|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
OP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.60 |
| Max. Negotiated Rate |
$2,100.93 |
| Rate for Payer: Aetna Commercial |
$806.66
|
| Rate for Payer: Aetna Medicare |
$474.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.86
|
| Rate for Payer: BCBS Complete |
$379.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,100.93
|
| Rate for Payer: BCN Commercial |
$2,100.93
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Advantage |
$664.31
|
| Rate for Payer: Cofinity Commercial |
$816.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$854.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$759.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: PHP Commercial |
$806.66
|
| Rate for Payer: Priority Health SBD |
$597.88
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
IP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$597.88 |
| Max. Negotiated Rate |
$854.11 |
| Rate for Payer: Aetna Commercial |
$806.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.86
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Advantage |
$664.31
|
| Rate for Payer: Cofinity Commercial |
$816.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$854.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: PHP Commercial |
$806.66
|
| Rate for Payer: Priority Health SBD |
$597.88
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
IP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,392.00 |
| Max. Negotiated Rate |
$6,274.29 |
| Rate for Payer: Aetna Commercial |
$5,925.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,531.43
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Advantage |
$4,880.00
|
| Rate for Payer: Cofinity Commercial |
$5,995.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,274.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: PHP Commercial |
$5,925.72
|
| Rate for Payer: Priority Health SBD |
$4,392.00
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
OP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,656.76 |
| Max. Negotiated Rate |
$6,274.29 |
| Rate for Payer: PHP Commercial |
$5,925.72
|
| Rate for Payer: Aetna Commercial |
$5,925.72
|
| Rate for Payer: Aetna Medicare |
$3,485.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,531.43
|
| Rate for Payer: BCBS Complete |
$2,788.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,656.76
|
| Rate for Payer: BCN Commercial |
$2,656.76
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Advantage |
$4,880.00
|
| Rate for Payer: Cofinity Commercial |
$5,995.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,274.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,577.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: Priority Health SBD |
$4,392.00
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
IP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,650.05 |
| Max. Negotiated Rate |
$5,214.36 |
| Rate for Payer: Aetna Commercial |
$4,924.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,765.92
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Advantage |
$4,055.61
|
| Rate for Payer: Cofinity Commercial |
$4,982.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,214.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: PHP Commercial |
$4,924.67
|
| Rate for Payer: Priority Health SBD |
$3,650.05
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
OP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,317.49 |
| Max. Negotiated Rate |
$5,214.36 |
| Rate for Payer: Aetna Commercial |
$4,924.67
|
| Rate for Payer: Aetna Medicare |
$2,896.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,765.92
|
| Rate for Payer: BCBS Complete |
$2,317.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,708.99
|
| Rate for Payer: BCN Commercial |
$2,708.99
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Advantage |
$4,055.61
|
| Rate for Payer: Cofinity Commercial |
$4,982.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,214.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,634.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: PHP Commercial |
$4,924.67
|
| Rate for Payer: Priority Health SBD |
$3,650.05
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Commercial |
$2,988.28
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,285.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.03
|
| Rate for Payer: BCN Commercial |
$1,780.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Advantage |
$2,460.93
|
| Rate for Payer: Cofinity Commercial |
$3,023.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,164.06
|
| Rate for Payer: Mclaren Medicaid |
$1,089.34
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,988.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,214.84
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,214.84 |
| Max. Negotiated Rate |
$3,164.06 |
| Rate for Payer: Aetna Commercial |
$2,988.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,285.15
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Advantage |
$2,460.93
|
| Rate for Payer: Cofinity Commercial |
$3,023.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Healthscope Commercial |
$3,164.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: PHP Commercial |
$2,988.28
|
| Rate for Payer: Priority Health SBD |
$2,214.84
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,151.56 |
| Max. Negotiated Rate |
$3,073.65 |
| Rate for Payer: Aetna Commercial |
$2,902.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,219.86
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Advantage |
$2,390.62
|
| Rate for Payer: Cofinity Commercial |
