|
CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$136,510.32
|
|
|
Service Code
|
MS-DRG 231
|
| Min. Negotiated Rate |
$55,989.88 |
| Max. Negotiated Rate |
$136,510.32 |
| Rate for Payer: Aetna Medicare |
$61,294.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73,670.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73,670.90
|
| Rate for Payer: BCBS MAPPO |
$58,936.72
|
| Rate for Payer: BCBS Trust/PPO |
$136,510.32
|
| Rate for Payer: BCN Medicare Advantage |
$58,936.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58,936.72
|
| Rate for Payer: Mclaren Medicare |
$58,936.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61,883.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67,777.23
|
| Rate for Payer: PACE Medicare |
$55,989.88
|
| Rate for Payer: PACE SWMI |
$58,936.72
|
| Rate for Payer: PHP Medicare Advantage |
$58,936.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116,452.47
|
| Rate for Payer: Priority Health Medicare |
$58,936.72
|
| Rate for Payer: Priority Health Narrow Network |
$93,161.98
|
| Rate for Payer: Railroad Medicare Medicare |
$58,936.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123,789.26
|
| Rate for Payer: UHC Core |
$75,958.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$58,936.72
|
| Rate for Payer: UHC Exchange |
$81,354.88
|
| Rate for Payer: UHC Medicare Advantage |
$60,704.82
|
| Rate for Payer: VA VA |
$58,936.72
|
|
|
CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$120,399.00
|
|
|
Service Code
|
MS-DRG 232
|
| Min. Negotiated Rate |
$41,166.65 |
| Max. Negotiated Rate |
$120,399.00 |
| Rate for Payer: Aetna Medicare |
$45,066.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54,166.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54,166.65
|
| Rate for Payer: BCBS MAPPO |
$43,333.32
|
| Rate for Payer: BCBS Trust/PPO |
$120,399.00
|
| Rate for Payer: BCN Medicare Advantage |
$43,333.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,333.32
|
| Rate for Payer: Mclaren Medicare |
$43,333.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45,499.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,833.32
|
| Rate for Payer: PACE Medicare |
$41,166.65
|
| Rate for Payer: PACE SWMI |
$43,333.32
|
| Rate for Payer: PHP Medicare Advantage |
$43,333.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85,361.93
|
| Rate for Payer: Priority Health Medicare |
$43,333.32
|
| Rate for Payer: Priority Health Narrow Network |
$68,289.54
|
| Rate for Payer: Railroad Medicare Medicare |
$43,333.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90,739.94
|
| Rate for Payer: UHC Core |
$55,678.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$43,333.32
|
| Rate for Payer: UHC Exchange |
$59,634.72
|
| Rate for Payer: UHC Medicare Advantage |
$44,633.32
|
| Rate for Payer: VA VA |
$43,333.32
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$89,902.34
|
|
|
Service Code
|
MS-DRG 323
|
| Min. Negotiated Rate |
$28,792.74 |
| Max. Negotiated Rate |
$89,902.34 |
| Rate for Payer: Aetna Medicare |
$31,520.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,885.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,885.19
|
| Rate for Payer: BCBS MAPPO |
$30,308.15
|
| Rate for Payer: BCBS Trust/PPO |
$89,902.34
|
| Rate for Payer: BCN Medicare Advantage |
$30,308.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,308.15
|
| Rate for Payer: Mclaren Medicare |
$30,308.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31,823.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,854.37
|
| Rate for Payer: PACE Medicare |
$28,792.74
|
| Rate for Payer: PACE SWMI |
$30,308.15
|
| Rate for Payer: PHP Medicare Advantage |
$30,308.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59,408.67
|
| Rate for Payer: Priority Health Medicare |
$30,308.15
|
| Rate for Payer: Priority Health Narrow Network |
$47,526.94
|
| Rate for Payer: Railroad Medicare Medicare |
$30,308.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,151.56
|
| Rate for Payer: UHC Core |
$38,750.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,308.15
|
| Rate for Payer: UHC Exchange |
$41,503.50
|
| Rate for Payer: UHC Medicare Advantage |
$31,217.39
|
| Rate for Payer: VA VA |
$30,308.15
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$60,312.59
|
|
|
Service Code
|
MS-DRG 324
|
| Min. Negotiated Rate |
$20,778.38 |
| Max. Negotiated Rate |
