Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC IR PLACEMENT TIPS WITH FLUORO

Facility

$5,401.96

Service Code	CPT 37182
Hospital Charge Code	36100147
Hospital Revenue Code	361
Min. Negotiated Rate	$2,160.78
Max. Negotiated Rate	$4,861.76
Rate for Payer: Aetna Commercial	$4,591.67
Rate for Payer: Aetna Medicare	$2,700.98
Rate for Payer: Aetna New Business (MI Preferred)	$3,511.27
Rate for Payer: BCBS Complete	$2,160.78
Rate for Payer: Cash Price	$4,321.57
Rate for Payer: Cofinity Commercial	$3,781.37
Rate for Payer: Cofinity Commercial	$4,645.69
Rate for Payer: Cofinity Medicare Advantage	$3,781.37
Rate for Payer: Encore Health Key Benefits Commercial	$4,321.57
Rate for Payer: Healthscope Commercial	$4,861.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,591.67
Rate for Payer: PHP Commercial	$4,591.67
Rate for Payer: Priority Health Cigna Priority Health	$3,511.27
Rate for Payer: Priority Health SBD	$3,403.23

HC IR PLACEMENT TIPS WITH FLUORO

Facility

$5,401.96

Service Code	CPT 37182
Hospital Charge Code	36100147
Hospital Revenue Code	361
Min. Negotiated Rate	$3,403.23
Max. Negotiated Rate	$4,861.76
Rate for Payer: Aetna Commercial	$4,591.67
Rate for Payer: Aetna New Business (MI Preferred)	$3,511.27
Rate for Payer: Cash Price	$4,321.57
Rate for Payer: Cofinity Commercial	$3,781.37
Rate for Payer: Cofinity Commercial	$4,645.69
Rate for Payer: Cofinity Medicare Advantage	$3,781.37
Rate for Payer: Encore Health Key Benefits Commercial	$4,321.57
Rate for Payer: Healthscope Commercial	$4,861.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,591.67
Rate for Payer: PHP Commercial	$4,591.67
Rate for Payer: Priority Health Cigna Priority Health	$3,511.27
Rate for Payer: Priority Health SBD	$3,403.23

HC IR PLACE STENT VERTEBRAL ART EA AD

Facility

$10,281.82

Service Code	CPT 0076T
Hospital Charge Code	36100368
Hospital Revenue Code	361
Min. Negotiated Rate	$6,477.55
Max. Negotiated Rate	$9,253.64
Rate for Payer: Aetna Commercial	$8,739.55
Rate for Payer: Aetna New Business (MI Preferred)	$6,683.18
Rate for Payer: Cash Price	$8,225.46
Rate for Payer: Cofinity Commercial	$7,197.27
Rate for Payer: Cofinity Commercial	$8,842.37
Rate for Payer: Cofinity Medicare Advantage	$7,197.27
Rate for Payer: Encore Health Key Benefits Commercial	$8,225.46
Rate for Payer: Healthscope Commercial	$9,253.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,739.55
Rate for Payer: PHP Commercial	$8,739.55
Rate for Payer: Priority Health Cigna Priority Health	$6,683.18
Rate for Payer: Priority Health SBD	$6,477.55

HC IR PLACE STENT VERTEBRAL ART EA AD

Facility

$10,281.82

Service Code	CPT 0076T
Hospital Charge Code	36100368
Hospital Revenue Code	361
Min. Negotiated Rate	$4,112.73
Max. Negotiated Rate	$9,253.64
Rate for Payer: Aetna Commercial	$8,739.55
Rate for Payer: Aetna Medicare	$5,140.91
Rate for Payer: Aetna New Business (MI Preferred)	$6,683.18
Rate for Payer: BCBS Complete	$4,112.73
Rate for Payer: Cash Price	$8,225.46
Rate for Payer: Cofinity Commercial	$7,197.27
Rate for Payer: Cofinity Commercial	$8,842.37
Rate for Payer: Cofinity Medicare Advantage	$7,197.27
Rate for Payer: Encore Health Key Benefits Commercial	$8,225.46
Rate for Payer: Healthscope Commercial	$9,253.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,739.55
Rate for Payer: PHP Commercial	$8,739.55
Rate for Payer: Priority Health Cigna Priority Health	$6,683.18
Rate for Payer: Priority Health SBD	$6,477.55