$2,937.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Healthscope Commercial |
$3,073.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: PHP Commercial |
$2,902.89
|
| Rate for Payer: Priority Health SBD |
$2,151.56
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,096.19 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Commercial |
$2,902.89
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,219.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.19
|
| Rate for Payer: BCN Commercial |
$1,096.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Advantage |
$2,390.62
|
| Rate for Payer: Cofinity Commercial |
$2,937.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$3,073.65
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$2,902.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$2,151.56
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,427.26 |
| Max. Negotiated Rate |
$8,117.52 |
| Rate for Payer: Aetna Commercial |
$7,666.55
|
| Rate for Payer: Aetna Medicare |
$4,509.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,862.66
|
| Rate for Payer: BCBS Complete |
$3,607.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,427.26
|
| Rate for Payer: BCN Commercial |
$3,427.26
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Advantage |
$6,313.63
|
| Rate for Payer: Cofinity Commercial |
$7,756.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,117.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,215.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: PHP Commercial |
$7,666.55
|
| Rate for Payer: Priority Health SBD |
$5,682.27
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,682.27 |
| Max. Negotiated Rate |
$8,117.52 |
| Rate for Payer: Aetna Commercial |
$7,666.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,862.66
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Advantage |
$6,313.63
|
| Rate for Payer: Cofinity Commercial |
$7,756.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,117.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: PHP Commercial |
$7,666.55
|
| Rate for Payer: Priority Health SBD |
$5,682.27
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,196.10 |
| Max. Negotiated Rate |
$4,941.23 |
| Rate for Payer: Aetna Commercial |
$4,666.72
|
| Rate for Payer: Aetna Medicare |
$2,745.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,568.67
|
| Rate for Payer: BCBS Complete |
$2,196.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,551.37
|
| Rate for Payer: BCN Commercial |
$2,551.37
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Advantage |
$3,843.18
|
| Rate for Payer: Cofinity Commercial |
$4,721.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$4,941.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,392.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: PHP Commercial |
$4,666.72
|
| Rate for Payer: Priority Health SBD |
$3,458.86
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,458.86 |
| Max. Negotiated Rate |
$4,941.23 |
| Rate for Payer: Aetna Commercial |
$4,666.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,568.67
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Advantage |
$3,843.18
|
| Rate for Payer: Cofinity Commercial |
$4,721.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$4,941.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: PHP Commercial |
$4,666.72
|
| Rate for Payer: Priority Health SBD |
$3,458.86
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
IP
|
$777.55
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$489.86 |
| Max. Negotiated Rate |
$699.79 |
| Rate for Payer: Aetna Commercial |
$660.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.41
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Commercial |
$668.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.04
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.16
|
| Rate for Payer: PHP Commercial |
$660.92
|
| Rate for Payer: Priority Health SBD |
$489.86
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
OP
|
$777.55
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.34 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$660.92
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$370.15
|
| Rate for Payer: BCCCP Commercial |
$330.34
|
| Rate for Payer: BCN Commercial |
$370.15
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Commercial |
$668.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.92
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.16
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$660.92
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$489.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
IP
|
$442.62
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.85 |
| Max. Negotiated Rate |
$398.36 |
| Rate for Payer: Aetna Commercial |
$376.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.70
|
| Rate for Payer: Cash Price |
$354.10
|
| Rate for Payer: Cofinity Advantage |
$309.83
|
| Rate for Payer: Cofinity Commercial |
$380.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.10
|
| Rate for Payer: Healthscope Commercial |
$398.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.96
|
| Rate for Payer: PHP Commercial |
$376.23
|
| Rate for Payer: Priority Health SBD |
$278.85
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
OP
|
$442.62
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.05 |
| Max. Negotiated Rate |
$1,225.08 |
| Rate for Payer: Aetna Commercial |
$376.23
|
| Rate for Payer: Aetna Medicare |
$221.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.70
|
| Rate for Payer: BCBS Complete |
$177.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.08
|
| Rate for Payer: BCCCP Commercial |