$60,312.59 |
| Rate for Payer: Aetna Medicare |
$22,746.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,339.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,339.98
|
| Rate for Payer: BCBS MAPPO |
$21,871.98
|
| Rate for Payer: BCBS Trust/PPO |
$60,312.59
|
| Rate for Payer: BCN Medicare Advantage |
$21,871.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,871.98
|
| Rate for Payer: Mclaren Medicare |
$21,871.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,965.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,152.78
|
| Rate for Payer: PACE Medicare |
$20,778.38
|
| Rate for Payer: PACE SWMI |
$21,871.98
|
| Rate for Payer: PHP Medicare Advantage |
$21,871.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,599.17
|
| Rate for Payer: Priority Health Medicare |
$21,871.98
|
| Rate for Payer: Priority Health Narrow Network |
$34,079.34
|
| Rate for Payer: Railroad Medicare Medicare |
$21,871.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,283.02
|
| Rate for Payer: UHC Core |
$27,786.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,871.98
|
| Rate for Payer: UHC Exchange |
$29,760.22
|
| Rate for Payer: UHC Medicare Advantage |
$22,528.14
|
| Rate for Payer: VA VA |
$21,871.98
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$40,336.15
|
|
|
Service Code
|
MS-DRG 325
|
| Min. Negotiated Rate |
$18,559.62 |
| Max. Negotiated Rate |
$40,336.15 |
| Rate for Payer: Aetna Medicare |
$20,317.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,420.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,420.55
|
| Rate for Payer: BCBS MAPPO |
$19,536.44
|
| Rate for Payer: BCBS Trust/PPO |
$35,733.88
|
| Rate for Payer: BCN Medicare Advantage |
$19,536.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,536.44
|
| Rate for Payer: Mclaren Medicare |
$19,536.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,513.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,466.91
|
| Rate for Payer: PACE Medicare |
$18,559.62
|
| Rate for Payer: PACE SWMI |
$19,536.44
|
| Rate for Payer: PHP Medicare Advantage |
$19,536.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,945.49
|
| Rate for Payer: Priority Health Medicare |
$19,536.44
|
| Rate for Payer: Priority Health Narrow Network |
$30,356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19,536.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,336.15
|
| Rate for Payer: UHC Core |
$24,750.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,536.44
|
| Rate for Payer: UHC Exchange |
$26,509.11
|
| Rate for Payer: UHC Medicare Advantage |
$20,122.53
|
| Rate for Payer: VA VA |
$19,536.44
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DISTAL METATARSAL OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$5,427.00
|
|
|
Service Code
|
CPT 28296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$508.52 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.37
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$508.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH DOUBLE OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$7,957.04
|
|
|
Service Code
|
CPT 28299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$589.72 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,626.72
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.69
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$589.72
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH FIRST METATARSAL AND MEDIAL CUNEIFORM JOINT ARTHRODESIS, ANY METHOD
|
Facility
|
OP
|
$7,957.04
|
|
|
Service Code
|
CPT 28297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$595.62 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,671.58
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.18
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$595.62
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH PROXIMAL METATARSAL OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$5,427.00
|
|
|
Service Code
|
CPT 28295
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$596.93 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.29
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.62
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$596.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH PROXIMAL PHALANX OSTEOTOMY, ANY METHOD
|
Facility
|
OP
|
$7,957.04
|
|
|
Service Code
|
CPT 28298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$503.61 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,355.03
