|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,685.98 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: Aetna Medicare |
$2,107.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,739.72
|
| Rate for Payer: BCBS Complete |
$1,685.98
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$2,950.47
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,950.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health SBD |
$2,655.42
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Cofinity Commercial |
$1,149.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,034.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$852.97
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,034.61 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.46
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,149.57
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health SBD |
$1,034.61
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
IP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$42,060.36 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43,395.61
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$46,733.73
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$46,733.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health SBD |
$42,060.36
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
OP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$26,704.99 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna Medicare |
$33,381.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43,395.61
|
| Rate for Payer: BCBS Complete |
$26,704.99
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$46,733.73
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$46,733.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health SBD |
$42,060.36
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
IP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$40,094.00 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,366.83
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$44,548.89
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$44,548.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health SBD |
$40,094.00
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
OP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$25,456.51 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna Medicare |
$31,820.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,366.83
|
| Rate for Payer: BCBS Complete |
$25,456.51
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$44,548.89
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$44,548.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health SBD |
$40,094.00
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
OP
|
$69,883.67
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$27,953.47 |
| Max. Negotiated Rate |
$62,895.30 |
| Rate for Payer: Aetna Commercial |
$59,401.12
|
| Rate for Payer: Aetna Medicare |
$34,941.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45,424.39
|
| Rate for Payer: BCBS Complete |
$27,953.47
|
| Rate for Payer: Cash Price |
$55,906.94
|
| Rate for Payer: Cofinity Commercial |
$48,918.57
|
| Rate for Payer: Cofinity Commercial |
$60,099.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$48,918.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55,906.94
|
| Rate for Payer: Healthscope Commercial |
$62,895.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,401.12
|
| Rate for Payer: PHP Commercial |
$59,401.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,424.39
|
| Rate for Payer: Priority Health SBD |
$44,026.71
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
IP
|
$69,883.67
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$44,026.71 |
| Max. Negotiated Rate |
$62,895.30 |
| Rate for Payer: Aetna Commercial |
$59,401.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45,424.39
|
| Rate for Payer: Cash Price |
$55,906.94
|
| Rate for Payer: Cofinity Commercial |
$48,918.57
|
| Rate for Payer: Cofinity Commercial |
$60,099.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$48,918.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55,906.94
|
| Rate for Payer: Healthscope Commercial |
$62,895.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,401.12
|
| Rate for Payer: PHP Commercial |
$59,401.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,424.39
|
| Rate for Payer: Priority Health SBD |
$44,026.71
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
OP
|
$60,520.07
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$24,208.03 |
| Max. Negotiated Rate |
$54,468.06 |
| Rate for Payer: Aetna Commercial |
$51,442.06
|
| Rate for Payer: Aetna Medicare |
$30,260.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39,338.05
|
| Rate for Payer: BCBS Complete |
$24,208.03
|
| Rate for Payer: Cash Price |
$48,416.06
|
| Rate for Payer: Cofinity Commercial |
$42,364.05
|
| Rate for Payer: Cofinity Commercial |
$52,047.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$42,364.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,416.06
|
| Rate for Payer: Healthscope Commercial |
$54,468.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,442.06
|
| Rate for Payer: PHP Commercial |
$51,442.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39,338.05
|
| Rate for Payer: Priority Health SBD |
$38,127.64
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
IP
|
$60,520.07
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$38,127.64 |
| Max. Negotiated Rate |
$54,468.06 |
| Rate for Payer: Aetna Commercial |
$51,442.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39,338.05
|
| Rate for Payer: Cash Price |
$48,416.06
|
| Rate for Payer: Cofinity Commercial |
$42,364.05
|
| Rate for Payer: Cofinity Commercial |
$52,047.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$42,364.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,416.06
|
| Rate for Payer: Healthscope Commercial |
$54,468.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,442.06
|
| Rate for Payer: PHP Commercial |
$51,442.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39,338.05
|
| Rate for Payer: Priority Health SBD |
$38,127.64
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
OP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,733.75 |
| Max. Negotiated Rate |
$61,621.88 |
| Rate for Payer: Aetna Commercial |
$18,440.21
|
| Rate for Payer: Aetna Medicare |
$22,766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,101.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,364.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,364.15
|
| Rate for Payer: BCBS Complete |
$12,320.43
|
| Rate for Payer: BCBS MAPPO |
$21,891.32
|
| Rate for Payer: BCN Medicare Advantage |
$21,891.32
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$18,657.16
|
| Rate for Payer: Cofinity Commercial |
$15,186.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,186.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$19,524.93
|
| Rate for Payer: Mclaren Medicaid |
$11,733.75
|
| Rate for Payer: Mclaren Medicare |
$21,891.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,985.89
|
| Rate for Payer: Meridian Medicaid |
$12,320.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,175.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$18,440.21
|
| Rate for Payer: PHP Medicare Advantage |
$21,891.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,733.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health SBD |
$13,667.45
|
| Rate for Payer: Railroad Medicare Medicare |
$21,891.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,621.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,891.32
|
| Rate for Payer: UHC Medicare Advantage |
$21,891.32
|
