|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,645.06 |
| Max. Negotiated Rate |
$3,526.75 |
| Rate for Payer: Aetna Commercial |
$3,174.07
|
| Rate for Payer: ASR ASR |
$3,420.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,896.17
|
| Rate for Payer: BCN Commercial |
$2,896.17
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,315.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,420.95
|
| Rate for Payer: Healthscope Whirlpool |
$3,526.75
|
| Rate for Payer: Mclaren Commercial |
$3,174.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,103.54
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,718.95 |
| Max. Negotiated Rate |
$10,051.22 |
| Rate for Payer: Aetna Commercial |
$9,046.10
|
| Rate for Payer: Aetna Medicare |
$3,718.95
|
| Rate for Payer: ASR ASR |
$9,749.68
|
| Rate for Payer: BCBS Complete |
$4,020.49
|
| Rate for Payer: BCBS Trust/PPO |
$8,287.23
|
| Rate for Payer: BCN Commercial |
$8,287.23
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Commercial |
$9,448.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Healthscope Commercial |
$9,749.68
|
| Rate for Payer: Healthscope Whirlpool |
$10,051.22
|
| Rate for Payer: Mclaren Commercial |
$9,046.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,040.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Nomi Health Commercial |
$8,242.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,806.88
|
| Rate for Payer: Priority Health Narrow Network |
$7,045.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,845.07
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,538.41 |
| Max. Negotiated Rate |
$10,051.22 |
| Rate for Payer: Aetna Commercial |
$9,046.10
|
| Rate for Payer: ASR ASR |
$9,749.68
|
| Rate for Payer: BCBS Trust/PPO |
$8,254.06
|
| Rate for Payer: BCN Commercial |
$8,254.06
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Commercial |
$9,448.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Healthscope Commercial |
$9,749.68
|
| Rate for Payer: Healthscope Whirlpool |
$10,051.22
|
| Rate for Payer: Mclaren Commercial |
$9,046.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Nomi Health Commercial |
$8,242.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,845.07
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
OP
|
$3,539.77
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,185.79
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,433.58
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,918.54
|
| Rate for Payer: BCN Commercial |
$2,918.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,831.82
|
| Rate for Payer: Cash Price |
$2,831.82
|
| Rate for Payer: Cofinity Commercial |
$3,327.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,831.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,433.58
|
| Rate for Payer: Healthscope Whirlpool |
$3,539.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,185.79
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,008.80
|
| Rate for Payer: Nomi Health Commercial |
$2,902.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,654.83
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,101.55
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,481.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,115.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
IP
|
$3,539.77
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,654.83 |
| Max. Negotiated Rate |
$3,539.77 |
| Rate for Payer: Aetna Commercial |
$3,185.79
|
| Rate for Payer: ASR ASR |
$3,433.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,906.86
|
| Rate for Payer: BCN Commercial |
$2,906.86
|
| Rate for Payer: Cash Price |
$2,831.82
|
| Rate for Payer: Cofinity Commercial |
$3,327.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,831.82
|
| Rate for Payer: Healthscope Commercial |
$3,433.58
|
| Rate for Payer: Healthscope Whirlpool |
$3,539.77
|
| Rate for Payer: Mclaren Commercial |
$3,185.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,008.80
|
| Rate for Payer: Nomi Health Commercial |
$2,902.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,654.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,115.00
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
IP
|
$4,198.39
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,148.79 |
| Max. Negotiated Rate |
$4,198.39 |
| Rate for Payer: Aetna Commercial |
$3,778.55
|
| Rate for Payer: ASR ASR |
$4,072.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,447.72
|
| Rate for Payer: BCN Commercial |
$3,447.72
|
| Rate for Payer: Cash Price |
$3,358.71
|
| Rate for Payer: Cofinity Commercial |
$3,946.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.71
|
| Rate for Payer: Healthscope Commercial |
$4,072.44
|
| Rate for Payer: Healthscope Whirlpool |
$4,198.39
|
| Rate for Payer: Mclaren Commercial |
$3,778.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,568.63
|
| Rate for Payer: Nomi Health Commercial |
$3,442.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.58
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
OP
|
$4,198.39
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$3,778.55
|
| Rate for Payer: Aetna Medicare |
