$185.90
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna Commercial |
$158.01
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$31.62
|
| Rate for Payer: BCN Commercial |
$31.62
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cofinity Advantage |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$167.31
|
| Rate for Payer: Mclaren Medicaid |
$30.74
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.01
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.43
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$158.01
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$117.12
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.83
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$73.06
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$185.90
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$117.12 |
| Max. Negotiated Rate |
$167.31 |
| Rate for Payer: Aetna Commercial |
$158.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.83
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cofinity Advantage |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.72
|
| Rate for Payer: Healthscope Commercial |
$167.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.43
|
| Rate for Payer: PHP Commercial |
$158.01
|
| Rate for Payer: Priority Health SBD |
$117.12
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$44.48
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.48 |
| Max. Negotiated Rate |
$40.03 |
| Rate for Payer: Aetna Commercial |
$37.81
|
| Rate for Payer: Aetna Medicare |
$22.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.91
|
| Rate for Payer: BCBS Complete |
$17.79
|
| Rate for Payer: Cash Price |
$35.58
|
| Rate for Payer: Cofinity Advantage |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.58
|
| Rate for Payer: Healthscope Commercial |
$40.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.36
|
| Rate for Payer: PHP Commercial |
$37.81
|
| Rate for Payer: Priority Health SBD |
$28.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$23.17
|
| Rate for Payer: UHC Exchange |
$17.48
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$44.48
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.02 |
| Max. Negotiated Rate |
$40.03 |
| Rate for Payer: Aetna Commercial |
$37.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.91
|
| Rate for Payer: Cash Price |
$35.58
|
| Rate for Payer: Cofinity Advantage |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.58
|
| Rate for Payer: Healthscope Commercial |
$40.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.36
|
| Rate for Payer: PHP Commercial |
$37.81
|
| Rate for Payer: Priority Health SBD |
$28.02
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$368.37
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.07 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.44
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Advantage |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: Priority Health SBD |
$232.07
|
|