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.97
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$503.61
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH RESECTION OF PROXIMAL PHALANX BASE, WHEN PERFORMED, ANY METHOD
|
Facility
|
OP
|
$5,427.00
|
|
|
Service Code
|
CPT 28292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$481.99 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,049.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.19
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$481.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)
|
Facility
|
OP
|
$4,155.00
|
|
|
Service Code
|
CPT 28285
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$384.09 |
| Max. Negotiated Rate |
$4,155.00 |
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.50
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$384.09
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$291.09
|
|
|
Service Code
|
HCPCS J0834
|
| Hospital Charge Code |
9686
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$261.98 |
| Rate for Payer: Aetna Commercial |
$247.43
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Commercial |
$112.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.68
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$105.46
|
| Rate for Payer: Cash Price |
$232.87
|
| Rate for Payer: Cofinity Commercial |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$113.37
|
| Rate for Payer: Cofinity Commercial |
$92.27
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Cofinity Commercial |
$203.76
|
| Rate for Payer: Cofinity Commercial |
$250.34
|
| Rate for Payer: Healthscope Commercial |
$261.98
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Healthscope Commercial |
$118.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$247.43
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Commercial |
$247.43
|
| Rate for Payer: PHP Commercial |
$112.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.27
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health SBD |
$83.05
|
| Rate for Payer: Priority Health SBD |
$183.39
|
|
|
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$131.82
|
|
|
Service Code
|
HCPCS J0834
|
| Hospital Charge Code |
9686
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.73 |
| Max. Negotiated Rate |
$118.64 |
| Rate for Payer: Aetna Commercial |
$112.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.68
|
| Rate for Payer: BCBS Complete |
$52.73
|
| Rate for Payer: BCBS Trust/PPO |
$80.26
|
| Rate for Payer: Cash Price |
$105.46
|
| Rate for Payer: Cash Price |
$105.46
|
| Rate for Payer: Cofinity Commercial |
$92.27
|
| Rate for Payer: Cofinity Commercial |
$113.37
|
| Rate for Payer: Healthscope Commercial |
$118.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.05
|
| Rate for Payer: PHP Commercial |
$112.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.27
|
| Rate for Payer: Priority Health SBD |
$83.05
|
|
|
CPT 0255T
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 0255T
|
| Min. Negotiated Rate |
$178.40 |
| Max. Negotiated Rate |
$312.20 |
| Rate for Payer: BCBS Complete |
$178.40
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
|
|
CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$24,978.36
|
|
|
Service Code
|
MS-DRG 073
|
| Min. Negotiated Rate |
$10,819.59 |
| Max. Negotiated Rate |
$24,978.36 |
| Rate for Payer: Aetna Medicare |
$11,844.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,236.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,236.30
|
| Rate for Payer: BCBS MAPPO |
$11,389.04
|
| Rate for Payer: BCBS Trust/PPO |
$24,978.36
|
| Rate for Payer: BCN Medicare Advantage |
$11,389.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,389.04
|
| Rate for Payer: Mclaren Medicare |
$11,389.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,958.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,097.40
|
| Rate for Payer: PACE Medicare |
$10,819.59
|
| Rate for Payer: PACE SWMI |
$11,389.04
|
| Rate for Payer: PHP Medicare Advantage |
$11,389.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,711.43
|
| Rate for Payer: Priority Health Medicare |
$11,389.04
|
| Rate for Payer: Priority Health Narrow Network |
$17,369.14
|
| Rate for Payer: Railroad Medicare Medicare |
$11,389.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,079.30