$5,544.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: ASR ASR |
$4,072.44
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,461.57
|
| Rate for Payer: BCN Commercial |
$3,461.57
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,358.71
|
| Rate for Payer: Cash Price |
$3,358.71
|
| Rate for Payer: Cofinity Commercial |
$3,946.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$4,072.44
|
| Rate for Payer: Healthscope Whirlpool |
$4,198.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$3,778.55
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$3,045.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,568.63
|
| Rate for Payer: Nomi Health Commercial |
$3,442.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.79
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$6,098.93
|
| Rate for Payer: PHP Medicaid |
$2,971.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,678.63
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,943.07
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$8,593.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP DNSP |
$5,544.48
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
OP
|
$3,862.58
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,476.32
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,746.70
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,184.70
|
| Rate for Payer: BCN Commercial |
$3,184.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,090.06
|
| Rate for Payer: Cash Price |
$3,090.06
|
| Rate for Payer: Cofinity Commercial |
$3,630.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,090.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,746.70
|
| Rate for Payer: Healthscope Whirlpool |
$3,862.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,476.32
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,283.19
|
| Rate for Payer: Nomi Health Commercial |
$3,167.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,896.93
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,384.39
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,707.67
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,399.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
IP
|
$3,862.58
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,896.93 |
| Max. Negotiated Rate |
$3,862.58 |
| Rate for Payer: Aetna Commercial |
$3,476.32
|
| Rate for Payer: ASR ASR |
$3,746.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,171.95
|
| Rate for Payer: BCN Commercial |
$3,171.95
|
| Rate for Payer: Cash Price |
$3,090.06
|
| Rate for Payer: Cofinity Commercial |
$3,630.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,090.06
|
| Rate for Payer: Healthscope Commercial |
$3,746.70
|
| Rate for Payer: Healthscope Whirlpool |
$3,862.58
|
| Rate for Payer: Mclaren Commercial |
$3,476.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,283.19
|
| Rate for Payer: Nomi Health Commercial |
$3,167.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,896.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,399.07
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
IP
|
$3,237.62
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,428.22 |
| Max. Negotiated Rate |
$3,237.62 |
| Rate for Payer: Aetna Commercial |
$2,913.86
|
| Rate for Payer: ASR ASR |
$3,140.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,658.73
|
| Rate for Payer: BCN Commercial |
$2,658.73
|
| Rate for Payer: Cash Price |
$2,590.10
|
| Rate for Payer: Cofinity Commercial |
$3,043.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.10
|
| Rate for Payer: Healthscope Commercial |
$3,140.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,237.62
|
| Rate for Payer: Mclaren Commercial |
$2,913.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.98
|
| Rate for Payer: Nomi Health Commercial |
$2,654.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,849.11
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
OP
|
$3,237.62
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,913.86
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,140.49
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,669.42
|
| Rate for Payer: BCN Commercial |
$2,669.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,590.10
|
| Rate for Payer: Cash Price |
$2,590.10
|
| Rate for Payer: Cofinity Commercial |
$3,043.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,140.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,237.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,913.86
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.98
|
| Rate for Payer: Nomi Health Commercial |
$2,654.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.22
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,836.80
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,269.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,849.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,326.52 |
| Max. Negotiated Rate |
$20,435.36 |
| Rate for Payer: Aetna Commercial |
$18,391.82
|
| Rate for Payer: ASR ASR |
$19,822.30
|
| Rate for Payer: BCBS Trust/PPO |
$16,781.52
|
| Rate for Payer: BCN Commercial |
$16,781.52
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Commercial |
