|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,081.27
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,956.89 |
| Max. Negotiated Rate |
$7,081.27 |
| Rate for Payer: Aetna Commercial |
$6,373.14
|
| Rate for Payer: ASR ASR |
$6,868.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,490.11
|
| Rate for Payer: BCN Commercial |
$5,490.11
|
| Rate for Payer: Cash Price |
$5,665.02
|
| Rate for Payer: Cofinity Commercial |
$6,656.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,665.02
|
| Rate for Payer: Healthscope Commercial |
$7,081.27
|
| Rate for Payer: Healthscope Whirlpool |
$6,868.83
|
| Rate for Payer: Mclaren Commercial |
$6,373.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,231.52
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,081.27
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,832.51 |
| Max. Negotiated Rate |
$7,081.27 |
| Rate for Payer: Aetna Commercial |
$6,373.14
|
| Rate for Payer: ASR ASR |
$6,868.83
|
| Rate for Payer: BCBS Complete |
$2,832.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,490.11
|
| Rate for Payer: BCN Commercial |
$5,490.11
|
| Rate for Payer: Cash Price |
$5,665.02
|
| Rate for Payer: Cofinity Commercial |
$6,656.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,665.02
|
| Rate for Payer: Healthscope Commercial |
$7,081.27
|
| Rate for Payer: Healthscope Whirlpool |
$6,868.83
|
| Rate for Payer: Mclaren Commercial |
$6,373.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,443.96
|
| Rate for Payer: Priority Health Narrow Network |
$5,027.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,231.52
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,174.50
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$12,223.36 |
| Rate for Payer: Aetna Commercial |
$10,957.05
|
| Rate for Payer: Aetna Medicare |
$9,778.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: ASR ASR |
$11,809.26
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$9,438.89
|
| Rate for Payer: BCN Commercial |
$9,438.89
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cofinity Commercial |
$11,444.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,739.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$12,174.50
|
| Rate for Payer: Healthscope Whirlpool |
$11,809.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$10,957.05
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,756.56
|
| Rate for Payer: PHP Medicaid |
$5,348.94
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,078.80
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$8,643.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,713.56
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,174.50
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,522.15 |
| Max. Negotiated Rate |
$12,174.50 |
| Rate for Payer: Aetna Commercial |
$10,957.05
|
| Rate for Payer: ASR ASR |
$11,809.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,438.89
|
| Rate for Payer: BCN Commercial |
$9,438.89
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cofinity Commercial |
$11,444.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,739.60
|
| Rate for Payer: Healthscope Commercial |
$12,174.50
|
| Rate for Payer: Healthscope Whirlpool |
$11,809.26
|
| Rate for Payer: Mclaren Commercial |
$10,957.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,713.56
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,437.71
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,406.40 |
| Max. Negotiated Rate |
$13,437.71 |
| Rate for Payer: Aetna Commercial |
$12,093.94
|
| Rate for Payer: ASR ASR |
$13,034.58
|
| Rate for Payer: BCBS Trust/PPO |
$10,418.26
|
| Rate for Payer: BCN Commercial |
$10,418.26
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cofinity Commercial |
$12,631.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,750.17
|
| Rate for Payer: Healthscope Commercial |
$13,437.71
|
| Rate for Payer: Healthscope Whirlpool |
$13,034.58
|
| Rate for Payer: Mclaren Commercial |
$12,093.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,825.18
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,437.71
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$13,437.71 |
| Rate for Payer: Aetna Commercial |
$12,093.94
|
| Rate for Payer: Aetna Medicare |
$9,778.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: ASR ASR |
$13,034.58
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$10,418.26
|
| Rate for Payer: BCN Commercial |
$10,418.26
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cofinity Commercial |
$12,631.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,750.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$13,437.71
|
| Rate for Payer: Healthscope Whirlpool |
$13,034.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$12,093.94
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,756.56
|
| Rate for Payer: PHP Medicaid |
$5,348.94
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,228.32
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$9,540.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,825.18
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,435.33
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,974.13 |
| Max. Negotiated Rate |
$7,435.33 |
| Rate for Payer: Aetna Commercial |
$6,691.80
|
| Rate for Payer: ASR ASR |
$7,212.27
|
| Rate for Payer: BCBS Complete |
$2,974.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,764.61
|
| Rate for Payer: BCN Commercial |
$5,764.61
|
| Rate for Payer: Cash Price |
$5,948.26
|
| Rate for Payer: Cofinity Commercial |
$6,989.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.26
|
| Rate for Payer: Healthscope Commercial |
$7,435.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,212.27
|
| Rate for Payer: Mclaren Commercial |
$6,691.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,766.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,279.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,543.09
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,435.33
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,204.73 |
| Max. Negotiated Rate |
$7,435.33 |
