|
HC IR ARTERIOGRAM
|
Facility
|
IP
|
$3,712.59
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,598.81 |
| Max. Negotiated Rate |
$3,712.59 |
| Rate for Payer: Aetna Commercial |
$3,341.33
|
| Rate for Payer: ASR ASR |
$3,601.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,878.37
|
| Rate for Payer: BCN Commercial |
$2,878.37
|
| Rate for Payer: Cash Price |
$2,970.07
|
| Rate for Payer: Cofinity Commercial |
$3,489.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,970.07
|
| Rate for Payer: Healthscope Commercial |
$3,712.59
|
| Rate for Payer: Healthscope Whirlpool |
$3,601.21
|
| Rate for Payer: Mclaren Commercial |
$3,341.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,155.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,598.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,267.08
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
OP
|
$3,111.90
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,800.71
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$3,018.54
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,412.66
|
| Rate for Payer: BCN Commercial |
$2,412.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cofinity Commercial |
$2,925.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,111.90
|
| Rate for Payer: Healthscope Whirlpool |
$3,018.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,800.71
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.12
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,831.83
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,209.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.47
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
IP
|
$3,111.90
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,178.33 |
| Max. Negotiated Rate |
$3,111.90 |
| Rate for Payer: Aetna Commercial |
$2,800.71
|
| Rate for Payer: ASR ASR |
$3,018.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,412.66
|
| Rate for Payer: BCN Commercial |
$2,412.66
|
| Rate for Payer: Cash Price |
$2,489.52
|
| Rate for Payer: Cofinity Commercial |
$2,925.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.52
|
| Rate for Payer: Healthscope Commercial |
$3,111.90
|
| Rate for Payer: Healthscope Whirlpool |
$3,018.54
|
| Rate for Payer: Mclaren Commercial |
$2,800.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.47
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$19,641.83
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$19,641.83 |
| Rate for Payer: Aetna Commercial |
$17,677.65
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$19,052.58
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$15,228.31
|
| Rate for Payer: BCN Commercial |
$15,228.31
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cofinity Commercial |
$18,463.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,713.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$19,641.83
|
| Rate for Payer: Healthscope Whirlpool |
$19,052.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$17,677.65
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,695.56
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,749.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,874.07
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$13,945.70
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,284.81
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$19,641.83
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,749.28 |
| Max. Negotiated Rate |
$19,641.83 |
| Rate for Payer: Aetna Commercial |
$17,677.65
|
| Rate for Payer: ASR ASR |
$19,052.58
|
| Rate for Payer: BCBS Trust/PPO |
$15,228.31
|
| Rate for Payer: BCN Commercial |
$15,228.31
|
| Rate for Payer: Cash Price |
$15,713.46
|
| Rate for Payer: Cofinity Commercial |
$18,463.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,713.46
|
| Rate for Payer: Healthscope Commercial |
$19,641.83
|
| Rate for Payer: Healthscope Whirlpool |
$19,052.58
|
| Rate for Payer: Mclaren Commercial |
$17,677.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,695.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,749.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,284.81
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$16,997.42
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,898.19 |
| Max. Negotiated Rate |
$16,997.42 |
| Rate for Payer: Aetna Commercial |
$15,297.68
|
| Rate for Payer: ASR ASR |
$16,487.50
|
| Rate for Payer: BCBS Trust/PPO |
$13,178.10
|
| Rate for Payer: BCN Commercial |
$13,178.10
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cofinity Commercial |
$15,977.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,597.94
|
| Rate for Payer: Healthscope Commercial |
$16,997.42
|
| Rate for Payer: Healthscope Whirlpool |
$16,487.50
|
| Rate for Payer: Mclaren Commercial |
$15,297.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,447.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,898.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,957.73
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$16,997.42
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$19,483.22 |
| Rate for Payer: Aetna Commercial |
$15,297.68
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$16,487.50
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$13,178.10
|
| Rate for Payer: BCN Commercial |
$13,178.10
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cash Price |
$13,597.94
|
| Rate for Payer: Cofinity Commercial |
$15,977.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,597.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$16,997.42
|
| Rate for Payer: Healthscope Whirlpool |
$16,487.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$15,297.68
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,447.81
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,898.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,467.65
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$12,068.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,957.73
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
IP
|
$19,694.46
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,786.12 |
| Max. Negotiated Rate |
$19,694.46 |
| Rate for Payer: Aetna Commercial |
$17,725.01
|
| Rate for Payer: ASR ASR |
$19,103.63
|
| Rate for Payer: BCBS Trust/PPO |
$15,269.11
|
| Rate for Payer: BCN Commercial |
$15,269.11
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$18,512.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,755.57
|
| Rate for Payer: Healthscope Commercial |
$19,694.46
|
