|
HC IR SHEATH
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
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 SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$714.77 |
| Rate for Payer: Aetna Commercial |
$643.29
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$693.33
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$554.16
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$671.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$714.77
|
| Rate for Payer: Healthscope Whirlpool |
$693.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$643.29
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.44
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$507.49
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$629.00
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$500.34 |
| Max. Negotiated Rate |
$714.77 |
| Rate for Payer: Aetna Commercial |
$643.29
|
| Rate for Payer: ASR ASR |
$693.33
|
| Rate for Payer: BCBS Trust/PPO |
$554.16
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$671.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Healthscope Commercial |
$714.77
|
| Rate for Payer: Healthscope Whirlpool |
$693.33
|
| Rate for Payer: Mclaren Commercial |
$643.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$629.00
|
|
|
HC IR SIALOGRAM
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$400.29 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
|
|
HC IR SIALOGRAM
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$472.04
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$377.63
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$669.38 |
| Max. Negotiated Rate |
$956.25 |
| Rate for Payer: Aetna Commercial |
$860.62
|
| Rate for Payer: ASR ASR |
$927.56
|
| Rate for Payer: BCBS Trust/PPO |
$741.38
|
| Rate for Payer: BCN Commercial |
$741.38
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$898.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Healthscope Commercial |
$956.25
|
| Rate for Payer: Healthscope Whirlpool |
$927.56
|
| Rate for Payer: Mclaren Commercial |
$860.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.50
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$956.25 |
| Rate for Payer: Aetna Commercial |
$860.62
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$927.56
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$741.38
|
| Rate for Payer: BCN Commercial |
$741.38
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$898.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$956.25
|
| Rate for Payer: Healthscope Whirlpool |
$927.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$860.62
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.81
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.73
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$534.98
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.50
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.23 |
| Max. Negotiated Rate |
$612.96 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: Aetna Medicare |
$490.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$490.37
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$539.41
|
| Rate for Payer: PHP Medicaid |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$472.04
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$377.63
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: VA VA |
$490.37
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.14 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,076.10 |
| Max. Negotiated Rate |
$1,537.29 |
| Rate for Payer: Aetna Commercial |
$1,383.56
|
| Rate for Payer: ASR ASR |
$1,491.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.86
|
| Rate for Payer: BCN Commercial |
$1,191.86
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,445.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,537.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.17
|
| Rate for Payer: Mclaren Commercial |
$1,383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.82
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,537.29
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$614.92 |
| Max. Negotiated Rate |
$1,537.29 |
| Rate for Payer: Aetna Commercial |
$1,383.56
|
| Rate for Payer: ASR ASR |
$1,491.17
|
| Rate for Payer: BCBS Complete |
$614.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.86
|
| Rate for Payer: BCN Commercial |
$1,191.86
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,445.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,537.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.17
|
| Rate for Payer: Mclaren Commercial |
$1,383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,398.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,091.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.82
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,727.13
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,608.99 |
| Max. Negotiated Rate |
$3,727.13 |
| Rate for Payer: Aetna Commercial |
$3,354.42
|
| Rate for Payer: ASR ASR |
$3,615.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.64
|
| Rate for Payer: BCN Commercial |
$2,889.64
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cofinity Commercial |
$3,503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,981.70
|
| Rate for Payer: Healthscope Commercial |
$3,727.13
|
| Rate for Payer: Healthscope Whirlpool |
$3,615.32
|
| Rate for Payer: Mclaren Commercial |
$3,354.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,168.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,279.87
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,727.13
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,608.99 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$3,354.42
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$3,615.32
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.64
|
| Rate for Payer: BCN Commercial |
$2,889.64
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cofinity Commercial |
$3,503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,981.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$3,727.13
|
| Rate for Payer: Healthscope Whirlpool |
$3,615.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$3,354.42
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,168.06
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,391.69
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,646.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,279.87
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,602.17
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,821.52 |
| Max. Negotiated Rate |
$2,602.17 |
| Rate for Payer: Aetna Commercial |
$2,341.95
|
| Rate for Payer: ASR ASR |
$2,524.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.46
|
| Rate for Payer: BCN Commercial |
$2,017.46
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cofinity Commercial |
$2,446.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.74
|
| Rate for Payer: Healthscope Commercial |
$2,602.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,524.10
|
| Rate for Payer: Mclaren Commercial |
$2,341.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,211.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,821.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,289.91
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,602.17
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$2,602.17 |
| Rate for Payer: Aetna Commercial |
$2,341.95
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$2,524.10
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.46
|
| Rate for Payer: BCN Commercial |
$2,017.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cofinity Commercial |
$2,446.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$2,602.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,524.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$2,341.95
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,211.84
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,821.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,367.97
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,847.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,289.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$7,341.10
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,138.77 |
| Max. Negotiated Rate |
$19,483.22 |
| Rate for Payer: Aetna Commercial |
$6,606.99
|
| 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 |
$7,120.87
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$5,691.55
|
| Rate for Payer: BCN Commercial |
$5,691.55
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cofinity Commercial |