| Rate for Payer: Aetna Commercial |
$6,691.80
|
| Rate for Payer: ASR ASR |
$7,212.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,764.61
|
| Rate for Payer: BCN Commercial |
$5,764.61
|
| Rate for Payer: Cash Price |
$5,948.26
|
| Rate for Payer: Cofinity Commercial |
$6,989.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.26
|
| Rate for Payer: Healthscope Commercial |
$7,435.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,212.27
|
| Rate for Payer: Mclaren Commercial |
$6,691.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,543.09
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,133.54
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,853.42 |
| Max. Negotiated Rate |
$12,133.54 |
| Rate for Payer: Aetna Commercial |
$10,920.19
|
| Rate for Payer: ASR ASR |
$11,769.53
|
| Rate for Payer: BCBS Complete |
$4,853.42
|
| Rate for Payer: BCBS Trust/PPO |
$9,407.13
|
| Rate for Payer: BCN Commercial |
$9,407.13
|
| Rate for Payer: Cash Price |
$9,706.83
|
| Rate for Payer: Cofinity Commercial |
$11,405.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,706.83
|
| Rate for Payer: Healthscope Commercial |
$12,133.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,769.53
|
| Rate for Payer: Mclaren Commercial |
$10,920.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,041.52
|
| Rate for Payer: Priority Health Narrow Network |
$8,614.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,677.52
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,133.54
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,493.48 |
| Max. Negotiated Rate |
$12,133.54 |
| Rate for Payer: Aetna Commercial |
$10,920.19
|
| Rate for Payer: ASR ASR |
$11,769.53
|
| Rate for Payer: BCBS Trust/PPO |
$9,407.13
|
| Rate for Payer: BCN Commercial |
$9,407.13
|
| Rate for Payer: Cash Price |
$9,706.83
|
| Rate for Payer: Cofinity Commercial |
$11,405.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,706.83
|
| Rate for Payer: Healthscope Commercial |
$12,133.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,769.53
|
| Rate for Payer: Mclaren Commercial |
$10,920.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,677.52
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,125.08 |
| Max. Negotiated Rate |
$10,312.70 |
| Rate for Payer: Aetna Commercial |
$9,281.43
|
| Rate for Payer: ASR ASR |
$10,003.32
|
| Rate for Payer: BCBS Complete |
$4,125.08
|
| Rate for Payer: BCBS Trust/PPO |
$7,995.44
|
| Rate for Payer: BCN Commercial |
$7,995.44
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$9,693.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Healthscope Commercial |
$10,312.70
|
| Rate for Payer: Healthscope Whirlpool |
$10,003.32
|
| Rate for Payer: Mclaren Commercial |
$9,281.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,384.56
|
| Rate for Payer: Priority Health Narrow Network |
$7,322.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,075.18
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,218.89 |
| Max. Negotiated Rate |
$10,312.70 |
| Rate for Payer: Aetna Commercial |
$9,281.43
|
| Rate for Payer: ASR ASR |
$10,003.32
|
| Rate for Payer: BCBS Trust/PPO |
$7,995.44
|
| Rate for Payer: BCN Commercial |
$7,995.44
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$9,693.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Healthscope Commercial |
$10,312.70
|
| Rate for Payer: Healthscope Whirlpool |
$10,003.32
|
| Rate for Payer: Mclaren Commercial |
$9,281.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,075.18
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,812.53 |
| Max. Negotiated Rate |
$11,160.76 |
| Rate for Payer: Aetna Commercial |
$10,044.68
|
| Rate for Payer: ASR ASR |
$10,825.94
|
| Rate for Payer: BCBS Trust/PPO |
$8,652.94
|
| Rate for Payer: BCN Commercial |
$8,652.94
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$10,491.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Healthscope Commercial |
$11,160.76
|
| Rate for Payer: Healthscope Whirlpool |
$10,825.94
|
| Rate for Payer: Mclaren Commercial |
$10,044.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,821.47
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,779.05 |
| Max. Negotiated Rate |
$11,160.76 |
| Rate for Payer: Aetna Commercial |
$10,044.68
|
| Rate for Payer: Aetna Medicare |
$5,080.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,350.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,350.66
|
| Rate for Payer: ASR ASR |
$10,825.94
|
| Rate for Payer: BCBS Complete |
$2,918.26
|
| Rate for Payer: BCBS MAPPO |
$5,080.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,652.94
|
| Rate for Payer: BCN Commercial |
$8,652.94
|
| Rate for Payer: BCN Medicare Advantage |
$5,080.53
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$10,491.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,080.53
|
| Rate for Payer: Healthscope Commercial |
$11,160.76
|
| Rate for Payer: Healthscope Whirlpool |
$10,825.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,080.53
|
| Rate for Payer: Mclaren Commercial |
$10,044.68
|
| Rate for Payer: Mclaren Medicaid |
$2,779.05
|
| Rate for Payer: Mclaren Medicare |
$5,080.53
|
| Rate for Payer: Meridian Medicaid |
$2,918.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,334.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,842.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: PACE Medicare |
$4,826.50
|
| Rate for Payer: PACE SWMI |
$5,080.53
|
| Rate for Payer: PHP Commercial |
$5,588.58
|
| Rate for Payer: PHP Medicaid |
$2,779.05
|
| Rate for Payer: PHP Medicare Advantage |
$5,080.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,779.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,156.29
|
| Rate for Payer: Priority Health Medicare |
$5,080.53
|
| Rate for Payer: Priority Health Narrow Network |
$7,924.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5,080.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,821.47
|
| Rate for Payer: UHC Medicare Advantage |
$5,232.95
|
| Rate for Payer: VA VA |
$5,080.53
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$178.68 |
