|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,810.96 |
| Max. Negotiated Rate |
$3,747.95 |
| Rate for Payer: Aetna Commercial |
$3,373.16
|
| Rate for Payer: ASR ASR |
$3,635.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,077.82
|
| Rate for Payer: BCN Commercial |
$3,077.82
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Commercial |
$3,523.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,635.51
|
| Rate for Payer: Healthscope Whirlpool |
$3,747.95
|
| Rate for Payer: Mclaren Commercial |
$3,373.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Nomi Health Commercial |
$3,073.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,298.20
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$702.81 |
| Max. Negotiated Rate |
$937.08 |
| Rate for Payer: Aetna Commercial |
$843.37
|
| Rate for Payer: ASR ASR |
$908.97
|
| Rate for Payer: BCBS Trust/PPO |
$769.53
|
| Rate for Payer: BCN Commercial |
$769.53
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$880.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Healthscope Commercial |
$908.97
|
| Rate for Payer: Healthscope Whirlpool |
$937.08
|
| Rate for Payer: Mclaren Commercial |
$843.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.63
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$1,210.70 |
| Rate for Payer: Aetna Commercial |
$843.37
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: ASR ASR |
$908.97
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$772.62
|
| Rate for Payer: BCN Commercial |
$772.62
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$880.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$908.97
|
| Rate for Payer: Healthscope Whirlpool |
$937.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$843.37
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.14
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$966.51
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$775.06 |
| Max. Negotiated Rate |
$1,033.41 |
| Rate for Payer: Aetna Commercial |
$930.07
|
| Rate for Payer: ASR ASR |
$1,002.41
|
| Rate for Payer: BCBS Trust/PPO |
$848.64
|
| Rate for Payer: BCN Commercial |
$848.64
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Commercial |
$971.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Healthscope Commercial |
$1,002.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.41
|
| Rate for Payer: Mclaren Commercial |
$930.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.40
|
| Rate for Payer: Nomi Health Commercial |
$847.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.40
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$1,210.70 |
| Rate for Payer: Aetna Commercial |
$930.07
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: ASR ASR |
$1,002.41
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$852.05
|
| Rate for Payer: BCN Commercial |
$852.05
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Commercial |
$971.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$1,002.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$930.07
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.40
|
| Rate for Payer: Nomi Health Commercial |
$847.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.14
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$966.51
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,041.05 |
| Max. Negotiated Rate |
$1,388.07 |
| Rate for Payer: Aetna Commercial |
$1,249.26
|
| Rate for Payer: ASR ASR |
$1,346.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.88
|
| Rate for Payer: BCN Commercial |
$1,139.88
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Commercial |
$1,304.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Healthscope Commercial |
$1,346.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,388.07
|
| Rate for Payer: Mclaren Commercial |
$1,249.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$1,138.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.50
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$1,388.07 |
| Rate for Payer: Aetna Commercial |
$1,249.26
|
| Rate for Payer: Aetna Medicare |
$781.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: ASR ASR |
$1,346.43
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.46
|
| Rate for Payer: BCN Commercial |
$1,144.46
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Commercial |
$1,304.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$1,346.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,388.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$781.10
|
| Rate for Payer: Mclaren Commercial |
$1,249.26
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$428.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$1,138.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$859.21
|
| Rate for Payer: PHP Medicaid |
$418.67
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.14
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health Narrow Network |
$966.51
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$1,210.70
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP DNSP |
$781.10
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: VA VA |
$781.10
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$46.85 |
| Rate for Payer: Aetna Commercial |
$42.16
|
| Rate for Payer: ASR ASR |
$45.44
|
| Rate for Payer: BCBS Trust/PPO |
$38.47
|
| Rate for Payer: BCN Commercial |
$38.47
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Commercial |
$44.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$45.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.85
|
| Rate for Payer: Mclaren Commercial |
$42.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.23