| Rate for Payer: UHCCP Medicaid |
$12,324.81
|
| Rate for Payer: VA VA |
$21,891.32
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
IP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,667.45 |
| Max. Negotiated Rate |
$19,524.93 |
| Rate for Payer: Aetna Commercial |
$18,440.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,101.34
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$15,186.06
|
| Rate for Payer: Cofinity Commercial |
$18,657.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,186.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Healthscope Commercial |
$19,524.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: PHP Commercial |
$18,440.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: Priority Health SBD |
$13,667.45
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
OP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,470.75 |
| Max. Negotiated Rate |
$28,730.64 |
| Rate for Payer: Aetna Commercial |
$13,964.45
|
| Rate for Payer: Aetna Medicare |
$10,614.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,678.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,758.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,758.29
|
| Rate for Payer: BCBS Complete |
$5,744.29
|
| Rate for Payer: BCBS MAPPO |
$10,206.63
|
| Rate for Payer: BCN Medicare Advantage |
$10,206.63
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$14,128.74
|
| Rate for Payer: Cofinity Commercial |
$11,500.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,500.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,206.63
|
| Rate for Payer: Healthscope Commercial |
$14,785.89
|
| Rate for Payer: Mclaren Medicaid |
$5,470.75
|
| Rate for Payer: Mclaren Medicare |
$10,206.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,716.96
|
| Rate for Payer: Meridian Medicaid |
$5,744.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,737.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: PACE Medicare |
$9,696.30
|
| Rate for Payer: PACE SWMI |
$10,206.63
|
| Rate for Payer: PHP Commercial |
$13,964.45
|
| Rate for Payer: PHP Medicare Advantage |
$10,206.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,470.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: Priority Health Medicare |
$10,206.63
|
| Rate for Payer: Priority Health SBD |
$10,350.13
|
| Rate for Payer: Railroad Medicare Medicare |
$10,206.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,730.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,206.63
|
| Rate for Payer: UHC Medicare Advantage |
$10,206.63
|
| Rate for Payer: UHCCP Medicaid |
$5,746.33
|
| Rate for Payer: VA VA |
$10,206.63
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
IP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,350.13 |
| Max. Negotiated Rate |
$14,785.89 |
| Rate for Payer: Aetna Commercial |
$13,964.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,678.70
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$11,500.14
|
| Rate for Payer: Cofinity Commercial |
$14,128.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,500.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Healthscope Commercial |
$14,785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: PHP Commercial |
$13,964.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: Priority Health SBD |
$10,350.13
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
OP
|
$3,052.33
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,594.48
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$2,136.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,136.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,441.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,747.10
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.48
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,594.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.01
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,922.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
IP
|
$3,052.33
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,922.97 |
| Max. Negotiated Rate |
$2,747.10 |
| Rate for Payer: Aetna Commercial |
$2,594.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.01
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cofinity Commercial |
$2,136.63
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,136.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,441.86
|
| Rate for Payer: Healthscope Commercial |
$2,747.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.48
|
| Rate for Payer: PHP Commercial |
$2,594.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.01
|
| Rate for Payer: Priority Health SBD |
$1,922.97
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
IP
|
$2,665.71
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,679.40 |
| Max. Negotiated Rate |
$2,399.14 |
| Rate for Payer: Aetna Commercial |
$2,265.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,732.71
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cofinity Commercial |
$1,866.00
|
| Rate for Payer: Cofinity Commercial |
$2,292.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,866.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,132.57
|
| Rate for Payer: Healthscope Commercial |
$2,399.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,265.85
|
| Rate for Payer: PHP Commercial |
$2,265.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.71
|
| Rate for Payer: Priority Health SBD |
$1,679.40
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
OP
|
$2,665.71
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,265.85
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,732.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cofinity Commercial |
$2,292.51
|
| Rate for Payer: Cofinity Commercial |
$1,866.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,866.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,132.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,399.14
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,265.85
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,265.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.71
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,679.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,470.89
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$1,250.26
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cofinity Commercial |
$1,264.97
|
| Rate for Payer: Cofinity Commercial |
$1,029.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,323.80
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.26
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,250.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.08
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$926.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$852.97
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,470.89
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$926.66 |
| Max. Negotiated Rate |
$1,323.80 |
| Rate for Payer: Aetna Commercial |
$1,250.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.08
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cofinity Commercial |
$1,029.62
|
| Rate for Payer: Cofinity Commercial |
$1,264.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.71
|
| Rate for Payer: Healthscope Commercial |
$1,323.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.26
|
| Rate for Payer: PHP Commercial |
$1,250.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.08
|
| Rate for Payer: Priority Health SBD |
$926.66
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,881.51 |
| Max. Negotiated Rate |
$4,116.44 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,881.51 |
| Max. Negotiated Rate |
$4,116.44 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