$6,900.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,872.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$7,341.10
|
| Rate for Payer: Healthscope Whirlpool |
$7,120.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,586.58
|
| Rate for Payer: Mclaren Commercial |
$6,606.99
|
| 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 |
$6,239.94
|
| 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 |
$5,138.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,680.40
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$5,212.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,460.17
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: VA VA |
$15,586.58
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$7,341.10
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,138.77 |
| Max. Negotiated Rate |
$7,341.10 |
| Rate for Payer: Aetna Commercial |
$6,606.99
|
| Rate for Payer: ASR ASR |
$7,120.87
|
| Rate for Payer: BCBS Trust/PPO |
$5,691.55
|
| Rate for Payer: BCN Commercial |
$5,691.55
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cofinity Commercial |
$6,900.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,872.88
|
| Rate for Payer: Healthscope Commercial |
$7,341.10
|
| Rate for Payer: Healthscope Whirlpool |
$7,120.87
|
| Rate for Payer: Mclaren Commercial |
$6,606.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,239.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,138.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,460.17
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,356.66
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,649.66 |
| Max. Negotiated Rate |
$2,356.66 |
| Rate for Payer: Aetna Commercial |
$2,120.99
|
| Rate for Payer: ASR ASR |
$2,285.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.12
|
| Rate for Payer: BCN Commercial |
$1,827.12
|
| Rate for Payer: Cash Price |
$1,885.33
|
| Rate for Payer: Cofinity Commercial |
$2,215.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.33
|
| Rate for Payer: Healthscope Commercial |
$2,356.66
|
| Rate for Payer: Healthscope Whirlpool |
$2,285.96
|
| Rate for Payer: Mclaren Commercial |
$2,120.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,649.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,073.86
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,356.66
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$942.66 |
| Max. Negotiated Rate |
$2,356.66 |
| Rate for Payer: Aetna Commercial |
$2,120.99
|
| Rate for Payer: ASR ASR |
$2,285.96
|
| Rate for Payer: BCBS Complete |
$942.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.12
|
| Rate for Payer: BCN Commercial |
$1,827.12
|
| Rate for Payer: Cash Price |
$1,885.33
|
| Rate for Payer: Cofinity Commercial |
$2,215.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.33
|
| Rate for Payer: Healthscope Commercial |
$2,356.66
|
| Rate for Payer: Healthscope Whirlpool |
$2,285.96
|
| Rate for Payer: Mclaren Commercial |
$2,120.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,649.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,144.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,673.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,073.86
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,605.92
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,242.37 |
| Max. Negotiated Rate |
$5,605.92 |
| Rate for Payer: Aetna Commercial |
$5,045.33
|
| Rate for Payer: ASR ASR |
$5,437.74
|
| Rate for Payer: BCBS Complete |
$2,242.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,346.27
|
| Rate for Payer: BCN Commercial |
$4,346.27
|
| Rate for Payer: Cash Price |
$4,484.74
|
| Rate for Payer: Cofinity Commercial |
$5,269.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,484.74
|
| Rate for Payer: Healthscope Commercial |
$5,605.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,437.74
|
| Rate for Payer: Mclaren Commercial |
$5,045.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,765.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,924.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,101.39
|
| Rate for Payer: Priority Health Narrow Network |
$3,980.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,933.21
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,605.92
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,924.14 |
| Max. Negotiated Rate |
$5,605.92 |
| Rate for Payer: Aetna Commercial |
$5,045.33
|
| Rate for Payer: ASR ASR |
$5,437.74
|
| Rate for Payer: BCBS Trust/PPO |
$4,346.27
|
| Rate for Payer: BCN Commercial |
$4,346.27
|
| Rate for Payer: Cash Price |
$4,484.74
|
| Rate for Payer: Cofinity Commercial |
$5,269.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,484.74
|
| Rate for Payer: Healthscope Commercial |
$5,605.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,437.74
|
| Rate for Payer: Mclaren Commercial |
$5,045.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,765.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,924.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,933.21
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,296.32
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,107.42 |
| Max. Negotiated Rate |
$12,223.36 |
| Rate for Payer: Aetna Commercial |
$6,566.69
|
| 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 |
$7,077.43
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$5,656.84
|
| Rate for Payer: BCN Commercial |
$5,656.84
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cofinity Commercial |
$6,858.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,837.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$7,296.32
|
| Rate for Payer: Healthscope Whirlpool |
$7,077.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$6,566.69
|
| 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 |
$6,201.87
|
| 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 |
$5,107.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,639.65
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,180.39
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,420.76
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,296.32
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,107.42 |
| Max. Negotiated Rate |
$7,296.32 |
| Rate for Payer: Aetna Commercial |
$6,566.69
|
| Rate for Payer: ASR ASR |
$7,077.43
|
| Rate for Payer: BCBS Trust/PPO |
$5,656.84
|
| Rate for Payer: BCN Commercial |
$5,656.84
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cofinity Commercial |
$6,858.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,837.06
|
| Rate for Payer: Healthscope Commercial |
$7,296.32
|
| Rate for Payer: Healthscope Whirlpool |
$7,077.43
|
| Rate for Payer: Mclaren Commercial |
$6,566.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,201.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,420.76
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,264.30
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$5,264.30 |
| Rate for Payer: Aetna Commercial |
$4,737.87
|
| 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 |
$5,106.37
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,081.41
|
| Rate for Payer: BCN Commercial |
$4,081.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$4,211.44
|
| Rate for Payer: Cash Price |
$4,211.44
|
| Rate for Payer: Cofinity Commercial |
$4,948.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,211.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$5,264.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,106.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$4,737.87
|
| 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 |
$4,474.66
|
| 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 |
$3,685.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,790.51
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,737.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,632.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,264.30
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,685.01 |
| Max. Negotiated Rate |
$5,264.30 |
| Rate for Payer: Aetna Commercial |
$4,737.87
|
| Rate for Payer: ASR ASR |
$5,106.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,081.41
|
| Rate for Payer: BCN Commercial |
$4,081.41
|
| Rate for Payer: Cash Price |
$4,211.44
|
| Rate for Payer: Cofinity Commercial |
$4,948.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,211.44
|
| Rate for Payer: Healthscope Commercial |
$5,264.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,106.37
|
| Rate for Payer: Mclaren Commercial |
$4,737.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,474.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,685.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,632.58
|
|
