|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$843.90 |
| Rate for Payer: Aetna Commercial |
$374.72
|
| Rate for Payer: Aetna Medicare |
$544.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: ASR ASR |
$403.87
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$343.29
|
| Rate for Payer: BCN Commercial |
$343.29
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$391.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$403.87
|
| Rate for Payer: Healthscope Whirlpool |
$416.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$544.45
|
| Rate for Payer: Mclaren Commercial |
$374.72
|
| Rate for Payer: Mclaren Medicaid |
$544.45
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$598.89
|
| Rate for Payer: PHP Medicaid |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$556.85
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health Narrow Network |
$445.48
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$843.90
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP DNSP |
$544.45
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: VA VA |
$544.45
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$591.78 |
| Max. Negotiated Rate |
$1,599.40 |
| Rate for Payer: Aetna Commercial |
$1,439.46
|
| Rate for Payer: Aetna Medicare |
$591.78
|
| Rate for Payer: ASR ASR |
$1,551.42
|
| Rate for Payer: BCBS Complete |
$639.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,318.71
|
| Rate for Payer: BCN Commercial |
$1,318.71
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,503.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,551.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.40
|
| Rate for Payer: Mclaren Commercial |
$1,439.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,279.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,401.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,121.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.47
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,199.55 |
| Max. Negotiated Rate |
$1,599.40 |
| Rate for Payer: Aetna Commercial |
$1,439.46
|
| Rate for Payer: ASR ASR |
$1,551.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.43
|
| Rate for Payer: BCN Commercial |
$1,313.43
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,503.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,551.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.40
|
| Rate for Payer: Mclaren Commercial |
$1,439.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.47
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,718.27 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$3,489.93
|
| 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 |
$3,761.37
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,197.16
|
| Rate for Payer: BCN Commercial |
$3,197.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,645.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,761.37
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$3,489.93
|
| 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 |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| 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 |
$3,397.64
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,718.27
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,412.38
|
| 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 SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,908.28 |
| Max. Negotiated Rate |
$3,877.70 |
| Rate for Payer: Aetna Commercial |
$3,489.93
|
| Rate for Payer: ASR ASR |
$3,761.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,184.37
|
| Rate for Payer: BCN Commercial |
$3,184.37
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,645.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Healthscope Commercial |
$3,761.37
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.70
|
| Rate for Payer: Mclaren Commercial |
$3,489.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,412.38
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,030.47 |
| Max. Negotiated Rate |
$2,707.29 |
| Rate for Payer: Aetna Commercial |
$2,436.56
|
| Rate for Payer: ASR ASR |
$2,626.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.23
|
| Rate for Payer: BCN Commercial |
$2,223.23
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Commercial |
$2,544.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Healthscope Commercial |
$2,626.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,707.29
|
| Rate for Payer: Mclaren Commercial |
$2,436.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Nomi Health Commercial |
$2,219.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,382.42
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,707.29 |
| Rate for Payer: Aetna Commercial |
$2,436.56
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$2,626.07
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.16
|
| Rate for Payer: BCN Commercial |
$2,232.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Commercial |
$2,544.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$2,626.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,707.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$2,436.56
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Nomi Health Commercial |
$2,219.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,372.13
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,897.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,382.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,051.19 |
| Max. Negotiated Rate |
$28,311.87 |
| Rate for Payer: Aetna Commercial |
$7,769.00
|
| 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 |
$8,373.25
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$7,117.27
|
| Rate for Payer: BCN Commercial |
$7,117.27
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Commercial |
$8,114.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$8,373.25
|
| Rate for Payer: Healthscope Whirlpool |
$8,632.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$7,769.00
|
| 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 |
$7,337.39
|
| Rate for Payer: Nomi Health Commercial |
$7,078.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| 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 |
$7,563.55
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$6,051.19
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,596.35
|
| 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 THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,474.16 |
| Max. Negotiated Rate |
