|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$3,292.89
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,798.96
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.38
|
| 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 |
$2,634.31
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cofinity Commercial |
$2,831.89
|
| Rate for Payer: Cofinity Commercial |
$2,305.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,305.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,963.60
|
| 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 |
$2,798.96
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,798.96
|
| 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 |
$2,140.38
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,074.52
|
| 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 CVC WO PORT OR PUMP
|
Facility
|
IP
|
$3,292.89
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,074.52 |
| Max. Negotiated Rate |
$2,963.60 |
| Rate for Payer: Aetna Commercial |
$2,798.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.38
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cofinity Commercial |
$2,305.02
|
| Rate for Payer: Cofinity Commercial |
$2,831.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,305.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.31
|
| Rate for Payer: Healthscope Commercial |
$2,963.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.96
|
| Rate for Payer: PHP Commercial |
$2,798.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.38
|
| Rate for Payer: Priority Health SBD |
$2,074.52
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
OP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$1,674.65
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,280.62
|
| 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 |
$1,576.14
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,694.35
|
| Rate for Payer: Cofinity Commercial |
$1,379.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,379.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,773.16
|
| 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 |
$1,674.65
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,674.65
|
| 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 |
$1,280.62
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,241.21
|
| 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 OF PICC W IMAGING
|
Facility
|
IP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,241.21 |
| Max. Negotiated Rate |
$1,773.16 |
| Rate for Payer: Aetna Commercial |
$1,674.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,280.62
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,379.13
|
| Rate for Payer: Cofinity Commercial |
$1,694.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,379.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Healthscope Commercial |
$1,773.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,674.65
|
| Rate for Payer: PHP Commercial |
$1,674.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.62
|
| Rate for Payer: Priority Health SBD |
$1,241.21
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
OP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna Commercial |
$904.68
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$745.03
|
| Rate for Payer: Cofinity Commercial |
$915.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$957.90
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$904.68
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$670.53
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$339.48
|
| Rate for Payer: VA VA |
$602.98
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
IP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$670.53 |
| Max. Negotiated Rate |
$957.90 |
| Rate for Payer: Aetna Commercial |
$904.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.81
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$745.03
|
| Rate for Payer: Cofinity Commercial |
$915.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Healthscope Commercial |
$957.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: PHP Commercial |
$904.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: Priority Health SBD |
$670.53
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
OP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,805.52 |
| Max. Negotiated Rate |
$88,019.16 |
| Rate for Payer: UHC Medicare Advantage |
$31,269.02
|
| Rate for Payer: UHCCP Medicaid |
$17,604.46
|
| Rate for Payer: VA VA |
$31,269.02
|
| Rate for Payer: Aetna Commercial |
$18,626.49
|
| Rate for Payer: Aetna Medicare |
$32,519.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,243.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,086.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,086.28
|
| Rate for Payer: BCBS Complete |
$17,598.20
|
| Rate for Payer: BCBS MAPPO |
$31,269.02
|
| Rate for Payer: BCN Medicare Advantage |
$31,269.02
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$18,845.63
|
| Rate for Payer: Cofinity Commercial |
$15,339.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,339.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,269.02
|
| Rate for Payer: Healthscope Commercial |
$19,722.17
|
| Rate for Payer: Mclaren Medicaid |
$16,760.19
|
| Rate for Payer: Mclaren Medicare |
$31,269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,832.47
|
| Rate for Payer: Meridian Medicaid |
$17,598.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,959.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: PACE Medicare |
$29,705.57
|
| Rate for Payer: PACE SWMI |
$31,269.02
|
| Rate for Payer: PHP Commercial |
$18,626.49
|
| Rate for Payer: PHP Medicare Advantage |
$31,269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: Priority Health Medicare |
$31,269.02
|
| Rate for Payer: Priority Health SBD |
$13,805.52
|
| Rate for Payer: Railroad Medicare Medicare |
$31,269.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88,019.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,269.02
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,805.52 |
| Max. Negotiated Rate |
$19,722.17 |
| Rate for Payer: Aetna Commercial |
$18,626.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,243.79
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$15,339.46
|
| Rate for Payer: Cofinity Commercial |
$18,845.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,339.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Healthscope Commercial |
$19,722.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: PHP Commercial |
$18,626.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: Priority Health SBD |
$13,805.52
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,969.45 |
| Max. Negotiated Rate |
$52,356.35 |
| Rate for Payer: Aetna Commercial |
$15,708.34
|
| Rate for Payer: Aetna Medicare |
$19,343.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,012.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,249.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,249.65
|
| Rate for Payer: BCBS Complete |
$10,467.92
|
| Rate for Payer: BCBS MAPPO |
$18,599.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,599.72
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$15,893.14
|
| Rate for Payer: Cofinity Commercial |
$12,936.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,936.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,599.72
|
| Rate for Payer: Healthscope Commercial |
$16,632.36
|
| Rate for Payer: Mclaren Medicaid |
$9,969.45
|
| Rate for Payer: Mclaren Medicare |
$18,599.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,529.71
|
| Rate for Payer: Meridian Medicaid |
$10,467.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,389.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: PACE Medicare |
$17,669.73
|
| Rate for Payer: PACE SWMI |
$18,599.72
|
| Rate for Payer: PHP Commercial |
$15,708.34
|
| Rate for Payer: PHP Medicare Advantage |
$18,599.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,969.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health Medicare |
