|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,212.57
|
| 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 |
$3,462.43
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,943.07
|
| Rate for Payer: BCN Commercial |
$2,943.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,355.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,462.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,569.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,212.57
|
| 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 |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| 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 |
$3,127.61
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.18
|
| 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 BILATERAL
|
Facility
|
IP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,677.14 |
| Max. Negotiated Rate |
$3,569.52 |
| Rate for Payer: Aetna Commercial |
$3,212.57
|
| Rate for Payer: ASR ASR |
$3,462.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,931.29
|
| Rate for Payer: BCN Commercial |
$2,931.29
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,355.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,462.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,569.52
|
| Rate for Payer: Mclaren Commercial |
$3,212.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.18
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$94.65 |
| Max. Negotiated Rate |
$126.20 |
| Rate for Payer: Aetna Commercial |
$113.58
|
| Rate for Payer: ASR ASR |
$122.41
|
| Rate for Payer: BCBS Trust/PPO |
$103.64
|
| Rate for Payer: BCN Commercial |
$103.64
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Commercial |
$118.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Healthscope Commercial |
$122.41
|
| Rate for Payer: Healthscope Whirlpool |
$126.20
|
| Rate for Payer: Mclaren Commercial |
$113.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$103.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.06
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$126.20 |
| Rate for Payer: Aetna Commercial |
$113.58
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: ASR ASR |
$122.41
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$104.05
|
| Rate for Payer: BCN Commercial |
$104.05
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Commercial |
$118.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$122.41
|
| Rate for Payer: Healthscope Whirlpool |
$126.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.22
|
| Rate for Payer: Mclaren Commercial |
$113.58
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$20.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$103.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Medicaid |
$19.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.58
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health Narrow Network |
$88.47
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$57.69
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP DNSP |
$37.22
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,492.17 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$3,199.65
|
| 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 |
$3,448.51
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,931.24
|
| Rate for Payer: BCN Commercial |
$2,931.24
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Commercial |
$3,341.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,448.51
|
| Rate for Payer: Healthscope Whirlpool |
$3,555.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$3,199.65
|
| 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 |
$3,021.89
|
| Rate for Payer: Nomi Health Commercial |
$2,915.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| 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 |
$3,115.04
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,492.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,128.55
|
| 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 RENIN
|
Facility
|
IP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,666.38 |
| Max. Negotiated Rate |
$3,555.17 |
| Rate for Payer: Aetna Commercial |
$3,199.65
|
| Rate for Payer: ASR ASR |
$3,448.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,919.51
|
| Rate for Payer: BCN Commercial |
$2,919.51
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Commercial |
$3,341.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Healthscope Commercial |
$3,448.51
|
| Rate for Payer: Healthscope Whirlpool |
$3,555.17
|
| Rate for Payer: Mclaren Commercial |
$3,199.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,021.89
|
| Rate for Payer: Nomi Health Commercial |
$2,915.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,128.55
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,633.31 |
| Max. Negotiated Rate |
$14,177.75 |
| Rate for Payer: Aetna Commercial |
$12,759.98
|
| Rate for Payer: ASR ASR |
$13,752.42
|
| Rate for Payer: BCBS Trust/PPO |
$11,642.77
|
| Rate for Payer: BCN Commercial |
$11,642.77
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$13,327.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$13,752.42
|
| Rate for Payer: Healthscope Whirlpool |
$14,177.75
|
| Rate for Payer: Mclaren Commercial |
$12,759.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,476.42
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$14,177.75 |
| Rate for Payer: Aetna Commercial |
$12,759.98
|
| Rate for Payer: Aetna Medicare |
$5,671.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: ASR ASR |
$13,752.42
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$11,689.55
|
| Rate for Payer: BCN Commercial |
$11,689.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$13,327.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$13,752.42
|
| Rate for Payer: Healthscope Whirlpool |
$14,177.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,671.10
|
| Rate for Payer: Mclaren Commercial |
$12,759.98
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$3,114.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$6,238.21
|
| Rate for Payer: PHP Medicaid |
$3,039.71
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,105.58
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health Narrow Network |
$4,884.47
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,476.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Exchange |
$8,790.20
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP DNSP |
$5,671.10
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,633.31 |
| Max. Negotiated Rate |
$14,177.75 |
| Rate for Payer: Aetna Commercial |
$12,759.98
|
| Rate for Payer: ASR ASR |
$13,752.42
|
| Rate for Payer: BCBS Trust/PPO |
$11,642.77
|
| Rate for Payer: BCN Commercial |
$11,642.77