$19,209.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Healthscope Commercial |
$19,822.30
|
| Rate for Payer: Healthscope Whirlpool |
$20,435.36
|
| Rate for Payer: Mclaren Commercial |
$18,391.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Nomi Health Commercial |
$16,757.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,983.12
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,561.08 |
| Max. Negotiated Rate |
$20,435.36 |
| Rate for Payer: Aetna Commercial |
$18,391.82
|
| Rate for Payer: Aetna Medicare |
$7,561.08
|
| Rate for Payer: ASR ASR |
$19,822.30
|
| Rate for Payer: BCBS Complete |
$8,174.14
|
| Rate for Payer: BCBS Trust/PPO |
$16,848.95
|
| Rate for Payer: BCN Commercial |
$16,848.95
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Commercial |
$19,209.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Healthscope Commercial |
$19,822.30
|
| Rate for Payer: Healthscope Whirlpool |
$20,435.36
|
| Rate for Payer: Mclaren Commercial |
$18,391.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,348.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Nomi Health Commercial |
$16,757.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,905.46
|
| Rate for Payer: Priority Health Narrow Network |
$14,325.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,983.12
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,543.12 |
| Max. Negotiated Rate |
$17,684.12 |
| Rate for Payer: Aetna Commercial |
$15,915.71
|
| Rate for Payer: Aetna Medicare |
$6,543.12
|
| Rate for Payer: ASR ASR |
$17,153.60
|
| Rate for Payer: BCBS Complete |
$7,073.65
|
| Rate for Payer: BCBS Trust/PPO |
$14,580.56
|
| Rate for Payer: BCN Commercial |
$14,580.56
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Commercial |
$16,623.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Healthscope Commercial |
$17,153.60
|
| Rate for Payer: Healthscope Whirlpool |
$17,684.12
|
| Rate for Payer: Mclaren Commercial |
$15,915.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,147.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Nomi Health Commercial |
$14,500.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15,494.83
|
| Rate for Payer: Priority Health Narrow Network |
$12,396.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,562.03
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,263.09 |
| Max. Negotiated Rate |
$17,684.12 |
| Rate for Payer: Aetna Commercial |
$15,915.71
|
| Rate for Payer: ASR ASR |
$17,153.60
|
| Rate for Payer: BCBS Trust/PPO |
$14,522.20
|
| Rate for Payer: BCN Commercial |
$14,522.20
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Commercial |
$16,623.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Healthscope Commercial |
$17,153.60
|
| Rate for Payer: Healthscope Whirlpool |
$17,684.12
|
| Rate for Payer: Mclaren Commercial |
$15,915.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Nomi Health Commercial |
$14,500.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,562.03
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,581.34 |
| Max. Negotiated Rate |
$20,490.12 |
| Rate for Payer: Aetna Commercial |
$18,441.11
|
| Rate for Payer: Aetna Medicare |
$7,581.34
|
| Rate for Payer: ASR ASR |
$19,875.42
|
| Rate for Payer: BCBS Complete |
$8,196.05
|
| Rate for Payer: BCBS Trust/PPO |
$16,894.10
|
| Rate for Payer: BCN Commercial |
$16,894.10
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$19,260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$19,875.42
|
| Rate for Payer: Healthscope Whirlpool |
$20,490.12
|
| Rate for Payer: Mclaren Commercial |
$18,441.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,392.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,953.44
|
| Rate for Payer: Priority Health Narrow Network |
$14,363.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,031.31
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,367.59 |
| Max. Negotiated Rate |
$20,490.12 |
| Rate for Payer: Aetna Commercial |
$18,441.11
|
| Rate for Payer: ASR ASR |
$19,875.42
|
| Rate for Payer: BCBS Trust/PPO |
$16,826.49
|
| Rate for Payer: BCN Commercial |
$16,826.49
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$19,260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$19,875.42
|
| Rate for Payer: Healthscope Whirlpool |
$20,490.12
|
| Rate for Payer: Mclaren Commercial |
$18,441.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,031.31
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,799.08 |
| Max. Negotiated Rate |
$22,398.77 |
| Rate for Payer: Aetna Commercial |
$20,158.89
|
| Rate for Payer: ASR ASR |
$21,726.81
|
| Rate for Payer: BCBS Trust/PPO |
$18,393.87
|
| Rate for Payer: BCN Commercial |
$18,393.87
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Commercial |
$21,054.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Healthscope Commercial |
$21,726.81
|
| Rate for Payer: Healthscope Whirlpool |
$22,398.77
|
| Rate for Payer: Mclaren Commercial |
$20,158.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Nomi Health Commercial |
$18,366.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,710.92
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,287.54 |