| Rate for Payer: Healthscope Whirlpool |
$19,103.63
|
| Rate for Payer: Mclaren Commercial |
$17,725.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,331.12
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$19,694.46
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$19,694.46 |
| Rate for Payer: Aetna Commercial |
$17,725.01
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$19,103.63
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$15,269.11
|
| Rate for Payer: BCN Commercial |
$15,269.11
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$18,512.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,755.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$19,694.46
|
| Rate for Payer: Healthscope Whirlpool |
$19,103.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$17,725.01
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,921.96
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$13,983.07
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,331.12
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$21,529.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,070.30 |
| Max. Negotiated Rate |
$21,529.00 |
| Rate for Payer: Aetna Commercial |
$19,376.10
|
| Rate for Payer: ASR ASR |
$20,883.13
|
| Rate for Payer: BCBS Trust/PPO |
$16,691.43
|
| Rate for Payer: BCN Commercial |
$16,691.43
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cofinity Commercial |
$20,237.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,223.20
|
| Rate for Payer: Healthscope Commercial |
$21,529.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,883.13
|
| Rate for Payer: Mclaren Commercial |
$19,376.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,299.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,070.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,945.52
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$21,529.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$21,529.00 |
| Rate for Payer: Aetna Commercial |
$19,376.10
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$20,883.13
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$16,691.43
|
| Rate for Payer: BCN Commercial |
$16,691.43
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cash Price |
$17,223.20
|
| Rate for Payer: Cofinity Commercial |
$20,237.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,223.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$21,529.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,883.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$19,376.10
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,299.65
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,070.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,591.39
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$15,285.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,945.52
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,329.13
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,731.65 |
| Max. Negotiated Rate |
$9,329.13 |
| Rate for Payer: Aetna Commercial |
$8,396.22
|
| Rate for Payer: ASR ASR |
$9,049.26
|
| Rate for Payer: BCBS Complete |
$3,731.65
|
| Rate for Payer: BCBS Trust/PPO |
$7,232.87
|
| Rate for Payer: BCN Commercial |
$7,232.87
|
| Rate for Payer: Cash Price |
$7,463.30
|
| Rate for Payer: Cofinity Commercial |
$8,769.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,463.30
|
| Rate for Payer: Healthscope Commercial |
$9,329.13
|
| Rate for Payer: Healthscope Whirlpool |
$9,049.26
|
| Rate for Payer: Mclaren Commercial |
$8,396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,929.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,530.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,489.51
|
| Rate for Payer: Priority Health Narrow Network |
$6,623.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,209.63
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,329.13
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,530.39 |
| Max. Negotiated Rate |
$9,329.13 |
| Rate for Payer: Aetna Commercial |
$8,396.22
|
| Rate for Payer: ASR ASR |
$9,049.26
|
| Rate for Payer: BCBS Trust/PPO |
$7,232.87
|
| Rate for Payer: BCN Commercial |
$7,232.87
|
| Rate for Payer: Cash Price |
$7,463.30
|
| Rate for Payer: Cofinity Commercial |
$8,769.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,463.30
|
| Rate for Payer: Healthscope Commercial |
$9,329.13
|
| Rate for Payer: Healthscope Whirlpool |
$9,049.26
|
| Rate for Payer: Mclaren Commercial |
$8,396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,929.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,530.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,209.63
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$19,694.46
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$19,694.46 |
| Rate for Payer: Aetna Commercial |
$17,725.01
|
| Rate for Payer: Aetna Medicare |
$15,586.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: ASR ASR |
$19,103.63
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$15,269.11
|
| Rate for Payer: BCN Commercial |
$15,269.11
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$18,512.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,755.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$19,694.46
|
| Rate for Payer: Healthscope Whirlpool |
$19,103.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$17,725.01
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$17,145.24
|
| Rate for Payer: PHP Medicaid |
$8,525.86
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,921.96
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$13,983.07
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,331.12
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$19,694.46
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,786.12 |
| Max. Negotiated Rate |
$19,694.46 |
| Rate for Payer: Aetna Commercial |
$17,725.01
|
| Rate for Payer: ASR ASR |
$19,103.63
|
| Rate for Payer: BCBS Trust/PPO |
$15,269.11
|
| Rate for Payer: BCN Commercial |
$15,269.11
|
| Rate for Payer: Cash Price |
$15,755.57
|
| Rate for Payer: Cofinity Commercial |
$18,512.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,755.57
|
| Rate for Payer: Healthscope Commercial |
$19,694.46
|
| Rate for Payer: Healthscope Whirlpool |
$19,103.63
|
| Rate for Payer: Mclaren Commercial |
$17,725.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,740.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,786.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,331.12