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$13,327.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$13,752.42
|
| Rate for Payer: Healthscope Whirlpool |
$14,177.75
|
| Rate for Payer: Mclaren Commercial |
$12,759.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,476.42
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$14,177.75 |
| Rate for Payer: Aetna Commercial |
$12,759.98
|
| Rate for Payer: Aetna Medicare |
$5,671.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: ASR ASR |
$13,752.42
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$11,689.55
|
| Rate for Payer: BCN Commercial |
$11,689.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$13,327.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$13,752.42
|
| Rate for Payer: Healthscope Whirlpool |
$14,177.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,671.10
|
| Rate for Payer: Mclaren Commercial |
$12,759.98
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$3,114.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$6,238.21
|
| Rate for Payer: PHP Medicaid |
$3,039.71
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,105.58
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health Narrow Network |
$4,884.47
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,476.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Exchange |
$8,790.20
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP DNSP |
$5,671.10
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC IR REVASC IVT W STENT UNILAT COMPLEX INIT VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37260
|
| Hospital Charge Code |
36100639
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$28,756.70 |
| Rate for Payer: Aetna Commercial |
$25,881.03
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$27,894.00
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$23,709.90
|
| Rate for Payer: BCN Commercial |
$23,709.90
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Commercial |
$27,031.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$27,894.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,756.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$25,881.03
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$23,580.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,383.94
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$9,907.15
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,305.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC IR REVASC IVT W STENT UNILAT COMPLEX INIT VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37260
|
| Hospital Charge Code |
36100639
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,567.53 |
| Max. Negotiated Rate |
$28,756.70 |
| Rate for Payer: Aetna Commercial |
$25,881.03
|
| Rate for Payer: ASR ASR |
$27,894.00
|
| Rate for Payer: BCBS Trust/PPO |
$23,615.00
|
| Rate for Payer: BCN Commercial |
$23,615.00
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Commercial |
$27,031.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$27,894.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,756.70
|
| Rate for Payer: Mclaren Commercial |
$25,881.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$23,580.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,305.90
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,567.53 |
| Max. Negotiated Rate |
$28,756.70 |
| Rate for Payer: Aetna Commercial |
$25,881.03
|
| Rate for Payer: ASR ASR |
$27,894.00
|
| Rate for Payer: BCBS Trust/PPO |
$23,615.00
|
| Rate for Payer: BCN Commercial |
$23,615.00
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Commercial |
$27,031.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$27,894.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,756.70
|
| Rate for Payer: Mclaren Commercial |
$25,881.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$23,580.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,305.90
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$28,756.70 |
| Rate for Payer: Aetna Commercial |
$25,881.03
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$27,894.00
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$23,709.90
|
| Rate for Payer: BCN Commercial |
$23,709.90
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Commercial |
$27,031.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$27,894.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,756.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$25,881.03
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$23,580.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,383.94
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$9,907.15
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,305.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,433.00 |
| Max. Negotiated Rate |
$11,244.00 |
| Rate for Payer: Aetna Commercial |
$10,119.60
|
| Rate for Payer: ASR ASR |
$10,906.68
|
| Rate for Payer: BCBS Trust/PPO |
$9,233.57
|
| Rate for Payer: BCN Commercial |
$9,233.57
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Commercial |
$10,569.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,906.68
|
| Rate for Payer: Healthscope Whirlpool |
$11,244.00
|
| Rate for Payer: Mclaren Commercial |
$10,119.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Nomi Health Commercial |
$9,220.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,894.72
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,160.28 |
| Max. Negotiated Rate |
$11,244.00 |
| Rate for Payer: Aetna Commercial |
$10,119.60
|
| Rate for Payer: Aetna Medicare |
$4,160.28
|
| Rate for Payer: ASR ASR |
$10,906.68
|
| Rate for Payer: BCBS Complete |
$4,497.60
|
| Rate for Payer: BCBS Trust/PPO |
$9,270.68
|
| Rate for Payer: BCN Commercial |
$9,270.68
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Commercial |
$10,569.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,906.68
|
| Rate for Payer: Healthscope Whirlpool |
$11,244.00
|
| Rate for Payer: Mclaren Commercial |
$10,119.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,995.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Nomi Health Commercial |
$9,220.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,851.99
|
| Rate for Payer: Priority Health Narrow Network |
$7,882.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,894.72
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,502.67 |
| Max. Negotiated Rate |
$11,336.90 |
| Rate for Payer: Aetna Commercial |
$10,203.21
|
| Rate for Payer: ASR ASR |
$10,996.79
|
| Rate for Payer: BCBS Trust/PPO |
$9,309.86
|
| Rate for Payer: BCN Commercial |
$9,309.86
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Commercial |
$10,656.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,996.79
|
| Rate for Payer: Healthscope Whirlpool |
$11,336.90
|
| Rate for Payer: Mclaren Commercial |