HC IR PLACE STENT VERTEBRAL ART INIT

Facility

$10,281.82

Service Code	CPT 0075T
Hospital Charge Code	36100367
Hospital Revenue Code	361
Min. Negotiated Rate	$6,477.55
Max. Negotiated Rate	$9,253.64
Rate for Payer: Aetna Commercial	$8,739.55
Rate for Payer: Aetna New Business (MI Preferred)	$6,683.18
Rate for Payer: Cash Price	$8,225.46
Rate for Payer: Cofinity Commercial	$7,197.27
Rate for Payer: Cofinity Commercial	$8,842.37
Rate for Payer: Cofinity Medicare Advantage	$7,197.27
Rate for Payer: Encore Health Key Benefits Commercial	$8,225.46
Rate for Payer: Healthscope Commercial	$9,253.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,739.55
Rate for Payer: PHP Commercial	$8,739.55
Rate for Payer: Priority Health Cigna Priority Health	$6,683.18
Rate for Payer: Priority Health SBD	$6,477.55

HC IR PLACE STENT VERTEBRAL ART INIT

Facility

$10,281.82

Service Code	CPT 0075T
Hospital Charge Code	36100367
Hospital Revenue Code	361
Min. Negotiated Rate	$4,112.73
Max. Negotiated Rate	$9,253.64
Rate for Payer: Aetna Commercial	$8,739.55
Rate for Payer: Aetna Medicare	$5,140.91
Rate for Payer: Aetna New Business (MI Preferred)	$6,683.18
Rate for Payer: BCBS Complete	$4,112.73
Rate for Payer: Cash Price	$8,225.46
Rate for Payer: Cofinity Commercial	$7,197.27
Rate for Payer: Cofinity Commercial	$8,842.37
Rate for Payer: Cofinity Medicare Advantage	$7,197.27
Rate for Payer: Encore Health Key Benefits Commercial	$8,225.46
Rate for Payer: Healthscope Commercial	$9,253.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,739.55
Rate for Payer: PHP Commercial	$8,739.55
Rate for Payer: Priority Health Cigna Priority Health	$6,683.18
Rate for Payer: Priority Health SBD	$6,477.55

HC IR PULMONARY

Facility

$2,010.44

Service Code	CPT 75741
Hospital Charge Code	32000195
Hospital Revenue Code	320
Min. Negotiated Rate	$1,266.58
Max. Negotiated Rate	$1,809.40
Rate for Payer: Aetna Commercial	$1,708.87
Rate for Payer: Aetna New Business (MI Preferred)	$1,306.79
Rate for Payer: Cash Price	$1,608.35
Rate for Payer: Cofinity Commercial	$1,407.31
Rate for Payer: Cofinity Commercial	$1,728.98
Rate for Payer: Cofinity Medicare Advantage	$1,407.31
Rate for Payer: Encore Health Key Benefits Commercial	$1,608.35
Rate for Payer: Healthscope Commercial	$1,809.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,708.87
Rate for Payer: PHP Commercial	$1,708.87
Rate for Payer: Priority Health Cigna Priority Health	$1,306.79
Rate for Payer: Priority Health SBD	$1,266.58