$276.28
|
| Rate for Payer: BCN Commercial |
$1,225.08
|
| Rate for Payer: Cash Price |
$354.10
|
| Rate for Payer: Cash Price |
$354.10
|
| Rate for Payer: Cash Price |
$354.10
|
| Rate for Payer: Cofinity Advantage |
$309.83
|
| Rate for Payer: Cofinity Commercial |
$380.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.10
|
| Rate for Payer: Healthscope Commercial |
$398.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.96
|
| Rate for Payer: PHP Commercial |
$376.23
|
| Rate for Payer: Priority Health SBD |
$278.85
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
OP
|
$6,955.38
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,015.30 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$5,912.07
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,521.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.30
|
| Rate for Payer: BCN Commercial |
$3,015.30
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$5,564.30
|
| Rate for Payer: Cash Price |
$5,564.30
|
| Rate for Payer: Cash Price |
$5,564.30
|
| Rate for Payer: Cofinity Advantage |
$4,868.77
|
| Rate for Payer: Cofinity Commercial |
$5,981.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,564.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$6,259.84
|
| Rate for Payer: Mclaren Medicaid |
$3,150.44
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,912.07
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,216.53
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$5,912.07
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$4,381.89
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
IP
|
$6,955.38
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,381.89 |
| Max. Negotiated Rate |
$6,259.84 |
| Rate for Payer: Aetna Commercial |
$5,912.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,521.00
|
| Rate for Payer: Cash Price |
$5,564.30
|
| Rate for Payer: Cofinity Advantage |
$4,868.77
|
| Rate for Payer: Cofinity Commercial |
$5,981.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,564.30
|
| Rate for Payer: Healthscope Commercial |
$6,259.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,912.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,216.53
|
| Rate for Payer: PHP Commercial |
$5,912.07
|
| Rate for Payer: Priority Health SBD |
$4,381.89
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
OP
|
$6,756.65
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,015.30 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$5,743.15
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,391.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.30
|
| Rate for Payer: BCN Commercial |
$3,015.30
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cofinity Advantage |
$4,729.65
|
| Rate for Payer: Cofinity Commercial |
$5,810.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$6,080.98
|
| Rate for Payer: Mclaren Medicaid |
$3,150.44
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.15
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,067.49
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$5,743.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$4,256.69
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
IP
|
$6,756.65
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,256.69 |
| Max. Negotiated Rate |
$6,080.98 |
| Rate for Payer: Aetna Commercial |
$5,743.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,391.82
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cofinity Advantage |
$4,729.65
|
| Rate for Payer: Cofinity Commercial |
$5,810.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.32
|
| Rate for Payer: Healthscope Commercial |
$6,080.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,067.49
|
| Rate for Payer: PHP Commercial |
$5,743.15
|
| Rate for Payer: Priority Health SBD |
$4,256.69
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
OP
|
$6,756.65
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,015.30 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$5,743.15
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,391.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.30
|
| Rate for Payer: BCN Commercial |
$3,015.30
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cofinity Advantage |
$4,729.65
|
| Rate for Payer: Cofinity Commercial |
$5,810.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$6,080.98
|
| Rate for Payer: Mclaren Medicaid |
$3,150.44
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.15
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,067.49
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$5,743.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$4,256.69
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,756.65
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,256.69 |
| Max. Negotiated Rate |
$6,080.98 |
| Rate for Payer: Aetna Commercial |
$5,743.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,391.82
|
| Rate for Payer: Cash Price |
$5,405.32
|
| Rate for Payer: Cofinity Advantage |
$4,729.65
|
| Rate for Payer: Cofinity Commercial |
$5,810.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.32
|
| Rate for Payer: Healthscope Commercial |
$6,080.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,067.49
|
| Rate for Payer: PHP Commercial |
$5,743.15
|
| Rate for Payer: Priority Health SBD |
$4,256.69
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$208.50
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$131.35 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.53
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Advantage |
$145.95
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: Priority Health SBD |
$131.35
|
|
