|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
IP
|
$4.16
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.70
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health SBD |
$2.62
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
IP
|
$878.12
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$553.22 |
| Max. Negotiated Rate |
$790.31 |
| Rate for Payer: Aetna Commercial |
$746.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.78
|
| Rate for Payer: Cash Price |
$702.50
|
| Rate for Payer: Cofinity Commercial |
$614.68
|
| Rate for Payer: Cofinity Commercial |
$755.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$614.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.50
|
| Rate for Payer: Healthscope Commercial |
$790.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.40
|
| Rate for Payer: PHP Commercial |
$746.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.78
|
| Rate for Payer: Priority Health SBD |
$553.22
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
OP
|
$878.12
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$351.25 |
| Max. Negotiated Rate |
$790.31 |
| Rate for Payer: Aetna Commercial |
$746.40
|
| Rate for Payer: Aetna Medicare |
$439.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.78
|
| Rate for Payer: BCBS Complete |
$351.25
|
| Rate for Payer: Cash Price |
$702.50
|
| Rate for Payer: Cofinity Commercial |
$614.68
|
| Rate for Payer: Cofinity Commercial |
$755.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$614.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.50
|
| Rate for Payer: Healthscope Commercial |
$790.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.40
|
| Rate for Payer: PHP Commercial |
$746.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.78
|
| Rate for Payer: Priority Health SBD |
$553.22
|
| Rate for Payer: UHC Core |
$649.81
|
| Rate for Payer: UHC Exchange |
$649.81
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.89 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.89 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$287.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$287.65
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$301.06
|
| Rate for Payer: VA VA |
$534.75
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
OP
|
$1,716.86
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,081.62 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$1,459.33
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cofinity Commercial |
$1,201.80
|
| Rate for Payer: Cofinity Commercial |
$1,476.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,545.17
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.33
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$1,459.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.96
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,081.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$1,270.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$1,270.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,716.86
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,081.62 |
| Max. Negotiated Rate |
$1,545.17 |
| Rate for Payer: Aetna Commercial |
$1,459.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.96
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cofinity Commercial |
$1,201.80
|
| Rate for Payer: Cofinity Commercial |
$1,476.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.49
|
| Rate for Payer: Healthscope Commercial |
$1,545.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.33
|
| Rate for Payer: PHP Commercial |
$1,459.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.96
|
| Rate for Payer: Priority Health SBD |
$1,081.62
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
OP
|
$3,266.13
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,057.66 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Core |
$2,416.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$2,416.94
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
IP
|
$3,266.13
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,057.66 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,383.04 |
| Max. Negotiated Rate |
$3,111.84 |
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: Aetna Medicare |
$1,728.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,247.44
|
| Rate for Payer: BCBS Complete |
$1,383.04
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,420.32
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,420.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health SBD |
$2,178.29
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,178.29 |
| Max. Negotiated Rate |
$3,111.84 |
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,247.44
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,420.32
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,420.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health SBD |
$2,178.29
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$9,854.14
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,941.66 |
| Max. Negotiated Rate |
$8,868.73 |
| Rate for Payer: Aetna Commercial |
$8,376.02
|
| Rate for Payer: Aetna Medicare |
$4,927.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,405.19
|
| Rate for Payer: BCBS Complete |
$3,941.66
|
| Rate for Payer: Cash Price |
$7,883.31
|
| Rate for Payer: Cofinity Commercial |
$6,897.90
|
| Rate for Payer: Cofinity Commercial |
$8,474.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,897.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.31
|
| Rate for Payer: Healthscope Commercial |
$8,868.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,376.02
|
| Rate for Payer: PHP Commercial |
$8,376.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.19
|
| Rate for Payer: Priority Health SBD |
$6,208.11
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$9,854.14
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,208.11 |
| Max. Negotiated Rate |
$8,868.73 |
| Rate for Payer: Aetna Commercial |
$8,376.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,405.19
|
| Rate for Payer: Cash Price |
$7,883.31
|
| Rate for Payer: Cofinity Commercial |
$6,897.90
|
| Rate for Payer: Cofinity Commercial |
$8,474.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,897.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.31
|
| Rate for Payer: Healthscope Commercial |
$8,868.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,376.02
|
| Rate for Payer: PHP Commercial |
$8,376.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.19
|
| Rate for Payer: Priority Health SBD |
$6,208.11
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
IP
|
$3,470.36
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,186.33 |
| Max. Negotiated Rate |
$3,123.32 |
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.73
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,429.25
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,429.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health SBD |
$2,186.33
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
OP
|
$3,470.36
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Cofinity Commercial |
$2,429.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,429.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,186.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$2,568.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$2,568.07
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
IP
|
$4,116.07
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,593.12 |
| Max. Negotiated Rate |
$3,704.46 |
| Rate for Payer: Aetna Commercial |
$3,498.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,675.45
|
| Rate for Payer: Cash Price |
$3,292.86
|
| Rate for Payer: Cofinity Commercial |
$2,881.25
|
| Rate for Payer: Cofinity Commercial |
$3,539.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,881.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,292.86
