|
HC STENT PLACE OTHER THAN LOWER EXTREM CER CAROTID INTRACRAN EA ADDLL
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
36100425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,822.21 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
OP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna Commercial |
$14,221.84
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,875.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$8,630.94
|
| Rate for Payer: BCN Commercial |
$8,630.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Advantage |
$11,712.11
|
| Rate for Payer: Cofinity Commercial |
$14,389.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$15,058.42
|
| Rate for Payer: Mclaren Medicaid |
$6,015.90
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$14,221.84
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$10,540.90
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
IP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,540.90 |
| Max. Negotiated Rate |
$15,058.42 |
| Rate for Payer: Aetna Commercial |
$14,221.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,875.53
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Advantage |
$11,712.11
|
| Rate for Payer: Cofinity Commercial |
$14,389.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Healthscope Commercial |
$15,058.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: PHP Commercial |
$14,221.84
|
| Rate for Payer: Priority Health SBD |
$10,540.90
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
IP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,046.73 |
| Max. Negotiated Rate |
$17,209.61 |
| Rate for Payer: Aetna Commercial |
$16,253.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,429.16
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Advantage |
$13,385.25
|
| Rate for Payer: Cofinity Commercial |
$16,444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Healthscope Commercial |
$17,209.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: PHP Commercial |
$16,253.52
|
| Rate for Payer: Priority Health SBD |
$12,046.73
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
OP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna Commercial |
$16,253.52
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,429.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$11,216.24
|
| Rate for Payer: BCN Commercial |
$11,216.24
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Advantage |
$13,385.25
|
| Rate for Payer: Cofinity Commercial |
$16,444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$17,209.61
|
| Rate for Payer: Mclaren Medicaid |
$6,015.90
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$16,253.52
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$12,046.73
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
OP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,331.56 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna Medicare |
$5,414.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: BCBS Complete |
$4,331.56
|
| Rate for Payer: BCBS Trust/PPO |
$5,267.18
|
| Rate for Payer: BCN Commercial |
$5,267.18
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,822.21 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
IP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,405.23 |
| Max. Negotiated Rate |
$6,293.19 |
| Rate for Payer: Aetna Commercial |
$5,943.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,545.08
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Advantage |
$4,894.70
|
| Rate for Payer: Cofinity Commercial |
$6,013.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,293.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: PHP Commercial |
$5,943.57
|
| Rate for Payer: Priority Health SBD |
$4,405.23
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
OP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,796.97 |
| Max. Negotiated Rate |
$6,293.19 |
| Rate for Payer: Aetna Commercial |
$5,943.57
|
| Rate for Payer: Aetna Medicare |
$3,496.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,545.08
|
| Rate for Payer: BCBS Complete |
$2,796.97
|
| Rate for Payer: BCBS Trust/PPO |
$5,267.18
|
| Rate for Payer: BCN Commercial |
$5,267.18
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Advantage |
$4,894.70
|
| Rate for Payer: Cofinity Commercial |
$6,013.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,293.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,593.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: PHP Commercial |
$5,943.57
|
| Rate for Payer: Priority Health SBD |
$4,405.23
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
OP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$7,409.86
|
| Rate for Payer: BCN Commercial |
$7,409.86
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Mclaren Medicaid |
$6,015.90
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
IP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,851.39 |
| Max. Negotiated Rate |
$22,644.84 |
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,051.15 |
| Max. Negotiated Rate |
$25,787.36 |
| Rate for Payer: Aetna Commercial |
$24,354.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,624.20
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Advantage |
$20,056.83
|
| Rate for Payer: Cofinity Commercial |
$24,641.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$25,787.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: PHP Commercial |
$24,354.73
|
| Rate for Payer: Priority Health SBD |
$18,051.15
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$25,787.36 |
| Rate for Payer: Aetna Commercial |