$18,599.72
|
| Rate for Payer: Priority Health SBD |
$11,642.65
|
| Rate for Payer: Railroad Medicare Medicare |
$18,599.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52,356.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,599.72
|
| Rate for Payer: UHC Medicare Advantage |
$18,599.72
|
| Rate for Payer: UHCCP Medicaid |
$10,471.64
|
| Rate for Payer: VA VA |
$18,599.72
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,642.65 |
| Max. Negotiated Rate |
$16,632.36 |
| Rate for Payer: Aetna Commercial |
$15,708.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,012.26
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$12,936.28
|
| Rate for Payer: Cofinity Commercial |
$15,893.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,936.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Healthscope Commercial |
$16,632.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: PHP Commercial |
$15,708.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health SBD |
$11,642.65
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,265.30 |
| Max. Negotiated Rate |
$16,093.29 |
| Rate for Payer: Aetna Commercial |
$15,199.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,622.93
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$12,517.00
|
| Rate for Payer: Cofinity Commercial |
$15,378.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,517.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Healthscope Commercial |
$16,093.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: PHP Commercial |
$15,199.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: Priority Health SBD |
$11,265.30
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,265.30 |
| Max. Negotiated Rate |
$61,621.88 |
| Rate for Payer: Aetna Commercial |
$15,199.22
|
| Rate for Payer: Aetna Medicare |
$22,766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,622.93
|
| 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 |
$14,305.14
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$15,378.03
|
| Rate for Payer: Cofinity Commercial |
$12,517.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,517.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$16,093.29
|
| 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 |
$15,199.22
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$15,199.22
|
| 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 |
$11,622.93
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health SBD |
$11,265.30
|
| 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 SINGLE CHAMBER PPM
|
Facility
|
IP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,674.07 |
| Max. Negotiated Rate |
$10,962.96 |
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,917.70
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Cofinity Commercial |
$8,526.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,526.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health SBD |
$7,674.07
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,326.27 |
| Max. Negotiated Rate |
$22,720.18 |
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: Aetna Medicare |
$8,394.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,917.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,089.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,089.25
|
| Rate for Payer: BCBS Complete |
$4,542.58
|
| Rate for Payer: BCBS MAPPO |
$8,071.40
|
| Rate for Payer: BCN Medicare Advantage |
$8,071.40
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$8,526.75
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,526.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,071.40
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Mclaren Medicaid |
$4,326.27
|
| Rate for Payer: Mclaren Medicare |
$8,071.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,474.97
|
| Rate for Payer: Meridian Medicaid |
$4,542.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,282.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: PACE Medicare |
$7,667.83
|
| Rate for Payer: PACE SWMI |
$8,071.40
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: PHP Medicare Advantage |
$8,071.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,326.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health Medicare |
$8,071.40
|
| Rate for Payer: Priority Health SBD |
$7,674.07
|
| Rate for Payer: Railroad Medicare Medicare |
$8,071.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,720.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,071.40
|
| Rate for Payer: UHC Medicare Advantage |
$8,071.40
|
| Rate for Payer: UHCCP Medicaid |
$4,544.20
|
| Rate for Payer: VA VA |
$8,071.40
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,733.75 |
| Max. Negotiated Rate |
$61,621.88 |
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: Aetna Medicare |
$22,766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23,550.14
|
| 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 |
$28,984.78
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$25,361.69
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$25,361.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| 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 |
$30,796.33
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| 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 |
$23,550.14
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health SBD |
$22,825.52
|
| 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 SQ ICD ONLY
|
Facility
|
IP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$22,825.52 |
| Max. Negotiated Rate |
$32,607.88 |
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23,550.14
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$25,361.69
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$25,361.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health SBD |
$22,825.52
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.73
|
| 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 |
$2,007.06
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Cofinity Commercial |
$1,756.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| 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 |
$2,132.50
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| 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 |
$1,630.73
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,580.56
|
| 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 REPOSITION CVAC
|
Facility
|
IP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,580.56 |
| Max. Negotiated Rate |
$2,257.94 |
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.73
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$1,756.17
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health SBD |
$1,580.56
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,912.06
|
| 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 |
$2,353.30
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Cofinity Commercial |
$2,059.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,059.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| 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 |
$2,500.39
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| 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 |
$1,912.06
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,853.23
|
| 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 REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.23 |
| Max. Negotiated Rate |
$2,647.47 |
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,912.06
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,059.14
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,059.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health SBD |
$1,853.23
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.47 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$53.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: BCBS Complete |
$42.84
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