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$43.86
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Complete |
$17.54
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.91
|
| Rate for Payer: Priority Health Narrow Network |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$43.86
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.70 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$177.93
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.84
|
| Rate for Payer: Priority Health Narrow Network |
$162.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$177.93
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$544.76
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.21 |
| Max. Negotiated Rate |
$544.76 |
| Rate for Payer: Aetna Commercial |
$490.28
|
| Rate for Payer: Aetna Medicare |
$190.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$238.15
|
| Rate for Payer: ASR ASR |
$528.42
|
| Rate for Payer: BCBS Complete |
$109.43
|
| Rate for Payer: BCBS MAPPO |
$190.52
|
| Rate for Payer: BCBS Trust/PPO |
$422.35
|
| Rate for Payer: BCN Commercial |
$422.35
|
| Rate for Payer: BCN Medicare Advantage |
$190.52
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$512.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.52
|
| Rate for Payer: Healthscope Commercial |
$544.76
|
| Rate for Payer: Healthscope Whirlpool |
$528.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$190.52
|
| Rate for Payer: Mclaren Commercial |
$490.28
|
| Rate for Payer: Mclaren Medicaid |
$104.21
|
| Rate for Payer: Mclaren Medicare |
$190.52
|
| Rate for Payer: Meridian Medicaid |
$109.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: PACE Medicare |
$180.99
|
| Rate for Payer: PACE SWMI |
$190.52
|
| Rate for Payer: PHP Commercial |
$209.57
|
| Rate for Payer: PHP Medicaid |
$104.21
|
| Rate for Payer: PHP Medicare Advantage |
$190.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.45
|
| Rate for Payer: Priority Health Medicare |
$190.52
|
| Rate for Payer: Priority Health Narrow Network |
$265.16
|
| Rate for Payer: Railroad Medicare Medicare |
$190.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.39
|
| Rate for Payer: UHC Medicare Advantage |
$196.24
|
| Rate for Payer: VA VA |
$190.52
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$544.76
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$381.33 |
| Max. Negotiated Rate |
$544.76 |
| Rate for Payer: Aetna Commercial |
$490.28
|
| Rate for Payer: ASR ASR |
$528.42
|
| Rate for Payer: BCBS Trust/PPO |
$422.35
|
| Rate for Payer: BCN Commercial |
$422.35
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$512.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Healthscope Commercial |
$544.76
|
| Rate for Payer: Healthscope Whirlpool |
$528.42
|
| Rate for Payer: Mclaren Commercial |
$490.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.39
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,490.95
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$3,490.95 |
| Rate for Payer: Aetna Commercial |
$3,141.86
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$3,386.22
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,706.53
|
| Rate for Payer: BCN Commercial |
$2,706.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,792.76
|
| Rate for Payer: Cash Price |
$2,792.76
|
| Rate for Payer: Cofinity Commercial |
$3,281.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$3,490.95
|
| Rate for Payer: Healthscope Whirlpool |
$3,386.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$3,141.86
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,967.31
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,176.76
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,478.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,072.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,490.95
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,443.66 |
| Max. Negotiated Rate |
$3,490.95 |
| Rate for Payer: Aetna Commercial |
$3,141.86
|
| Rate for Payer: ASR ASR |
$3,386.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,706.53
|
| Rate for Payer: BCN Commercial |
$2,706.53
|
| Rate for Payer: Cash Price |
$2,792.76
|
| Rate for Payer: Cofinity Commercial |
$3,281.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.76
|
| Rate for Payer: Healthscope Commercial |
$3,490.95
|
| Rate for Payer: Healthscope Whirlpool |
$3,386.22
|
| Rate for Payer: Mclaren Commercial |
$3,141.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,967.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,072.04
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,507.98
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$2,507.98 |
| Rate for Payer: Aetna Commercial |
$2,257.18
|
| Rate for Payer: Aetna Medicare |
$1,716.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: ASR ASR |
$2,432.74
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.44
|
| Rate for Payer: BCN Commercial |
$1,944.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,006.38
|
| Rate for Payer: Cash Price |
$2,006.38
|
| Rate for Payer: Cofinity Commercial |
$2,357.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,006.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,507.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,432.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$2,257.18
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,131.78
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: PHP Medicaid |
$938.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,755.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,282.26
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,780.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,207.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,507.98
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,755.59 |
| Max. Negotiated Rate |
$2,507.98 |
| Rate for Payer: Aetna Commercial |
$2,257.18
|
| Rate for Payer: ASR ASR |
$2,432.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.44
|
| Rate for Payer: BCN Commercial |
$1,944.44
|
| Rate for Payer: Cash Price |
$2,006.38
|
| Rate for Payer: Cofinity Commercial |
$2,357.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,006.38
|
| Rate for Payer: Healthscope Commercial |
$2,507.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,432.74
|
| Rate for Payer: Mclaren Commercial |
$2,257.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,131.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,755.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,207.02
|
|