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$173.32
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$138.53
|
| Rate for Payer: BCN Commercial |
$138.53
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$167.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$178.68
|
| Rate for Payer: Healthscope Whirlpool |
$173.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$160.81
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.28
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$71.42
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.24
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.08 |
| Max. Negotiated Rate |
$178.68 |
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: ASR ASR |
$173.32
|
| Rate for Payer: BCBS Trust/PPO |
$138.53
|
| Rate for Payer: BCN Commercial |
$138.53
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$167.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Healthscope Commercial |
$178.68
|
| Rate for Payer: Healthscope Whirlpool |
$173.32
|
| Rate for Payer: Mclaren Commercial |
$160.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.24
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.10 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: ASR ASR |
$41.47
|
| Rate for Payer: BCBS Complete |
$17.10
|
| Rate for Payer: BCBS Trust/PPO |
$33.14
|
| Rate for Payer: BCN Commercial |
$33.14
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$42.75
|
| Rate for Payer: Healthscope Whirlpool |
$41.47
|
| Rate for Payer: Mclaren Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.90
|
| Rate for Payer: Priority Health Narrow Network |
$30.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.62
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.92 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Aetna Commercial |
$38.48
|
| Rate for Payer: ASR ASR |
$41.47
|
| Rate for Payer: BCBS Trust/PPO |
$33.14
|
| Rate for Payer: BCN Commercial |
$33.14
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$42.75
|
| Rate for Payer: Healthscope Whirlpool |
$41.47
|
| Rate for Payer: Mclaren Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.62
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$354.07 |
| Rate for Payer: Aetna Commercial |
$318.66
|
| Rate for Payer: Aetna Medicare |
$219.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: ASR ASR |
$343.45
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$274.51
|
| Rate for Payer: BCN Commercial |
$274.51
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$332.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$354.07
|
| Rate for Payer: Healthscope Whirlpool |
$343.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$219.68
|
| Rate for Payer: Mclaren Commercial |
$318.66
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$241.65
|
| Rate for Payer: PHP Medicaid |
$120.16
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.20
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$251.39
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.58
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.85 |
| Max. Negotiated Rate |
$354.07 |
| Rate for Payer: Aetna Commercial |
$318.66
|
| Rate for Payer: ASR ASR |
$343.45
|
| Rate for Payer: BCBS Trust/PPO |
$274.51
|
| Rate for Payer: BCN Commercial |
$274.51
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$332.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Healthscope Commercial |
$354.07
|
| Rate for Payer: Healthscope Whirlpool |
$343.45
|
| Rate for Payer: Mclaren Commercial |
$318.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.58
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$17.72 |
| Rate for Payer: Aetna Commercial |
$15.95
|
| Rate for Payer: ASR ASR |
$17.19
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$13.74
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$16.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$17.72
|
| Rate for Payer: Healthscope Whirlpool |
$17.19
|
| Rate for Payer: Mclaren Commercial |
$15.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.59
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$17.72 |
| Rate for Payer: Aetna Commercial |
$15.95
|
| Rate for Payer: ASR ASR |
$17.19
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$13.74
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$16.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$17.72
|
| Rate for Payer: Healthscope Whirlpool |
$17.19
|
| Rate for Payer: Mclaren Commercial |
$15.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.13
|
| Rate for Payer: Priority Health Narrow Network |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.59
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$768.52 |
| Max. Negotiated Rate |
$1,921.31 |
| Rate for Payer: Aetna Commercial |
$1,729.18
|
| Rate for Payer: ASR ASR |
$1,863.67
|
| Rate for Payer: BCBS Complete |
$768.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.59
|
| Rate for Payer: BCN Commercial |
$1,489.59
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,806.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Healthscope Commercial |
$1,921.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,863.67
|
| Rate for Payer: Mclaren Commercial |
$1,729.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,748.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,364.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.75
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,344.92 |
| Max. Negotiated Rate |
$1,921.31 |
| Rate for Payer: Aetna Commercial |
$1,729.18
|
| Rate for Payer: ASR ASR |
$1,863.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.59
|
| Rate for Payer: BCN Commercial |
$1,489.59
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,806.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Healthscope Commercial |
$1,921.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,863.67
|
| Rate for Payer: Mclaren Commercial |
$1,729.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.75
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
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
|
|