$24,354.73
|
| Rate for Payer: Aetna Medicare |
$14,326.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,624.20
|
| Rate for Payer: BCBS Complete |
$11,461.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Advantage |
$20,056.83
|
| Rate for Payer: Cofinity Commercial |
$24,641.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$25,787.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,922.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: PHP Commercial |
$24,354.73
|
| Rate for Payer: Priority Health SBD |
$18,051.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,624.20
|
| Rate for Payer: UHC Core |
$14,928.02
|
| Rate for Payer: UHC Exchange |
$11,260.48
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
IP
|
$5,942.76
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,743.94 |
| Max. Negotiated Rate |
$5,348.48 |
| Rate for Payer: Aetna Commercial |
$5,051.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,862.79
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cofinity Advantage |
$4,159.93
|
| Rate for Payer: Cofinity Commercial |
$5,110.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,754.21
|
| Rate for Payer: Healthscope Commercial |
$5,348.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,051.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,457.07
|
| Rate for Payer: PHP Commercial |
$5,051.35
|
| Rate for Payer: Priority Health SBD |
$3,743.94
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,942.76
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,348.48 |
| Rate for Payer: Aetna Commercial |
$5,051.35
|
| Rate for Payer: Aetna Medicare |
$2,971.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,862.79
|
| Rate for Payer: BCBS Complete |
$2,377.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cofinity Advantage |
$4,159.93
|
| Rate for Payer: Cofinity Commercial |
$5,110.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,754.21
|
| Rate for Payer: Healthscope Commercial |
$5,348.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,754.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,051.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,457.07
|
| Rate for Payer: PHP Commercial |
$5,051.35
|
| Rate for Payer: Priority Health SBD |
$3,743.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,862.79
|
| Rate for Payer: UHC Core |
$3,096.18
|
| Rate for Payer: UHC Exchange |
$2,335.50
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
IP
|
$9,550.87
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,017.05 |
| Max. Negotiated Rate |
$8,595.78 |
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.07
|
| Rate for Payer: Cash Price |
$7,640.70
|
| Rate for Payer: Cofinity Advantage |
$6,685.61
|
| Rate for Payer: Cofinity Commercial |
$8,213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,640.70
|
| Rate for Payer: Healthscope Commercial |
$8,595.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,163.15
|
| Rate for Payer: PHP Commercial |
$8,118.24
|
| Rate for Payer: Priority Health SBD |
$6,017.05
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
OP
|
$9,550.87
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,753.49 |
| Max. Negotiated Rate |
$8,595.78 |
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: Aetna Medicare |
$4,775.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.07
|
| Rate for Payer: BCBS Complete |
$3,820.35
|
| Rate for Payer: Cash Price |
$7,640.70
|
| Rate for Payer: Cofinity Advantage |
$6,685.61
|
| Rate for Payer: Cofinity Commercial |
$8,213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,640.70
|
| Rate for Payer: Healthscope Commercial |
$8,595.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,640.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,163.15
|
| Rate for Payer: PHP Commercial |
$8,118.24
|
| Rate for Payer: Priority Health SBD |
$6,017.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,208.07
|
| Rate for Payer: UHC Core |
$4,976.00
|
| Rate for Payer: UHC Exchange |
$3,753.49
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
IP
|
$21,648.64
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,638.64 |
| Max. Negotiated Rate |
$19,483.78 |
| Rate for Payer: Aetna Commercial |
$18,401.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,071.62
|
| Rate for Payer: Cash Price |
$17,318.91
|
| Rate for Payer: Cofinity Advantage |
$15,154.05
|
| Rate for Payer: Cofinity Commercial |
$18,617.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,318.91
|
| Rate for Payer: Healthscope Commercial |
$19,483.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,401.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,236.48
|
| Rate for Payer: PHP Commercial |
$18,401.34
|
| Rate for Payer: Priority Health SBD |
$13,638.64
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
OP
|
$21,648.64
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,507.92 |
| Max. Negotiated Rate |
$19,483.78 |
| Rate for Payer: Aetna Commercial |
$18,401.34
|
| Rate for Payer: Aetna Medicare |
$10,824.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,071.62
|
| Rate for Payer: BCBS Complete |
$8,659.46
|
| Rate for Payer: Cash Price |
$17,318.91
|
| Rate for Payer: Cofinity Advantage |
$15,154.05
|
| Rate for Payer: Cofinity Commercial |
$18,617.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,318.91
|
| Rate for Payer: Healthscope Commercial |
$19,483.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,318.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,401.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,236.48
|