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$42.16
|
| Rate for Payer: Aetna Medicare |
$8.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.93
|
| Rate for Payer: ASR ASR |
$45.44
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$38.63
|
| Rate for Payer: BCN Commercial |
$38.63
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Commercial |
$44.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$45.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.74
|
| Rate for Payer: Mclaren Commercial |
$42.16
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: Meridian Medicaid |
$4.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Medicaid |
$4.68
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.50
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health Narrow Network |
$46.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.74
|
| Rate for Payer: UHC Exchange |
$13.55
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHCCP DNSP |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$8.74
|
|
|
HC IRON LEVEL
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.50
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$46.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$440.83 |
| Max. Negotiated Rate |
$587.78 |
| Rate for Payer: Aetna Commercial |
$529.00
|
| Rate for Payer: ASR ASR |
$570.15
|
| Rate for Payer: BCBS Trust/PPO |
$482.68
|
| Rate for Payer: BCN Commercial |
$482.68
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Commercial |
$552.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Healthscope Commercial |
$570.15
|
| Rate for Payer: Healthscope Whirlpool |
$587.78
|
| Rate for Payer: Mclaren Commercial |
$529.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Nomi Health Commercial |
$481.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.25
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.48 |
| Max. Negotiated Rate |
$587.78 |
| Rate for Payer: Aetna Commercial |
$529.00
|
| Rate for Payer: Aetna Medicare |
$217.48
|
| Rate for Payer: ASR ASR |
$570.15
|
| Rate for Payer: BCBS Complete |
$235.11
|
| Rate for Payer: BCBS Trust/PPO |
$484.62
|
| Rate for Payer: BCN Commercial |
$484.62
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Commercial |
$552.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Healthscope Commercial |
$570.15
|
| Rate for Payer: Healthscope Whirlpool |
$587.78
|
| Rate for Payer: Mclaren Commercial |
$529.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$470.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Nomi Health Commercial |
$481.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$515.01
|
| Rate for Payer: Priority Health Narrow Network |
$412.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.25
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,391.94 |
| Max. Negotiated Rate |
$11,870.12 |
| Rate for Payer: Aetna Commercial |
$10,683.11
|
| Rate for Payer: Aetna Medicare |
$4,391.94
|
| Rate for Payer: ASR ASR |
$11,514.02
|
| Rate for Payer: BCBS Complete |
$4,748.05
|
| Rate for Payer: BCBS Trust/PPO |
$9,786.91
|
| Rate for Payer: BCN Commercial |
$9,786.91
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Commercial |
$11,157.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Healthscope Commercial |
$11,514.02
|
| Rate for Payer: Healthscope Whirlpool |
$11,870.12
|
| Rate for Payer: Mclaren Commercial |
$10,683.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,496.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Nomi Health Commercial |
$9,733.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,400.60
|
| Rate for Payer: Priority Health Narrow Network |
$8,320.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,445.71
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,902.59 |
| Max. Negotiated Rate |
$11,870.12 |
| Rate for Payer: Aetna Commercial |
$10,683.11
|
| Rate for Payer: ASR ASR |
$11,514.02
|
| Rate for Payer: BCBS Trust/PPO |
$9,747.74
|
| Rate for Payer: BCN Commercial |
$9,747.74
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Commercial |
$11,157.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Healthscope Commercial |
$11,514.02
|
| Rate for Payer: Healthscope Whirlpool |
$11,870.12
|
| Rate for Payer: Mclaren Commercial |
$10,683.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Nomi Health Commercial |
$9,733.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,445.71
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
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 PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,304.90 |
| Max. Negotiated Rate |
$3,526.75 |
| Rate for Payer: Aetna Commercial |
$3,174.07
|
| Rate for Payer: Aetna Medicare |
$1,304.90
|
| Rate for Payer: ASR ASR |
$3,420.95
|
| Rate for Payer: BCBS Complete |
$1,410.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,907.81
|
| Rate for Payer: BCN Commercial |
$2,907.81
|
| 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: MI Amish Medical Board Commercial |
$2,821.40
|
| 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: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,090.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,472.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,103.54
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,862.51 |
| Max. Negotiated Rate |
$28,311.87 |
| Rate for Payer: Aetna Commercial |
$4,959.00
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$5,344.70
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,542.99
|
| Rate for Payer: BCN Commercial |
$4,542.99
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Commercial |