| Max. Negotiated Rate |
$22,398.77 |
| Rate for Payer: Aetna Commercial |
$20,158.89
|
| Rate for Payer: Aetna Medicare |
$8,287.54
|
| Rate for Payer: ASR ASR |
$21,726.81
|
| Rate for Payer: BCBS Complete |
$8,959.51
|
| Rate for Payer: BCBS Trust/PPO |
$18,467.79
|
| Rate for Payer: BCN Commercial |
$18,467.79
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Commercial |
$21,054.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Healthscope Commercial |
$21,726.81
|
| Rate for Payer: Healthscope Whirlpool |
$22,398.77
|
| Rate for Payer: Mclaren Commercial |
$20,158.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,919.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Nomi Health Commercial |
$18,366.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19,625.80
|
| Rate for Payer: Priority Health Narrow Network |
$15,701.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,710.92
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,279.52 |
| Max. Negotiated Rate |
$9,706.02 |
| Rate for Payer: Aetna Commercial |
$8,735.42
|
| Rate for Payer: ASR ASR |
$9,414.84
|
| Rate for Payer: BCBS Trust/PPO |
$7,970.58
|
| Rate for Payer: BCN Commercial |
$7,970.58
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Commercial |
$9,123.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Healthscope Commercial |
$9,414.84
|
| Rate for Payer: Healthscope Whirlpool |
$9,706.02
|
| Rate for Payer: Mclaren Commercial |
$8,735.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Nomi Health Commercial |
$7,958.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,541.30
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,591.23 |
| Max. Negotiated Rate |
$9,706.02 |
| Rate for Payer: Aetna Commercial |
$8,735.42
|
| Rate for Payer: Aetna Medicare |
$3,591.23
|
| Rate for Payer: ASR ASR |
$9,414.84
|
| Rate for Payer: BCBS Complete |
$3,882.41
|
| Rate for Payer: BCBS Trust/PPO |
$8,002.61
|
| Rate for Payer: BCN Commercial |
$8,002.61
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Commercial |
$9,123.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Healthscope Commercial |
$9,414.84
|
| Rate for Payer: Healthscope Whirlpool |
$9,706.02
|
| Rate for Payer: Mclaren Commercial |
$8,735.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,764.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Nomi Health Commercial |
$7,958.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,504.41
|
| Rate for Payer: Priority Health Narrow Network |
$6,803.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,541.30
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,367.59 |
| Max. Negotiated Rate |
$20,490.12 |
| Rate for Payer: Aetna Commercial |
$18,441.11
|
| Rate for Payer: ASR ASR |
$19,875.42
|
| Rate for Payer: BCBS Trust/PPO |
$16,826.49
|
| Rate for Payer: BCN Commercial |
$16,826.49
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$19,260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$19,875.42
|
| Rate for Payer: Healthscope Whirlpool |
$20,490.12
|
| Rate for Payer: Mclaren Commercial |
$18,441.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,031.31
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,581.34 |
| Max. Negotiated Rate |
$20,490.12 |
| Rate for Payer: Aetna Commercial |
$18,441.11
|
| Rate for Payer: Aetna Medicare |
$7,581.34
|
| Rate for Payer: ASR ASR |
$19,875.42
|
| Rate for Payer: BCBS Complete |
$8,196.05
|
| Rate for Payer: BCBS Trust/PPO |
$16,894.10
|
| Rate for Payer: BCN Commercial |
$16,894.10
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$19,260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$19,875.42
|
| Rate for Payer: Healthscope Whirlpool |
$20,490.12
|
| Rate for Payer: Mclaren Commercial |
$18,441.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,392.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,953.44
|
| Rate for Payer: Priority Health Narrow Network |
$14,363.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,031.31
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$45.63 |
| Rate for Payer: Aetna Commercial |
$41.07
|
| Rate for Payer: ASR ASR |
$44.26
|
| Rate for Payer: BCBS Trust/PPO |
$37.47
|
| Rate for Payer: BCN Commercial |
$37.47
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$42.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$44.26
|
| Rate for Payer: Healthscope Whirlpool |
$45.63
|
| Rate for Payer: Mclaren Commercial |
$41.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.15
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$45.63 |
| Rate for Payer: Aetna Commercial |
$41.07
|
| Rate for Payer: Aetna Medicare |
$16.88
|
| Rate for Payer: ASR ASR |
$44.26
|
| Rate for Payer: BCBS Complete |
$18.25
|
| Rate for Payer: BCBS Trust/PPO |
$37.62
|
| Rate for Payer: BCN Commercial |
$37.62
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$42.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$44.26
|
| Rate for Payer: Healthscope Whirlpool |
$45.63
|
| Rate for Payer: Mclaren Commercial |
$41.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39.98
|
| Rate for Payer: Priority Health Narrow Network |
$31.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.15
|
|