|
| Rate for Payer: UHC Core |
$14,161.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,389.04
|
| Rate for Payer: UHC Exchange |
$15,167.83
|
| Rate for Payer: UHC Medicare Advantage |
$11,730.71
|
| Rate for Payer: VA VA |
$11,389.04
|
|
|
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$18,085.43
|
|
|
Service Code
|
MS-DRG 074
|
| Min. Negotiated Rate |
$7,489.05 |
| Max. Negotiated Rate |
$18,085.43 |
| Rate for Payer: Aetna Medicare |
$8,198.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,854.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,854.01
|
| Rate for Payer: BCBS MAPPO |
$7,883.21
|
| Rate for Payer: BCBS Trust/PPO |
$18,085.43
|
| Rate for Payer: BCN Medicare Advantage |
$7,883.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,883.21
|
| Rate for Payer: Mclaren Medicare |
$7,883.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,277.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,065.69
|
| Rate for Payer: PACE Medicare |
$7,489.05
|
| Rate for Payer: PACE SWMI |
$7,883.21
|
| Rate for Payer: PHP Medicare Advantage |
$7,883.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,725.89
|
| Rate for Payer: Priority Health Medicare |
$7,883.21
|
| Rate for Payer: Priority Health Narrow Network |
$11,780.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7,883.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,653.65
|
| Rate for Payer: UHC Core |
$9,605.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,883.21
|
| Rate for Payer: UHC Exchange |
$10,287.66
|
| Rate for Payer: UHC Medicare Advantage |
$8,119.71
|
| Rate for Payer: VA VA |
$7,883.21
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$63,296.82
|
|
|
Service Code
|
MS-DRG 026
|
| Min. Negotiated Rate |
$20,672.33 |
| Max. Negotiated Rate |
$63,296.82 |
| Rate for Payer: Aetna Medicare |
$22,630.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,200.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,200.44
|
| Rate for Payer: BCBS MAPPO |
$21,760.35
|
| Rate for Payer: BCBS Trust/PPO |
$63,296.82
|
| Rate for Payer: BCN Medicare Advantage |
$21,760.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,760.35
|
| Rate for Payer: Mclaren Medicare |
$21,760.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,848.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,024.40
|
| Rate for Payer: PACE Medicare |
$20,672.33
|
| Rate for Payer: PACE SWMI |
$21,760.35
|
| Rate for Payer: PHP Medicare Advantage |
$21,760.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,376.75
|
| Rate for Payer: Priority Health Medicare |
$21,760.35
|
| Rate for Payer: Priority Health Narrow Network |
$33,901.40
|
| Rate for Payer: Railroad Medicare Medicare |
$21,760.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,046.59
|
| Rate for Payer: UHC Core |
$27,641.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,760.35
|
| Rate for Payer: UHC Exchange |
$29,604.83
|
| Rate for Payer: UHC Medicare Advantage |
$22,413.16
|
| Rate for Payer: VA VA |
$21,760.35
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,961.57
|
|
|
Service Code
|
MS-DRG 025
|
| Min. Negotiated Rate |
$30,681.06 |
| Max. Negotiated Rate |
$84,961.57 |
| Rate for Payer: Aetna Medicare |
$33,587.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,369.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,369.81
|
| Rate for Payer: BCBS MAPPO |
$32,295.85
|
| Rate for Payer: BCBS Trust/PPO |
$84,961.57
|
| Rate for Payer: BCN Medicare Advantage |
$32,295.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,295.85
|
| Rate for Payer: Mclaren Medicare |
$32,295.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33,910.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,140.23
|
| Rate for Payer: PACE Medicare |
$30,681.06
|
| Rate for Payer: PACE SWMI |
$32,295.85
|
| Rate for Payer: PHP Medicare Advantage |
$32,295.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63,369.25
|
| Rate for Payer: Priority Health Medicare |
$32,295.85
|
| Rate for Payer: Priority Health Narrow Network |
$50,695.40
|
| Rate for Payer: Railroad Medicare Medicare |
$32,295.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67,361.66
|
| Rate for Payer: UHC Core |
$41,333.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,295.85
|
| Rate for Payer: UHC Exchange |
$44,270.40
|
| Rate for Payer: UHC Medicare Advantage |
$33,264.73
|