$5,179.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$5,344.70
|
| Rate for Payer: Healthscope Whirlpool |
$5,510.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$4,959.00
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Nomi Health Commercial |
$4,518.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,827.86
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$3,862.51
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,848.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,132.50 |
| Max. Negotiated Rate |
$5,510.00 |
| Rate for Payer: Aetna Commercial |
$4,959.00
|
| Rate for Payer: ASR ASR |
$5,344.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,524.81
|
| Rate for Payer: BCN Commercial |
$4,524.81
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Commercial |
$5,179.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Healthscope Commercial |
$5,344.70
|
| Rate for Payer: Healthscope Whirlpool |
$5,510.00
|
| Rate for Payer: Mclaren Commercial |
$4,959.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Nomi Health Commercial |
$4,518.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,848.80
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,880.36 |
| Max. Negotiated Rate |
$10,487.46 |
| Rate for Payer: Aetna Commercial |
$9,438.71
|
| Rate for Payer: Aetna Medicare |
$3,880.36
|
| Rate for Payer: ASR ASR |
$10,172.84
|
| Rate for Payer: BCBS Complete |
$4,194.98
|
| Rate for Payer: BCBS Trust/PPO |
$8,646.91
|
| Rate for Payer: BCN Commercial |
$8,646.91
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,858.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$10,172.84
|
| Rate for Payer: Healthscope Whirlpool |
$10,487.46
|
| Rate for Payer: Mclaren Commercial |
$9,438.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,389.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,189.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,351.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,228.96
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,865.60 |
| Max. Negotiated Rate |
$10,487.46 |
| Rate for Payer: Aetna Commercial |
$9,438.71
|
| Rate for Payer: ASR ASR |
$10,172.84
|
| Rate for Payer: BCBS Trust/PPO |
$8,612.30
|
| Rate for Payer: BCN Commercial |
$8,612.30
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,858.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$10,172.84
|
| Rate for Payer: Healthscope Whirlpool |
$10,487.46
|
| Rate for Payer: Mclaren Commercial |
$9,438.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,228.96
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,865.60 |
| Max. Negotiated Rate |
$10,487.46 |
| Rate for Payer: Aetna Commercial |
$9,438.71
|
| Rate for Payer: ASR ASR |
$10,172.84
|
| Rate for Payer: BCBS Trust/PPO |
$8,612.30
|
| Rate for Payer: BCN Commercial |
$8,612.30
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,858.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$10,172.84
|
| Rate for Payer: Healthscope Whirlpool |
$10,487.46
|
| Rate for Payer: Mclaren Commercial |
$9,438.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,228.96
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,880.36 |
| Max. Negotiated Rate |
$10,487.46 |
| Rate for Payer: Aetna Commercial |
$9,438.71
|
| Rate for Payer: Aetna Medicare |
$3,880.36
|
| Rate for Payer: ASR ASR |
$10,172.84
|
| Rate for Payer: BCBS Complete |
$4,194.98
|
| Rate for Payer: BCBS Trust/PPO |
$8,646.91
|
| Rate for Payer: BCN Commercial |
$8,646.91
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,858.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$10,172.84
|
| Rate for Payer: Healthscope Whirlpool |
$10,487.46
|
| Rate for Payer: Mclaren Commercial |
$9,438.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,389.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,189.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,351.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,228.96
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,437.51 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$1,845.59
|
| 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 |
$1,989.13
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.76
|
| Rate for Payer: BCN Commercial |
$1,690.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Commercial |
$1,927.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,989.13
|
| Rate for Payer: Healthscope Whirlpool |
$2,050.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$1,845.59
|
| 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 |
$1,743.05
|
| Rate for Payer: Nomi Health Commercial |
$1,681.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| 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 |
$1,796.78
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,437.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,804.57
|
| 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 PULMONARY
|
Facility
|
IP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,537.99 |
| Max. Negotiated Rate |
$2,050.65 |
| Rate for Payer: Aetna Commercial |
$1,845.59
|
| Rate for Payer: ASR ASR |
$1,989.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,683.99
|
| Rate for Payer: BCN Commercial |
$1,683.99
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Commercial |
$1,927.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Healthscope Commercial |
$1,989.13
|
| Rate for Payer: Healthscope Whirlpool |
$2,050.65
|
| Rate for Payer: Mclaren Commercial |
$1,845.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,743.05
|
| Rate for Payer: Nomi Health Commercial |
$1,681.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,804.57
|
|