|
| Rate for Payer: Healthscope Commercial |
$3,704.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,498.66
|
| Rate for Payer: PHP Commercial |
$3,498.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,675.45
|
| Rate for Payer: Priority Health SBD |
$2,593.12
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
OP
|
$4,116.07
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,593.12 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$3,498.66
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,675.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,292.86
|
| Rate for Payer: Cash Price |
$3,292.86
|
| Rate for Payer: Cofinity Commercial |
$3,539.82
|
| Rate for Payer: Cofinity Commercial |
$2,881.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,881.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,292.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,704.46
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,498.66
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,498.66
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,675.45
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,593.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Core |
$3,045.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$3,045.89
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
IP
|
$3,786.84
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,385.71 |
| Max. Negotiated Rate |
$3,408.16 |
| Rate for Payer: Aetna Commercial |
$3,218.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,461.45
|
| Rate for Payer: Cash Price |
$3,029.47
|
| Rate for Payer: Cofinity Commercial |
$2,650.79
|
| Rate for Payer: Cofinity Commercial |
$3,256.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,650.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,029.47
|
| Rate for Payer: Healthscope Commercial |
$3,408.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,218.81
|
| Rate for Payer: PHP Commercial |
$3,218.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,461.45
|
| Rate for Payer: Priority Health SBD |
$2,385.71
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
OP
|
$3,786.84
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$3,218.81
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,461.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,029.47
|
| Rate for Payer: Cash Price |
$3,029.47
|
| Rate for Payer: Cofinity Commercial |
$3,256.68
|
| Rate for Payer: Cofinity Commercial |
$2,650.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,650.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,029.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,408.16
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,218.81
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,218.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,461.45
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,385.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$2,802.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$2,802.26
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
IP
|
$3,174.14
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,999.71 |
| Max. Negotiated Rate |
$2,856.73 |
| Rate for Payer: Aetna Commercial |
$2,698.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.19
|
| Rate for Payer: Cash Price |
$2,539.31
|
| Rate for Payer: Cofinity Commercial |
$2,221.90
|
| Rate for Payer: Cofinity Commercial |
$2,729.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.31
|
| Rate for Payer: Healthscope Commercial |
$2,856.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.02
|
| Rate for Payer: PHP Commercial |
$2,698.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.19
|
| Rate for Payer: Priority Health SBD |
$1,999.71
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
OP
|
$3,174.14
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,698.02
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,539.31
|
| Rate for Payer: Cash Price |
$2,539.31
|
| Rate for Payer: Cofinity Commercial |
$2,729.76
|
| Rate for Payer: Cofinity Commercial |
$2,221.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,856.73
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.02
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,698.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.19
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$2,348.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$2,348.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$20,034.67
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,621.84 |
| Max. Negotiated Rate |
$18,031.20 |
| Rate for Payer: Aetna Commercial |
$17,029.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,022.54
|
| Rate for Payer: Cash Price |
$16,027.74
|
| Rate for Payer: Cofinity Commercial |
$14,024.27
|
| Rate for Payer: Cofinity Commercial |
$17,229.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,024.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,027.74
|
| Rate for Payer: Healthscope Commercial |
$18,031.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,029.47
|
| Rate for Payer: PHP Commercial |
$17,029.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,022.54
|
| Rate for Payer: Priority Health SBD |
$12,621.84
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$20,034.67
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna Commercial |
$17,029.47
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,022.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$16,027.74
|
| Rate for Payer: Cash Price |
$16,027.74
|
| Rate for Payer: Cofinity Commercial |
$17,229.82
|
| Rate for Payer: Cofinity Commercial |
$14,024.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,024.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,027.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$18,031.20
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,029.47
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$17,029.47
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,022.54
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$12,621.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,859.72
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$17,337.37
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna Commercial |
$14,736.76
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,269.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$13,869.90
|
| Rate for Payer: Cash Price |
$13,869.90
|
| Rate for Payer: Cofinity Commercial |
$14,910.14
|
| Rate for Payer: Cofinity Commercial |
$12,136.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,136.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,869.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$15,603.63
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,736.76
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$14,736.76
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,269.29
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$10,922.54
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,859.72
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$17,337.37
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,922.54 |
| Max. Negotiated Rate |
$15,603.63 |
| Rate for Payer: Aetna Commercial |
$14,736.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,269.29
|
| Rate for Payer: Cash Price |
$13,869.90
|
| Rate for Payer: Cofinity Commercial |
$12,136.16
|
| Rate for Payer: Cofinity Commercial |
$14,910.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,136.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,869.90
|
| Rate for Payer: Healthscope Commercial |
$15,603.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,736.76
|
| Rate for Payer: PHP Commercial |
$14,736.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,269.29
|
| Rate for Payer: Priority Health SBD |
$10,922.54
|
|