$8,632.22 |
| Rate for Payer: Aetna Commercial |
$7,769.00
|
| Rate for Payer: ASR ASR |
$8,373.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,088.78
|
| Rate for Payer: BCN Commercial |
$7,088.78
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Commercial |
$8,114.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Healthscope Commercial |
$8,373.25
|
| Rate for Payer: Healthscope Whirlpool |
$8,632.22
|
| Rate for Payer: Mclaren Commercial |
$7,769.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,337.39
|
| Rate for Payer: Nomi Health Commercial |
$7,078.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,596.35
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.19 |
| Max. Negotiated Rate |
$2,451.87 |
| Rate for Payer: Aetna Commercial |
$2,206.68
|
| Rate for Payer: Aetna Medicare |
$907.19
|
| Rate for Payer: ASR ASR |
$2,378.31
|
| Rate for Payer: BCBS Complete |
$980.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.57
|
| Rate for Payer: BCN Commercial |
$2,021.57
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cofinity Commercial |
$2,304.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,961.50
|
| Rate for Payer: Healthscope Commercial |
$2,378.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,451.87
|
| Rate for Payer: Mclaren Commercial |
$2,206.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,961.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.09
|
| Rate for Payer: Nomi Health Commercial |
$2,010.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,148.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,157.65
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,838.90 |
| Max. Negotiated Rate |
$2,451.87 |
| Rate for Payer: Aetna Commercial |
$2,206.68
|
| Rate for Payer: ASR ASR |
$2,378.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.48
|
| Rate for Payer: BCN Commercial |
$2,013.48
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cofinity Commercial |
$2,304.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,961.50
|
| Rate for Payer: Healthscope Commercial |
$2,378.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,451.87
|
| Rate for Payer: Mclaren Commercial |
$2,206.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.09
|
| Rate for Payer: Nomi Health Commercial |
$2,010.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,157.65
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,374.30 |
| Max. Negotiated Rate |
$5,832.40 |
| Rate for Payer: Aetna Commercial |
$5,249.16
|
| Rate for Payer: ASR ASR |
$5,657.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,789.57
|
| Rate for Payer: BCN Commercial |
$4,789.57
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Commercial |
$5,482.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Healthscope Commercial |
$5,657.43
|
| Rate for Payer: Healthscope Whirlpool |
$5,832.40
|
| Rate for Payer: Mclaren Commercial |
$5,249.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Nomi Health Commercial |
$4,782.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,132.51
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,157.99 |
| Max. Negotiated Rate |
$5,832.40 |
| Rate for Payer: Aetna Commercial |
$5,249.16
|
| Rate for Payer: Aetna Medicare |
$2,157.99
|
| Rate for Payer: ASR ASR |
$5,657.43
|
| Rate for Payer: BCBS Complete |
$2,332.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,808.81
|
| Rate for Payer: BCN Commercial |
$4,808.81
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Commercial |
$5,482.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Healthscope Commercial |
$5,657.43
|
| Rate for Payer: Healthscope Whirlpool |
$5,832.40
|
| Rate for Payer: Mclaren Commercial |
$5,249.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,665.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Nomi Health Commercial |
$4,782.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,110.35
|
| Rate for Payer: Priority Health Narrow Network |
$4,088.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,132.51
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,477.87 |
| Max. Negotiated Rate |
$17,829.15 |
| Rate for Payer: Aetna Commercial |
$7,032.92
|
| 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 |
$7,579.93
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$6,442.94
|
| Rate for Payer: BCN Commercial |
$6,442.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Commercial |
$7,345.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$7,579.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,814.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$7,032.92
|
| 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 |
$6,642.21
|
| Rate for Payer: Nomi Health Commercial |
$6,407.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| 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 |
$6,846.94
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$5,477.87
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,876.64
|
| 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 THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,860.77 |
| Max. Negotiated Rate |
$7,814.36 |
| Rate for Payer: Aetna Commercial |
$7,032.92
|
| Rate for Payer: ASR ASR |
$7,579.93
|
| Rate for Payer: BCBS Trust/PPO |
$6,417.15
|
| Rate for Payer: BCN Commercial |
$6,417.15
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Commercial |
$7,345.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Healthscope Commercial |
$7,579.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,814.36
|
| Rate for Payer: Mclaren Commercial |
$7,032.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,642.21
|
| Rate for Payer: Nomi Health Commercial |
$6,407.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,876.64
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,107.73 |
| Max. Negotiated Rate |
$5,476.98 |
| Rate for Payer: Aetna Commercial |
$4,929.28
|
| Rate for Payer: ASR ASR |
$5,312.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,497.70
|
| Rate for Payer: BCN Commercial |
$4,497.70
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Commercial |
$5,148.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Healthscope Commercial |
$5,312.67
|
| Rate for Payer: Healthscope Whirlpool |
$5,476.98
|
| Rate for Payer: Mclaren Commercial |
$4,929.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,655.43
|
| Rate for Payer: Nomi Health Commercial |
$4,491.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,819.74