| Rate for Payer: PHP Commercial |
$18,401.34
|
| Rate for Payer: Priority Health SBD |
$13,638.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,071.62
|
| Rate for Payer: UHC Core |
$11,278.94
|
| Rate for Payer: UHC Exchange |
$8,507.92
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
IP
|
$14,347.53
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,038.94 |
| Max. Negotiated Rate |
$12,912.78 |
| Rate for Payer: Aetna Commercial |
$12,195.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,325.89
|
| Rate for Payer: Cash Price |
$11,478.02
|
| Rate for Payer: Cofinity Advantage |
$10,043.27
|
| Rate for Payer: Cofinity Commercial |
$12,338.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,478.02
|
| Rate for Payer: Healthscope Commercial |
$12,912.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,195.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,760.65
|
| Rate for Payer: PHP Commercial |
$12,195.40
|
| Rate for Payer: Priority Health SBD |
$9,038.94
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
OP
|
$14,347.53
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,638.58 |
| Max. Negotiated Rate |
$12,912.78 |
| Rate for Payer: Aetna Commercial |
$12,195.40
|
| Rate for Payer: Aetna Medicare |
$7,173.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,325.89
|
| Rate for Payer: BCBS Complete |
$5,739.01
|
| Rate for Payer: Cash Price |
$11,478.02
|
| Rate for Payer: Cofinity Advantage |
$10,043.27
|
| Rate for Payer: Cofinity Commercial |
$12,338.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,478.02
|
| Rate for Payer: Healthscope Commercial |
$12,912.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,478.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,195.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,760.65
|
| Rate for Payer: PHP Commercial |
$12,195.40
|
| Rate for Payer: Priority Health SBD |
$9,038.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,325.89
|
| Rate for Payer: UHC Core |
$7,475.06
|
| Rate for Payer: UHC Exchange |
$5,638.58
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
OP
|
$7,322.34
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,877.68 |
| Max. Negotiated Rate |
$6,590.11 |
| Rate for Payer: Aetna Commercial |
$6,223.99
|
| Rate for Payer: Aetna Medicare |
$3,661.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,759.52
|
| Rate for Payer: BCBS Complete |
$2,928.94
|
| Rate for Payer: Cash Price |
$5,857.87
|
| Rate for Payer: Cofinity Advantage |
$5,125.64
|
| Rate for Payer: Cofinity Commercial |
$6,297.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,857.87
|
| Rate for Payer: Healthscope Commercial |
$6,590.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,857.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,223.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,491.76
|
| Rate for Payer: PHP Commercial |
$6,223.99
|
| Rate for Payer: Priority Health SBD |
$4,613.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,759.52
|
| Rate for Payer: UHC Core |
$3,814.94
|
| Rate for Payer: UHC Exchange |
$2,877.68
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
IP
|
$7,322.34
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,613.07 |
| Max. Negotiated Rate |
$6,590.11 |
| Rate for Payer: Aetna Commercial |
$6,223.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,759.52
|
| Rate for Payer: Cash Price |
$5,857.87
|
| Rate for Payer: Cofinity Advantage |
$5,125.64
|
| Rate for Payer: Cofinity Commercial |
$6,297.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,857.87
|
| Rate for Payer: Healthscope Commercial |
$6,590.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,223.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,491.76
|
| Rate for Payer: PHP Commercial |
$6,223.99
|
| Rate for Payer: Priority Health SBD |
$4,613.07
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,328.01
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,246.65 |
| Max. Negotiated Rate |
$7,495.21 |
| Rate for Payer: Aetna Commercial |
$7,078.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,413.21
|
| Rate for Payer: Cash Price |
$6,662.41
|
| Rate for Payer: Cofinity Advantage |
$5,829.61
|
| Rate for Payer: Cofinity Commercial |
$7,162.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,662.41
|
| Rate for Payer: Healthscope Commercial |
$7,495.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,078.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,246.01
|
| Rate for Payer: PHP Commercial |
$7,078.81
|
| Rate for Payer: Priority Health SBD |
$5,246.65
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,328.01
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,272.91 |
| Max. Negotiated Rate |
$7,495.21 |
| Rate for Payer: Aetna Commercial |
$7,078.81
|
| Rate for Payer: Aetna Medicare |
$4,164.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,413.21
|
| Rate for Payer: BCBS Complete |
$3,331.20
|
| Rate for Payer: Cash Price |
$6,662.41
|
| Rate for Payer: Cofinity Advantage |
$5,829.61
|
| Rate for Payer: Cofinity Commercial |
$7,162.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,662.41
|
| Rate for Payer: Healthscope Commercial |
$7,495.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,662.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,078.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,246.01
|
| Rate for Payer: PHP Commercial |
$7,078.81
|
| Rate for Payer: Priority Health SBD |
$5,246.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,413.21
|
| Rate for Payer: UHC Core |
$4,338.89
|
| Rate for Payer: UHC Exchange |
$3,272.91
|
|