HC IR PULMONARY

Facility

$2,010.44

Service Code	CPT 75741
Hospital Charge Code	32000195
Hospital Revenue Code	320
Min. Negotiated Rate	$1,266.58
Max. Negotiated Rate	$8,640.87
Rate for Payer: Aetna Commercial	$1,708.87
Rate for Payer: Aetna Medicare	$3,192.48
Rate for Payer: Aetna New Business (MI Preferred)	$1,306.79
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	$1,608.35
Rate for Payer: Cash Price	$1,608.35
Rate for Payer: Cofinity Commercial	$1,728.98
Rate for Payer: Cofinity Commercial	$1,407.31
Rate for Payer: Cofinity Medicare Advantage	$1,407.31
Rate for Payer: Encore Health Key Benefits Commercial	$1,608.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,069.69
Rate for Payer: Healthscope Commercial	$1,809.40
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	$1,708.87
Rate for Payer: PACE Medicare	$2,916.21
Rate for Payer: PACE SWMI	$3,069.69
Rate for Payer: PHP Commercial	$1,708.87
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	$1,306.79
Rate for Payer: Priority Health Medicare	$3,069.69
Rate for Payer: Priority Health SBD	$1,266.58
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	$1,487.73
Rate for Payer: UHC Dual Complete DSNP	$3,069.69
Rate for Payer: UHC Exchange	$1,487.73
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 PULMONARY BILATERAL

Facility

$3,499.53

Service Code	CPT 75743
Hospital Charge Code	32000196
Hospital Revenue Code	320
Min. Negotiated Rate	$2,204.70
Max. Negotiated Rate	$3,149.58
Rate for Payer: Aetna Commercial	$2,974.60
Rate for Payer: Aetna New Business (MI Preferred)	$2,274.69
Rate for Payer: Cash Price	$2,799.62
Rate for Payer: Cofinity Commercial	$2,449.67
Rate for Payer: Cofinity Commercial	$3,009.60
Rate for Payer: Cofinity Medicare Advantage	$2,449.67
Rate for Payer: Encore Health Key Benefits Commercial	$2,799.62
Rate for Payer: Healthscope Commercial	$3,149.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,974.60
Rate for Payer: PHP Commercial	$2,974.60
Rate for Payer: Priority Health Cigna Priority Health	$2,274.69
Rate for Payer: Priority Health SBD	$2,204.70

HC IR PULMONARY BILATERAL

Facility

$3,499.53

Service Code	CPT 75743
Hospital Charge Code	32000196
Hospital Revenue Code	320
Min. Negotiated Rate	$1,645.35
Max. Negotiated Rate	$8,640.87
Rate for Payer: Aetna Commercial	$2,974.60
Rate for Payer: Aetna Medicare	$3,192.48
Rate for Payer: Aetna New Business (MI Preferred)	$2,274.69
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	$2,799.62
Rate for Payer: Cash Price	$2,799.62
Rate for Payer: Cofinity Commercial	$3,009.60
Rate for Payer: Cofinity Commercial	$2,449.67
Rate for Payer: Cofinity Medicare Advantage	$2,449.67
Rate for Payer: Encore Health Key Benefits Commercial	$2,799.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,069.69
Rate for Payer: Healthscope Commercial	$3,149.58
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	$2,974.60
Rate for Payer: PACE Medicare	$2,916.21
Rate for Payer: PACE SWMI	$3,069.69
Rate for Payer: PHP Commercial	$2,974.60
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	$2,274.69
Rate for Payer: Priority Health Medicare	$3,069.69
Rate for Payer: Priority Health SBD	$2,204.70
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	$2,589.65
Rate for Payer: UHC Dual Complete DSNP	$3,069.69
Rate for Payer: UHC Exchange	$2,589.65
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 IRRADIATION BLOOD PROD-EA UNIT

Facility

$123.73

Service Code	CPT 86945
Hospital Charge Code	39000026
Hospital Revenue Code	300
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$111.36
Rate for Payer: Aetna Commercial	$105.17
Rate for Payer: Aetna New Business (MI Preferred)	$80.42
Rate for Payer: Cash Price	$98.98
Rate for Payer: Cofinity Commercial	$106.41
Rate for Payer: Cofinity Commercial	$86.61
Rate for Payer: Cofinity Medicare Advantage	$86.61
Rate for Payer: Encore Health Key Benefits Commercial	$98.98
Rate for Payer: Healthscope Commercial	$111.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.17
Rate for Payer: PHP Commercial	$105.17
Rate for Payer: Priority Health Cigna Priority Health	$80.42
Rate for Payer: Priority Health SBD	$77.95

