|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,348.21
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,124.80
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,348.21
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,109.37 |
| Max. Negotiated Rate |
$3,013.39 |
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,348.21
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$9,468.51 |
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna Medicare |
$3,498.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,468.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,893.77
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$8,589.97
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,435.99 |
| Max. Negotiated Rate |
$7,730.97 |
| Rate for Payer: Aetna Commercial |
$7,301.47
|
| Rate for Payer: Aetna Medicare |
$4,294.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,583.48
|
| Rate for Payer: BCBS Complete |
$3,435.99
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cofinity Commercial |
$6,012.98
|
| Rate for Payer: Cofinity Commercial |
$7,387.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,012.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,871.98
|
| Rate for Payer: Healthscope Commercial |
$7,730.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,301.47
|
| Rate for Payer: PHP Commercial |
$7,301.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,583.48
|
| Rate for Payer: Priority Health SBD |
$5,411.68
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$8,589.97
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,411.68 |
| Max. Negotiated Rate |
$7,730.97 |
| Rate for Payer: Aetna Commercial |
$7,301.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,583.48
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cofinity Commercial |
$6,012.98
|
| Rate for Payer: Cofinity Commercial |
$7,387.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,012.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,871.98
|
| Rate for Payer: Healthscope Commercial |
$7,730.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,301.47
|
| Rate for Payer: PHP Commercial |
$7,301.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,583.48
|
| Rate for Payer: Priority Health SBD |
$5,411.68
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,382.61
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,391.04 |
| Max. Negotiated Rate |
$4,844.35 |
| Rate for Payer: Aetna Commercial |
$4,575.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,498.70
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cofinity Commercial |
$3,767.83
|
| Rate for Payer: Cofinity Commercial |
$4,629.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,767.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.09
|
| Rate for Payer: Healthscope Commercial |
$4,844.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.22
|
| Rate for Payer: PHP Commercial |
$4,575.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,498.70
|
| Rate for Payer: Priority Health SBD |
$3,391.04
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,382.61
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,153.04 |
| Max. Negotiated Rate |
$4,844.35 |
| Rate for Payer: Aetna Commercial |
$4,575.22
|
| Rate for Payer: Aetna Medicare |
$2,691.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,498.70
|
| Rate for Payer: BCBS Complete |
$2,153.04
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cofinity Commercial |
$3,767.83
|
| Rate for Payer: Cofinity Commercial |
$4,629.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,767.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.09
|
| Rate for Payer: Healthscope Commercial |
$4,844.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.22
|
| Rate for Payer: PHP Commercial |
$4,575.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,498.70
|
| Rate for Payer: Priority Health SBD |
$3,391.04
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
OP
|
$740.52
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$629.44
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$592.42
|
| Rate for Payer: Cash Price |
$592.42
|
| Rate for Payer: Cofinity Commercial |
$636.85
|
| Rate for Payer: Cofinity Commercial |
$518.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$518.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$666.47
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.44
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$629.44
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.34
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$466.53
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
IP
|
$740.52
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$466.53 |
| Max. Negotiated Rate |
$666.47 |
| Rate for Payer: Aetna Commercial |
$629.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.34
|
| Rate for Payer: Cash Price |
$592.42
|
| Rate for Payer: Cofinity Commercial |
$518.36
|
| Rate for Payer: Cofinity Commercial |
$636.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$518.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.42
|
| Rate for Payer: Healthscope Commercial |
$666.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.44
|
| Rate for Payer: PHP Commercial |
$629.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.34
|
| Rate for Payer: Priority Health SBD |
$466.53
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
IP
|
$421.54
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$265.57 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.00
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health SBD |
$265.57
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
OP
|
$421.54
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$168.62 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: Aetna Medicare |
$210.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.00
|
| Rate for Payer: BCBS Complete |
$168.62
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health SBD |
$265.57
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,173.23 |
| Max. Negotiated Rate |
$5,961.75 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,173.23 |
| Max. Negotiated Rate |
$5,961.75 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,173.23 |
| Max. Negotiated Rate |
$5,961.75 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
OP
|
$6,624.17
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,049.91 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Cofinity Commercial |
$4,636.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,636.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$4,173.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.78 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.87
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$143.09
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health SBD |
$128.78
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.76 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: Aetna Medicare |
$102.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.87
|
| Rate for Payer: BCBS Complete |
$81.76
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$143.09
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health SBD |
$128.78
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,631.20 |
| Max. Negotiated Rate |
$8,170.20 |
| Rate for Payer: Aetna Commercial |
$7,716.30
|
| Rate for Payer: Aetna Medicare |
$4,539.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,900.70
|
| Rate for Payer: BCBS Complete |
$3,631.20
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$6,354.60
|
| Rate for Payer: Cofinity Commercial |
$7,807.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,354.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Healthscope Commercial |
$8,170.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: PHP Commercial |
$7,716.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: Priority Health SBD |
$5,719.14
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,719.14 |
| Max. Negotiated Rate |
$8,170.20 |
| Rate for Payer: Aetna Commercial |
$7,716.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,900.70
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$6,354.60
|
| Rate for Payer: Cofinity Commercial |
$7,807.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,354.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Healthscope Commercial |
$8,170.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: PHP Commercial |
$7,716.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: Priority Health SBD |
$5,719.14
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.66 |
| Max. Negotiated Rate |
$298.09 |
| Rate for Payer: Aetna Commercial |
$281.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.29
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$231.85
|
| Rate for Payer: Cofinity Commercial |
$284.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Healthscope Commercial |
$298.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: PHP Commercial |
$281.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: Priority Health SBD |
$208.66
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.66 |
| Max. Negotiated Rate |
$9,468.51 |
| Rate for Payer: Aetna Commercial |
$281.53
|
| Rate for Payer: Aetna Medicare |
$3,498.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$284.84
|
| Rate for Payer: Cofinity Commercial |
$231.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$298.09
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$281.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health SBD |
$208.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,468.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,893.77
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,295.28 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,368.14
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$2,550.31
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,550.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health SBD |
$2,295.28
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$9,468.51 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna Medicare |
$3,498.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,368.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Cofinity Commercial |
$2,550.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,550.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health SBD |
$2,295.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,468.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,893.77
|
| Rate for Payer: VA VA |
$3,363.71
|
|