| Rate for Payer: VA VA |
$32,295.85
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$57,528.19
|
|
|
Service Code
|
MS-DRG 027
|
| Min. Negotiated Rate |
$17,113.27 |
| Max. Negotiated Rate |
$57,528.19 |
| Rate for Payer: Aetna Medicare |
$18,734.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,517.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,517.46
|
| Rate for Payer: BCBS MAPPO |
$18,013.97
|
| Rate for Payer: BCBS Trust/PPO |
$57,528.19
|
| Rate for Payer: BCN Medicare Advantage |
$18,013.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,013.97
|
| Rate for Payer: Mclaren Medicare |
$18,013.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,914.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,716.07
|
| Rate for Payer: PACE Medicare |
$17,113.27
|
| Rate for Payer: PACE SWMI |
$18,013.97
|
| Rate for Payer: PHP Medicare Advantage |
$18,013.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,911.92
|
| Rate for Payer: Priority Health Medicare |
$18,013.97
|
| Rate for Payer: Priority Health Narrow Network |
$27,929.54
|
| Rate for Payer: Railroad Medicare Medicare |
$18,013.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37,111.46
|
| Rate for Payer: UHC Core |
$22,771.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,013.97
|
| Rate for Payer: UHC Exchange |
$24,389.82
|
| Rate for Payer: UHC Medicare Advantage |
$18,554.39
|
| Rate for Payer: VA VA |
$18,013.97
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$165,854.13
|
|
|
Service Code
|
MS-DRG 955
|
| Min. Negotiated Rate |
$42,135.43 |
| Max. Negotiated Rate |
$165,854.13 |
| Rate for Payer: Aetna Medicare |
$46,127.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,441.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,441.35
|
| Rate for Payer: BCBS MAPPO |
$44,353.08
|
| Rate for Payer: BCBS Trust/PPO |
$165,854.13
|
| Rate for Payer: BCN Medicare Advantage |
$44,353.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,353.08
|
| Rate for Payer: Mclaren Medicare |
$44,353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46,570.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,006.04
|
| Rate for Payer: PACE Medicare |
$42,135.43
|
| Rate for Payer: PACE SWMI |
$44,353.08
|
| Rate for Payer: PHP Medicare Advantage |
$44,353.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87,393.88
|
| Rate for Payer: Priority Health Medicare |
$44,353.08
|
| Rate for Payer: Priority Health Narrow Network |
$69,915.10
|
| Rate for Payer: Railroad Medicare Medicare |
$44,353.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92,899.91
|
| Rate for Payer: UHC Core |
$57,004.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,353.08
|
| Rate for Payer: UHC Exchange |
$61,054.26
|
| Rate for Payer: UHC Medicare Advantage |
$45,683.67
|
| Rate for Payer: VA VA |
$44,353.08
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$98,927.49
|
|
|
Service Code
|
MS-DRG 023
|
| Min. Negotiated Rate |
$39,252.35 |
| Max. Negotiated Rate |
$98,927.49 |
| Rate for Payer: Aetna Medicare |
$42,970.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51,647.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51,647.82
|
| Rate for Payer: BCBS MAPPO |
$41,318.26
|
| Rate for Payer: BCBS Trust/PPO |
$98,927.49
|
| Rate for Payer: BCN Medicare Advantage |
$41,318.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,318.26
|
| Rate for Payer: Mclaren Medicare |
$41,318.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43,384.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47,516.00
|
| Rate for Payer: PACE Medicare |
$39,252.35
|
| Rate for Payer: PACE SWMI |
$41,318.26
|
| Rate for Payer: PHP Medicare Advantage |
$41,318.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81,346.83
|
| Rate for Payer: Priority Health Medicare |
$41,318.26
|
| Rate for Payer: Priority Health Narrow Network |
$65,077.46
|
| Rate for Payer: Railroad Medicare Medicare |
$41,318.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86,471.88
|
| Rate for Payer: UHC Core |
$53,059.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$41,318.26
|
| Rate for Payer: UHC Exchange |
$56,829.72
|
| Rate for Payer: UHC Medicare Advantage |
$42,557.81
|
| Rate for Payer: VA VA |
$41,318.26
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$76,004.49
|
|
|
Service Code
|
MS-DRG 024
|
| Min. Negotiated Rate |
$26,389.94 |
| Max. Negotiated Rate |
