|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$578.79 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health SBD |
$578.79
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.43 |
| Max. Negotiated Rate |
$2,432.92 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$131.38
|
| Rate for Payer: BCN Commercial |
$131.38
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health SBD |
$578.79
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$679.85
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.47 |
| Max. Negotiated Rate |
$2,432.92 |
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$122.59
|
| Rate for Payer: BCN Commercial |
$122.59
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Cofinity Commercial |
$709.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$861.18
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health SBD |
$638.28
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$749.73
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$638.28 |
| Max. Negotiated Rate |
$911.84 |
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.55
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$709.20
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: PHP Commercial |
$861.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health SBD |
$638.28
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$857.34 |
| Max. Negotiated Rate |
$1,224.76 |
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.55
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Cofinity Commercial |
$952.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$952.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Healthscope Commercial |
$1,224.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health SBD |
$857.34
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.40 |
| Max. Negotiated Rate |
$2,432.92 |
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: Aetna Medicare |
$805.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$166.59
|
| Rate for Payer: BCN Commercial |
$166.59
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$952.60
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$952.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$1,224.76
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$2,322.24
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.92
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,946.34
|
| Rate for Payer: Priority Health SBD |
$857.34
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,007.03
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$435.81
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.94 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health SBD |
$28.94
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$7.74
|
| Rate for Payer: BCN Commercial |
$7.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: Nomi Health Commercial |
$13.11
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health Narrow Network |
$7.10
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$4.92
|
| Rate for Payer: VA VA |
$8.74
|
|
|
HC IRON LEVEL
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.72
|
| Rate for Payer: BCN Commercial |
$5.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$9.70
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.66
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.16 |
| Max. Negotiated Rate |
$518.62 |
| Rate for Payer: Aetna Commercial |
$489.81
|
| Rate for Payer: Aetna Medicare |
$288.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.56
|
| Rate for Payer: BCBS Complete |
$230.50
|
| Rate for Payer: BCBS Trust/PPO |
$109.38
|
| Rate for Payer: BCN Commercial |
$109.38
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$495.58
|
| Rate for Payer: Cofinity Commercial |
$403.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$518.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: PHP Commercial |
$489.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: Priority Health SBD |
$363.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.16
|
| Rate for Payer: UHC Exchange |
$426.42
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$363.04 |
| Max. Negotiated Rate |
$518.62 |
| Rate for Payer: Aetna Commercial |
$489.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.56
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$403.38
|
| Rate for Payer: Cofinity Commercial |
$495.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$518.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: PHP Commercial |
$489.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: Priority Health SBD |
$363.04
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,331.54 |
| Max. Negotiated Rate |
$10,473.63 |
| Rate for Payer: Aetna Commercial |
$9,891.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,564.29
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,008.14
|
| Rate for Payer: Cofinity Commercial |
$8,146.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$10,473.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: PHP Commercial |
$9,891.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: Priority Health SBD |
$7,331.54
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,053.01 |
| Max. Negotiated Rate |
$10,473.63 |
| Rate for Payer: Aetna Commercial |
$9,891.76
|
| Rate for Payer: Aetna Medicare |
$5,818.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,564.29
|
| Rate for Payer: BCBS Complete |
$4,654.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.39
|
| Rate for Payer: BCN Commercial |
$2,109.39
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,008.14
|
| Rate for Payer: Cofinity Commercial |
$8,146.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$10,473.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: PHP Commercial |
$9,891.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: Priority Health SBD |
$7,331.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.01
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
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 PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,383.04 |
| Max. Negotiated Rate |
$3,362.00 |
| 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: BCBS Trust/PPO |
$3,030.30
|
| Rate for Payer: BCN Commercial |
$3,030.30
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Cofinity Commercial |
$2,420.32
|
| 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
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,604.13
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,401.96
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.38 |
| Max. Negotiated Rate |
$9,445.00 |
| 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: BCBS Trust/PPO |
$1,746.82
|
| Rate for Payer: BCN Commercial |
$1,746.82
|
| Rate for Payer: Cash Price |
$4,321.57
|
| Rate for Payer: Cash Price |
$4,321.57
|
| 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
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$846.38
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Exchange |
$9,445.00
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$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
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,138.00 |
| 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: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$8,842.37
|
| Rate for Payer: Cofinity Commercial |
$7,197.27
|
| 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
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$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 INIT
|
Facility
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,138.00 |
| 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: 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
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$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 PULMONARY
|
Facility
|
OP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.88 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$1,708.87
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$133.27
|
| Rate for Payer: BCN Commercial |
$133.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,809.40
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.87
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$1,708.87
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,266.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$1,487.73
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$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 BILATERAL
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.78 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$135.78
|
| Rate for Payer: BCN Commercial |
$135.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,204.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$2,589.65
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