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$5,476.98 |
| Rate for Payer: Aetna Commercial |
$4,929.28
|
| 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 |
$5,312.67
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,515.77
|
| Rate for Payer: BCN Commercial |
$4,515.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Commercial |
$5,148.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$5,312.67
|
| Rate for Payer: Healthscope Whirlpool |
$5,476.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,929.28
|
| 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 |
$4,655.43
|
| Rate for Payer: Nomi Health Commercial |
$4,491.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| 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 |
$4,798.93
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,839.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,819.74
|
| 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 TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$678.74 |
| Max. Negotiated Rate |
$1,834.43 |
| Rate for Payer: Aetna Commercial |
$1,650.99
|
| Rate for Payer: Aetna Medicare |
$678.74
|
| Rate for Payer: ASR ASR |
$1,779.40
|
| Rate for Payer: BCBS Complete |
$733.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,512.49
|
| Rate for Payer: BCN Commercial |
$1,512.49
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Commercial |
$1,724.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Healthscope Commercial |
$1,779.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,834.43
|
| Rate for Payer: Mclaren Commercial |
$1,650.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,467.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Nomi Health Commercial |
$1,504.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,607.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,285.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,614.30
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,375.82 |
| Max. Negotiated Rate |
$1,834.43 |
| Rate for Payer: Aetna Commercial |
$1,650.99
|
| Rate for Payer: ASR ASR |
$1,779.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,506.43
|
| Rate for Payer: BCN Commercial |
$1,506.43
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Commercial |
$1,724.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Healthscope Commercial |
$1,779.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,834.43
|
| Rate for Payer: Mclaren Commercial |
$1,650.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Nomi Health Commercial |
$1,504.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,614.30
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$2,215.93 |
| Rate for Payer: Aetna Commercial |
$1,994.34
|
| Rate for Payer: Aetna Medicare |
$248.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: ASR ASR |
$2,149.45
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.03
|
| Rate for Payer: BCN Commercial |
$1,827.03
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Commercial |
$2,082.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$2,149.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,215.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$248.95
|
| Rate for Payer: Mclaren Commercial |
$1,994.34
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$136.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,883.54
|
| Rate for Payer: Nomi Health Commercial |
$1,817.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$273.85
|
| Rate for Payer: PHP Medicaid |
$133.44
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,941.60
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,553.37
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,950.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$385.87
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP DNSP |
$248.95
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,661.95 |
| Max. Negotiated Rate |
$2,215.93 |
| Rate for Payer: Aetna Commercial |
$1,994.34
|
| Rate for Payer: ASR ASR |
$2,149.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.72
|
| Rate for Payer: BCN Commercial |
$1,819.72
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Commercial |
$2,082.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Healthscope Commercial |
$2,149.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,215.93
|
| Rate for Payer: Mclaren Commercial |
$1,994.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,883.54
|
| Rate for Payer: Nomi Health Commercial |
$1,817.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,950.02
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$538.81 |
| Rate for Payer: Aetna Commercial |
$425.43
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$458.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$389.74
|
| Rate for Payer: BCN Commercial |
$389.74
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Commercial |
$444.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$458.52
|
| Rate for Payer: Healthscope Whirlpool |
$472.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$425.43
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Nomi Health Commercial |
$387.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$426.10
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$340.88
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$354.52 |
| Max. Negotiated Rate |
$472.70 |
| Rate for Payer: Aetna Commercial |
$425.43
|
| Rate for Payer: ASR ASR |
$458.52
|
| Rate for Payer: BCBS Trust/PPO |
$388.18
|
| Rate for Payer: BCN Commercial |
$388.18
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Commercial |
$444.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Healthscope Commercial |
$458.52
|
| Rate for Payer: Healthscope Whirlpool |
$472.70
|
| Rate for Payer: Mclaren Commercial |
$425.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Nomi Health Commercial |
$387.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.98
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$134.88 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: Aetna Medicare |
$134.88
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Complete |
$145.81
|
| Rate for Payer: BCBS Trust/PPO |
$300.55
|
| Rate for Payer: BCN Commercial |
$300.55
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.20
|
| Rate for Payer: Priority Health Narrow Network |
$237.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Trust/PPO |
$299.35
|
| Rate for Payer: BCN Commercial |
$299.35
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
|