HC IRRADIATION BLOOD PROD-EA UNIT

Facility

$123.73

Service Code	CPT 86945
Hospital Charge Code	39000026
Hospital Revenue Code	300
Min. Negotiated Rate	$20.52
Max. Negotiated Rate	$111.36
Rate for Payer: Aetna Commercial	$105.17
Rate for Payer: Aetna Medicare	$39.81
Rate for Payer: Aetna New Business (MI Preferred)	$80.42
Rate for Payer: Allen County Amish Medical Aid Commercial	$47.85
Rate for Payer: Amish Plain Church Group Commercial	$47.85
Rate for Payer: BCBS Complete	$21.54
Rate for Payer: BCBS MAPPO	$38.28
Rate for Payer: BCN Medicare Advantage	$38.28
Rate for Payer: Cash Price	$98.98
Rate for Payer: Cash Price	$98.98
Rate for Payer: Cofinity Commercial	$86.61
Rate for Payer: Cofinity Commercial	$106.41
Rate for Payer: Cofinity Medicare Advantage	$86.61
Rate for Payer: Encore Health Key Benefits Commercial	$98.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$38.28
Rate for Payer: Healthscope Commercial	$111.36
Rate for Payer: Mclaren Medicaid	$20.52
Rate for Payer: Mclaren Medicare	$38.28
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$40.19
Rate for Payer: Meridian Medicaid	$21.54
Rate for Payer: MI Amish Medical Board Commercial	$44.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.17
Rate for Payer: PACE Medicare	$36.37
Rate for Payer: PACE SWMI	$38.28
Rate for Payer: PHP Commercial	$105.17
Rate for Payer: PHP Medicare Advantage	$38.28
Rate for Payer: Priority Health Choice Medicaid	$20.52
Rate for Payer: Priority Health Cigna Priority Health	$80.42
Rate for Payer: Priority Health Medicare	$38.28
Rate for Payer: Priority Health SBD	$77.95
Rate for Payer: Railroad Medicare Medicare	$38.28
Rate for Payer: UHC All Payor (Choice/PPO)	$107.75
Rate for Payer: UHC Dual Complete DSNP	$38.28
Rate for Payer: UHC Medicare Advantage	$38.28
Rate for Payer: UHCCP Medicaid	$21.55
Rate for Payer: VA VA	$38.28

HC IR RENIN

Facility

$3,485.46

Service Code	CPT 75893
Hospital Charge Code	32000209
Hospital Revenue Code	320
Min. Negotiated Rate	$2,195.84
Max. Negotiated Rate	$14,840.35
Rate for Payer: Aetna Commercial	$2,962.64
Rate for Payer: Aetna Medicare	$5,482.95
Rate for Payer: Aetna New Business (MI Preferred)	$2,265.55
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	$2,788.37
Rate for Payer: Cash Price	$2,788.37
Rate for Payer: Cofinity Commercial	$2,997.50
Rate for Payer: Cofinity Commercial	$2,439.82
Rate for Payer: Cofinity Medicare Advantage	$2,439.82
Rate for Payer: Encore Health Key Benefits Commercial	$2,788.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,272.07
Rate for Payer: Healthscope Commercial	$3,136.91
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	$2,962.64
Rate for Payer: PACE Medicare	$5,008.47
Rate for Payer: PACE SWMI	$5,272.07
Rate for Payer: PHP Commercial	$2,962.64
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	$2,265.55
Rate for Payer: Priority Health Medicare	$5,272.07
Rate for Payer: Priority Health SBD	$2,195.84
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	$2,579.24
Rate for Payer: UHC Dual Complete DSNP	$5,272.07
Rate for Payer: UHC Exchange	$2,579.24
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 RENIN