$10,203.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Nomi Health Commercial |
$9,296.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,976.47
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,194.65 |
| Max. Negotiated Rate |
$11,336.90 |
| Rate for Payer: Aetna Commercial |
$10,203.21
|
| Rate for Payer: Aetna Medicare |
$4,194.65
|
| Rate for Payer: ASR ASR |
$10,996.79
|
| Rate for Payer: BCBS Complete |
$4,534.76
|
| Rate for Payer: BCBS Trust/PPO |
$9,347.27
|
| Rate for Payer: BCN Commercial |
$9,347.27
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Commercial |
$10,656.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,996.79
|
| Rate for Payer: Healthscope Whirlpool |
$11,336.90
|
| Rate for Payer: Mclaren Commercial |
$10,203.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,069.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Nomi Health Commercial |
$9,296.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,933.39
|
| Rate for Payer: Priority Health Narrow Network |
$7,947.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,976.47
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,725.92 |
| Max. Negotiated Rate |
$7,367.36 |
| Rate for Payer: Aetna Commercial |
$6,630.62
|
| Rate for Payer: Aetna Medicare |
$2,725.92
|
| Rate for Payer: ASR ASR |
$7,146.34
|
| Rate for Payer: BCBS Complete |
$2,946.94
|
| Rate for Payer: BCBS Trust/PPO |
$6,074.39
|
| Rate for Payer: BCN Commercial |
$6,074.39
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Commercial |
$6,925.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$7,146.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,367.36
|
| Rate for Payer: Mclaren Commercial |
$6,630.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,893.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Nomi Health Commercial |
$6,041.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,455.28
|
| Rate for Payer: Priority Health Narrow Network |
$5,164.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,483.28
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,525.52 |
| Max. Negotiated Rate |
$7,367.36 |
| Rate for Payer: Aetna Commercial |
$6,630.62
|
| Rate for Payer: ASR ASR |
$7,146.34
|
| Rate for Payer: BCBS Trust/PPO |
$6,050.08
|
| Rate for Payer: BCN Commercial |
$6,050.08
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Commercial |
$6,925.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$7,146.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,367.36
|
| Rate for Payer: Mclaren Commercial |
$6,630.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Nomi Health Commercial |
$6,041.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,483.28
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,686.55 |
| Max. Negotiated Rate |
$12,666.35 |
| Rate for Payer: Aetna Commercial |
$11,399.72
|
| Rate for Payer: Aetna Medicare |
$4,686.55
|
| Rate for Payer: ASR ASR |
$12,286.36
|
| Rate for Payer: BCBS Complete |
$5,066.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,443.41
|
| Rate for Payer: BCN Commercial |
$10,443.41
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Commercial |
$11,906.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$12,286.36
|
| Rate for Payer: Healthscope Whirlpool |
$12,666.35
|
| Rate for Payer: Mclaren Commercial |
$11,399.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,133.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Nomi Health Commercial |
$10,386.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,098.26
|
| Rate for Payer: Priority Health Narrow Network |
$8,879.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,146.39
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,499.76 |
| Max. Negotiated Rate |
$12,666.35 |
| Rate for Payer: Aetna Commercial |
$11,399.72
|
| Rate for Payer: ASR ASR |
$12,286.36
|
| Rate for Payer: BCBS Trust/PPO |
$10,401.61
|
| Rate for Payer: BCN Commercial |
$10,401.61
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Commercial |
$11,906.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$12,286.36
|
| Rate for Payer: Healthscope Whirlpool |
$12,666.35
|
| Rate for Payer: Mclaren Commercial |
$11,399.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Nomi Health Commercial |
$10,386.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,146.39
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,485.44 |
| Max. Negotiated Rate |
$13,980.59 |
| Rate for Payer: Aetna Commercial |
$12,582.53
|
| Rate for Payer: ASR ASR |
$13,561.17
|
| Rate for Payer: BCBS Trust/PPO |
$11,480.86
|
| Rate for Payer: BCN Commercial |
$11,480.86
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Commercial |
$13,141.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$13,561.17
|
| Rate for Payer: Healthscope Whirlpool |
$13,980.59
|
| Rate for Payer: Mclaren Commercial |
$12,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Nomi Health Commercial |
$11,464.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,302.92
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,172.82 |
| Max. Negotiated Rate |
$13,980.59 |
| Rate for Payer: Aetna Commercial |
$12,582.53
|
| Rate for Payer: Aetna Medicare |
$5,172.82
|
| Rate for Payer: ASR ASR |
$13,561.17
|
| Rate for Payer: BCBS Complete |
$5,592.24
|
| Rate for Payer: BCBS Trust/PPO |
$11,527.00
|
| Rate for Payer: BCN Commercial |
$11,527.00
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Commercial |
$13,141.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$13,561.17
|
| Rate for Payer: Healthscope Whirlpool |
$13,980.59
|
| Rate for Payer: Mclaren Commercial |
$12,582.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,184.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Nomi Health Commercial |
$11,464.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,249.79
|
| Rate for Payer: Priority Health Narrow Network |
$9,800.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,302.92
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,735.72
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,801.79 |
| Max. Negotiated Rate |
$7,735.72 |
| Rate for Payer: Aetna Commercial |
$6,962.15
|
| Rate for Payer: ASR ASR |
$7,503.65
|
| Rate for Payer: BCBS Trust/PPO |
$6,352.57
|
| Rate for Payer: BCN Commercial |
$6,352.57
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cofinity Commercial |
$7,271.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,188.58
|
| Rate for Payer: Healthscope Commercial |
$7,503.65
|
| Rate for Payer: Healthscope Whirlpool |
$7,735.72
|
| Rate for Payer: Mclaren Commercial |
$6,962.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,575.36
|
| Rate for Payer: Nomi Health Commercial |
$6,343.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,801.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,807.43
|
|