$76,004.49 |
| Rate for Payer: Aetna Medicare |
$28,890.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,723.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,723.60
|
| Rate for Payer: BCBS MAPPO |
$27,778.88
|
| Rate for Payer: BCBS Trust/PPO |
$76,004.49
|
| Rate for Payer: BCN Medicare Advantage |
$27,778.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,778.88
|
| Rate for Payer: Mclaren Medicare |
$27,778.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29,167.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,945.71
|
| Rate for Payer: PACE Medicare |
$26,389.94
|
| Rate for Payer: PACE SWMI |
$27,778.88
|
| Rate for Payer: PHP Medicare Advantage |
$27,778.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54,368.98
|
| Rate for Payer: Priority Health Medicare |
$27,778.88
|
| Rate for Payer: Priority Health Narrow Network |
$43,495.18
|
| Rate for Payer: Railroad Medicare Medicare |
$27,778.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57,794.36
|
| Rate for Payer: UHC Core |
$35,463.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,778.88
|
| Rate for Payer: UHC Exchange |
$37,982.72
|
| Rate for Payer: UHC Medicare Advantage |
$28,612.25
|
| Rate for Payer: VA VA |
$27,778.88
|
|
|
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); AUTOGENOUS GRAFT
|
Facility
|
OP
|
$15,411.76
|
|
|
Service Code
|
CPT 36825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$763.59 |
| Max. Negotiated Rate |
$15,411.76 |
| Rate for Payer: Aetna Medicare |
$5,085.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,112.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,112.15
|
| Rate for Payer: BCBS Complete |
$2,808.66
|
| Rate for Payer: BCBS MAPPO |
$4,889.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,534.33
|
| Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
| Rate for Payer: Mclaren Medicaid |
$2,674.68
|
| Rate for Payer: Mclaren Medicare |
$4,889.72
|
| Rate for Payer: Meridian Medicaid |
$2,808.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,134.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,623.18
|
| Rate for Payer: PACE Medicare |
$4,645.23
|
| Rate for Payer: PACE SWMI |
$4,889.72
|
| Rate for Payer: PHP Medicare Advantage |
$4,889.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,674.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,411.76
|
| Rate for Payer: Priority Health Medicare |
$4,889.72
|
| Rate for Payer: Priority Health Narrow Network |
$12,329.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.95
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
| Rate for Payer: UHC Exchange |
$763.59
|
| Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
| Rate for Payer: VA VA |
$4,889.72
|
|
|
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); NONAUTOGENOUS GRAFT (EG, BIOLOGICAL COLLAGEN, THERMOPLASTIC GRAFT)
|
Facility
|
OP
|
$15,411.76
|
|
|
Service Code
|
CPT 36830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$641.13 |
| Max. Negotiated Rate |
$15,411.76 |
| Rate for Payer: Aetna Medicare |
$5,085.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,112.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,112.15
|
| Rate for Payer: BCBS Complete |
$2,808.66
|
| Rate for Payer: BCBS MAPPO |
$4,889.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,768.15
|
| Rate for Payer: BCN Medicare Advantage |
$4,889.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,889.72
|
| Rate for Payer: Mclaren Medicaid |
$2,674.68
|
| Rate for Payer: Mclaren Medicare |
$4,889.72
|
| Rate for Payer: Meridian Medicaid |
$2,808.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,134.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,623.18
|
| Rate for Payer: PACE Medicare |
$4,645.23
|
| Rate for Payer: PACE SWMI |
$4,889.72
|
| Rate for Payer: PHP Medicare Advantage |
$4,889.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,674.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,411.76
|
| Rate for Payer: Priority Health Medicare |
$4,889.72
|
| Rate for Payer: Priority Health Narrow Network |
$12,329.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4,889.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.24
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,889.72
|
| Rate for Payer: UHC Exchange |
$641.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,036.41
|
| Rate for Payer: VA VA |
$4,889.72
|
|