Facility

$3,485.46

Service Code	CPT 75893
Hospital Charge Code	32000209
Hospital Revenue Code	320
Min. Negotiated Rate	$2,195.84
Max. Negotiated Rate	$3,136.91
Rate for Payer: Aetna Commercial	$2,962.64
Rate for Payer: Aetna New Business (MI Preferred)	$2,265.55
Rate for Payer: Cash Price	$2,788.37
Rate for Payer: Cofinity Commercial	$2,439.82
Rate for Payer: Cofinity Commercial	$2,997.50
Rate for Payer: Cofinity Medicare Advantage	$2,439.82
Rate for Payer: Encore Health Key Benefits Commercial	$2,788.37
Rate for Payer: Healthscope Commercial	$3,136.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,962.64
Rate for Payer: PHP Commercial	$2,962.64
Rate for Payer: Priority Health Cigna Priority Health	$2,265.55
Rate for Payer: Priority Health SBD	$2,195.84

HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI

Facility

$11,023.53

Service Code	CPT 37224
Hospital Charge Code	36100168
Hospital Revenue Code	361
Min. Negotiated Rate	$6,944.82
Max. Negotiated Rate	$9,921.18
Rate for Payer: Aetna Commercial	$9,370.00
Rate for Payer: Aetna New Business (MI Preferred)	$7,165.29
Rate for Payer: Cash Price	$8,818.82
Rate for Payer: Cofinity Commercial	$7,716.47
Rate for Payer: Cofinity Commercial	$9,480.24
Rate for Payer: Cofinity Medicare Advantage	$7,716.47
Rate for Payer: Encore Health Key Benefits Commercial	$8,818.82
Rate for Payer: Healthscope Commercial	$9,921.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,370.00
Rate for Payer: PHP Commercial	$9,370.00
Rate for Payer: Priority Health Cigna Priority Health	$7,165.29
Rate for Payer: Priority Health SBD	$6,944.82

HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI

Facility

$11,023.53

Service Code	CPT 37224
Hospital Charge Code	36100168
Hospital Revenue Code	361
Min. Negotiated Rate	$2,980.47
Max. Negotiated Rate	$15,652.48
Rate for Payer: Aetna Commercial	$9,370.00
Rate for Payer: Aetna Medicare	$5,783.00
Rate for Payer: Aetna New Business (MI Preferred)	$7,165.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,950.73
Rate for Payer: Amish Plain Church Group Commercial	$6,950.73
Rate for Payer: BCBS Complete	$3,129.49
Rate for Payer: BCBS MAPPO	$5,560.58
Rate for Payer: BCN Medicare Advantage	$5,560.58
Rate for Payer: Cash Price	$8,818.82
Rate for Payer: Cash Price	$8,818.82
Rate for Payer: Cofinity Commercial	$9,480.24
Rate for Payer: Cofinity Commercial	$7,716.47
Rate for Payer: Cofinity Medicare Advantage	$7,716.47
Rate for Payer: Encore Health Key Benefits Commercial	$8,818.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,560.58
Rate for Payer: Healthscope Commercial	$9,921.18
Rate for Payer: Mclaren Medicaid	$2,980.47
Rate for Payer: Mclaren Medicare	$5,560.58
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,838.61
Rate for Payer: Meridian Medicaid	$3,129.49
Rate for Payer: MI Amish Medical Board Commercial	$6,394.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,370.00
Rate for Payer: PACE Medicare	$5,282.55
Rate for Payer: PACE SWMI	$5,560.58
Rate for Payer: PHP Commercial	$9,370.00
Rate for Payer: PHP Medicare Advantage	$5,560.58
Rate for Payer: Priority Health Choice Medicaid	$2,980.47
Rate for Payer: Priority Health Cigna Priority Health	$7,165.29
Rate for Payer: Priority Health Medicare	$5,560.58
Rate for Payer: Priority Health SBD	$6,944.82
Rate for Payer: Railroad Medicare Medicare	$5,560.58
Rate for Payer: UHC All Payor (Choice/PPO)	$15,652.48
Rate for Payer: UHC Dual Complete DSNP	$5,560.58
Rate for Payer: UHC Medicare Advantage	$5,560.58
Rate for Payer: UHCCP Medicaid	$3,130.61
Rate for Payer: VA VA	$5,560.58

HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL

Facility

$11,114.61

Service Code	CPT 37220
Hospital Charge Code	36100164
Hospital Revenue Code	361
Min. Negotiated Rate	$7,002.20
Max. Negotiated Rate	$10,003.15
Rate for Payer: Aetna Commercial	$9,447.42
Rate for Payer: Aetna New Business (MI Preferred)	$7,224.50
Rate for Payer: Cash Price	$8,891.69
Rate for Payer: Cofinity Commercial	$7,780.23
Rate for Payer: Cofinity Commercial	$9,558.56
Rate for Payer: Cofinity Medicare Advantage	$7,780.23
Rate for Payer: Encore Health Key Benefits Commercial	$8,891.69
Rate for Payer: Healthscope Commercial	$10,003.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,447.42
Rate for Payer: PHP Commercial	$9,447.42
Rate for Payer: Priority Health Cigna Priority Health	$7,224.50
Rate for Payer: Priority Health SBD	$7,002.20

HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL

Facility

$11,114.61

Service Code	CPT 37220
Hospital Charge Code	36100164
Hospital Revenue Code	361
Min. Negotiated Rate	$2,980.47
Max. Negotiated Rate	$15,652.48
Rate for Payer: Aetna Commercial	$9,447.42
Rate for Payer: Aetna Medicare	$5,783.00
Rate for Payer: Aetna New Business (MI Preferred)	$7,224.50
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,950.73
Rate for Payer: Amish Plain Church Group Commercial	$6,950.73
Rate for Payer: BCBS Complete	$3,129.49
Rate for Payer: BCBS MAPPO	$5,560.58
Rate for Payer: BCN Medicare Advantage	$5,560.58
Rate for Payer: Cash Price	$8,891.69
Rate for Payer: Cash Price	$8,891.69
Rate for Payer: Cofinity Commercial	$7,780.23
Rate for Payer: Cofinity Commercial	$9,558.56
Rate for Payer: Cofinity Medicare Advantage	$7,780.23
Rate for Payer: Encore Health Key Benefits Commercial	$8,891.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,560.58
Rate for Payer: Healthscope Commercial	$10,003.15
Rate for Payer: Mclaren Medicaid	$2,980.47
Rate for Payer: Mclaren Medicare	$5,560.58
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,838.61
Rate for Payer: Meridian Medicaid	$3,129.49
Rate for Payer: MI Amish Medical Board Commercial	$6,394.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,447.42
Rate for Payer: PACE Medicare	$5,282.55
Rate for Payer: PACE SWMI	$5,560.58
Rate for Payer: PHP Commercial	$9,447.42
Rate for Payer: PHP Medicare Advantage	$5,560.58
Rate for Payer: Priority Health Choice Medicaid	$2,980.47
Rate for Payer: Priority Health Cigna Priority Health	$7,224.50
Rate for Payer: Priority Health Medicare	$5,560.58
Rate for Payer: Priority Health SBD	$7,002.20
Rate for Payer: Railroad Medicare Medicare	$5,560.58
Rate for Payer: UHC All Payor (Choice/PPO)	$15,652.48
Rate for Payer: UHC Dual Complete DSNP	$5,560.58
Rate for Payer: UHC Medicare Advantage	$5,560.58
Rate for Payer: UHCCP Medicaid	$3,130.61
Rate for Payer: VA VA	$5,560.58

HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL

Facility

$7,222.90

Service Code	CPT 37222
Hospital Charge Code	36100166
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 Commercial	$5,056.03
Rate for Payer: Cofinity Commercial	$6,211.69
Rate for Payer: Cofinity Medicare Advantage	$5,056.03
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: PHP Commercial	$6,139.47
Rate for Payer: Priority Health Cigna Priority Health	$4,694.89
Rate for Payer: Priority Health SBD	$4,550.43

HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL

Facility

$7,222.90

Service Code	CPT 37222
Hospital Charge Code	36100166
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 Commercial	$5,056.03
Rate for Payer: Cofinity Commercial	$6,211.69
Rate for Payer: Cofinity Medicare Advantage	$5,056.03
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: PHP Commercial	$6,139.47
Rate for Payer: Priority Health Cigna Priority Health	$4,694.89
Rate for Payer: Priority Health SBD	$4,550.43

HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL

Facility

$12,417.99

Service Code	CPT 37221
Hospital Charge Code	36100165
Hospital Revenue Code	361
Min. Negotiated Rate	$5,928.28
Max. Negotiated Rate	$31,133.44
Rate for Payer: Aetna Commercial	$10,555.29
Rate for Payer: Aetna Medicare	$11,502.64
Rate for Payer: Aetna New Business (MI Preferred)	$8,071.69
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,825.29
Rate for Payer: Amish Plain Church Group Commercial	$13,825.29
Rate for Payer: BCBS Complete	$6,224.70
Rate for Payer: BCBS MAPPO	$11,060.23
Rate for Payer: BCN Medicare Advantage	$11,060.23
Rate for Payer: Cash Price	$9,934.39
Rate for Payer: Cash Price	$9,934.39
Rate for Payer: Cofinity Commercial	$8,692.59
Rate for Payer: Cofinity Commercial	$10,679.47
Rate for Payer: Cofinity Medicare Advantage	$8,692.59
Rate for Payer: Encore Health Key Benefits Commercial	$9,934.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,060.23
Rate for Payer: Healthscope Commercial	$11,176.19
Rate for Payer: Mclaren Medicaid	$5,928.28
Rate for Payer: Mclaren Medicare	$11,060.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,613.24
Rate for Payer: Meridian Medicaid	$6,224.70
Rate for Payer: MI Amish Medical Board Commercial	$12,719.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,555.29
Rate for Payer: PACE Medicare	$10,507.22
Rate for Payer: PACE SWMI	$11,060.23
Rate for Payer: PHP Commercial	$10,555.29
Rate for Payer: PHP Medicare Advantage	$11,060.23
Rate for Payer: Priority Health Choice Medicaid	$5,928.28
Rate for Payer: Priority Health Cigna Priority Health	$8,071.69
Rate for Payer: Priority Health Medicare	$11,060.23
Rate for Payer: Priority Health SBD	$7,823.33
Rate for Payer: Railroad Medicare Medicare	$11,060.23
Rate for Payer: UHC All Payor (Choice/PPO)	$31,133.44
Rate for Payer: UHC Dual Complete DSNP	$11,060.23
Rate for Payer: UHC Medicare Advantage	$11,060.23
Rate for Payer: UHCCP Medicaid	$6,226.91
Rate for Payer: VA VA	$11,060.23

HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL

Facility

$12,417.99

Service Code	CPT 37221
Hospital Charge Code	36100165
Hospital Revenue Code	361
Min. Negotiated Rate	$7,823.33
Max. Negotiated Rate	$11,176.19
Rate for Payer: Aetna Commercial	$10,555.29
Rate for Payer: Aetna New Business (MI Preferred)	$8,071.69
Rate for Payer: Cash Price	$9,934.39
Rate for Payer: Cofinity Commercial	$10,679.47
Rate for Payer: Cofinity Commercial	$8,692.59
Rate for Payer: Cofinity Medicare Advantage	$8,692.59
Rate for Payer: Encore Health Key Benefits Commercial	$9,934.39
Rate for Payer: Healthscope Commercial	$11,176.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,555.29
Rate for Payer: PHP Commercial	$10,555.29
Rate for Payer: Priority Health Cigna Priority Health	$8,071.69
Rate for Payer: Priority Health SBD	$7,823.33

HC IR REVASCULARIZATION PLASTY TIB PERONL UNI

Facility

$13,706.46

Service Code	CPT 37228
Hospital Charge Code	36100172
Hospital Revenue Code	361
Min. Negotiated Rate	$8,635.07
Max. Negotiated Rate	$12,335.81
Rate for Payer: Aetna Commercial	$11,650.49
Rate for Payer: Aetna New Business (MI Preferred)	$8,909.20
Rate for Payer: Cash Price	$10,965.17
Rate for Payer: Cofinity Commercial	$11,787.56
Rate for Payer: Cofinity Commercial	$9,594.52
Rate for Payer: Cofinity Medicare Advantage	$9,594.52
Rate for Payer: Encore Health Key Benefits Commercial	$10,965.17
Rate for Payer: Healthscope Commercial	$12,335.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11,650.49
Rate for Payer: PHP Commercial	$11,650.49
Rate for Payer: Priority Health Cigna Priority Health	$8,909.20
Rate for Payer: Priority Health SBD	$8,635.07

HC IR REVASCULARIZATION PLASTY TIB PERONL UNI

Facility

$13,706.46

Service Code	CPT 37228
Hospital Charge Code	36100172
Hospital Revenue Code	361
Min. Negotiated Rate	$5,928.28
Max. Negotiated Rate	$31,133.44
Rate for Payer: Aetna Commercial	$11,650.49
Rate for Payer: Aetna Medicare	$11,502.64
Rate for Payer: Aetna New Business (MI Preferred)	$8,909.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,825.29
Rate for Payer: Amish Plain Church Group Commercial	$13,825.29
Rate for Payer: BCBS Complete	$6,224.70
Rate for Payer: BCBS MAPPO	$11,060.23
Rate for Payer: BCN Medicare Advantage	$11,060.23
Rate for Payer: Cash Price	$10,965.17
Rate for Payer: Cash Price	$10,965.17
Rate for Payer: Cofinity Commercial	$9,594.52
Rate for Payer: Cofinity Commercial	$11,787.56
Rate for Payer: Cofinity Medicare Advantage	$9,594.52
Rate for Payer: Encore Health Key Benefits Commercial	$10,965.17
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,060.23
Rate for Payer: Healthscope Commercial	$12,335.81
Rate for Payer: Mclaren Medicaid	$5,928.28
Rate for Payer: Mclaren Medicare	$11,060.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,613.24
Rate for Payer: Meridian Medicaid	$6,224.70
Rate for Payer: MI Amish Medical Board Commercial	$12,719.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11,650.49
Rate for Payer: PACE Medicare	$10,507.22
Rate for Payer: PACE SWMI	$11,060.23
Rate for Payer: PHP Commercial	$11,650.49
Rate for Payer: PHP Medicare Advantage	$11,060.23
Rate for Payer: Priority Health Choice Medicaid	$5,928.28
Rate for Payer: Priority Health Cigna Priority Health	$8,909.20
Rate for Payer: Priority Health Medicare	$11,060.23
Rate for Payer: Priority Health SBD	$8,635.07
Rate for Payer: Railroad Medicare Medicare	$11,060.23
Rate for Payer: UHC All Payor (Choice/PPO)	$31,133.44
Rate for Payer: UHC Dual Complete DSNP	$11,060.23
Rate for Payer: UHC Medicare Advantage	$11,060.23
Rate for Payer: UHCCP Medicaid	$6,226.91
Rate for Payer: VA VA	$11,060.23

HC IR REVASCULARIZATION PLASTY TIB PERO UNI E

Facility

$7,584.04

Service Code	CPT 37232
Hospital Charge Code	36100176
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 Commercial	$5,308.83
Rate for Payer: Cofinity Commercial	$6,522.27
Rate for Payer: Cofinity Medicare Advantage	$5,308.83
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: PHP Commercial	$6,446.43
Rate for Payer: Priority Health Cigna Priority Health	$4,929.63
Rate for Payer: Priority Health SBD	$4,777.95

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