|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$20,088.35
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$27,270.14 |
| Rate for Payer: Aetna Commercial |
$18,079.52
|
| Rate for Payer: Aetna Medicare |
$17,593.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: ASR ASR |
$19,485.70
|
| Rate for Payer: ASR Commercial |
$19,485.70
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$16,450.35
|
| Rate for Payer: BCN Commercial |
$15,574.50
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cofinity Commercial |
$18,883.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,070.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$20,088.35
|
| Rate for Payer: Healthscope Whirlpool |
$19,485.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$18,079.52
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,075.10
|
| Rate for Payer: Nomi Health Commercial |
$16,472.45
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$19,353.00
|
| Rate for Payer: PHP Medicaid |
$9,430.19
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,057.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,601.41
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$14,081.93
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,677.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$27,270.14
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP DNSP |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$21,959.58
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,273.73 |
| Max. Negotiated Rate |
$21,959.58 |
| Rate for Payer: Aetna Commercial |
$19,763.62
|
| Rate for Payer: ASR ASR |
$21,300.79
|
| Rate for Payer: ASR Commercial |
$21,300.79
|
| Rate for Payer: BCBS Trust/PPO |
$17,894.86
|
| Rate for Payer: BCN Commercial |
$17,025.26
|
| Rate for Payer: Cash Price |
$17,567.66
|
| Rate for Payer: Cofinity Commercial |
$20,642.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,567.66
|
| Rate for Payer: Healthscope Commercial |
$21,959.58
|
| Rate for Payer: Healthscope Whirlpool |
$21,300.79
|
| Rate for Payer: Mclaren Commercial |
$19,763.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,665.64
|
| Rate for Payer: Nomi Health Commercial |
$18,006.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,273.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,324.43
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$21,959.58
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$27,270.14 |
| Rate for Payer: Aetna Commercial |
$19,763.62
|
| Rate for Payer: Aetna Medicare |
$17,593.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: ASR ASR |
$21,300.79
|
| Rate for Payer: ASR Commercial |
$21,300.79
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$17,982.70
|
| Rate for Payer: BCN Commercial |
$17,025.26
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$17,567.66
|
| Rate for Payer: Cash Price |
$17,567.66
|
| Rate for Payer: Cofinity Commercial |
$20,642.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,567.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$21,959.58
|
| Rate for Payer: Healthscope Whirlpool |
$21,300.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$19,763.62
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,665.64
|
| Rate for Payer: Nomi Health Commercial |
$18,006.86
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$19,353.00
|
| Rate for Payer: PHP Medicaid |
$9,430.19
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,273.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,240.98
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$15,393.67
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,324.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$27,270.14
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP DNSP |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,515.71
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,185.21 |
| Max. Negotiated Rate |
$9,515.71 |
| Rate for Payer: Aetna Commercial |
$8,564.14
|
| Rate for Payer: ASR ASR |
$9,230.24
|
| Rate for Payer: ASR Commercial |
$9,230.24
|
| Rate for Payer: BCBS Trust/PPO |
$7,754.35
|
| Rate for Payer: BCN Commercial |
$7,377.53
|
| Rate for Payer: Cash Price |
$7,612.57
|
| Rate for Payer: Cofinity Commercial |
$8,944.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,612.57
|
| Rate for Payer: Healthscope Commercial |
$9,515.71
|
| Rate for Payer: Healthscope Whirlpool |
$9,230.24
|
| Rate for Payer: Mclaren Commercial |
$8,564.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,088.35
|
| Rate for Payer: Nomi Health Commercial |
$7,802.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,185.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,373.82
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,515.71
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,806.28 |
| Max. Negotiated Rate |
$9,515.71 |
| Rate for Payer: Aetna Commercial |
$8,564.14
|
| Rate for Payer: Aetna Medicare |
$4,757.86
|
| Rate for Payer: ASR ASR |
$9,230.24
|
| Rate for Payer: ASR Commercial |
$9,230.24
|
| Rate for Payer: BCBS Complete |
$3,806.28
|
| Rate for Payer: BCBS Trust/PPO |
$7,792.41
|
| Rate for Payer: BCN Commercial |
$7,377.53
|
| Rate for Payer: Cash Price |
$7,612.57
|
| Rate for Payer: Cofinity Commercial |
$8,944.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,612.57
|
| Rate for Payer: Healthscope Commercial |
$9,515.71
|
| Rate for Payer: Healthscope Whirlpool |
$9,230.24
|
| Rate for Payer: Mclaren Commercial |
$8,564.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,088.35
|
| Rate for Payer: Nomi Health Commercial |
$7,802.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,185.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,337.67
|
| Rate for Payer: Priority Health Narrow Network |
$6,670.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,373.82
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$20,088.35
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,057.43 |
| Max. Negotiated Rate |
$20,088.35 |
| Rate for Payer: Aetna Commercial |
$18,079.52
|
| Rate for Payer: ASR ASR |
$19,485.70
|
| Rate for Payer: ASR Commercial |
$19,485.70
|
| Rate for Payer: BCBS Trust/PPO |
$16,370.00
|
| Rate for Payer: BCN Commercial |
$15,574.50
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cofinity Commercial |
$18,883.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,070.68
|
| Rate for Payer: Healthscope Commercial |
$20,088.35
|
| Rate for Payer: Healthscope Whirlpool |
$19,485.70
|
| Rate for Payer: Mclaren Commercial |
$18,079.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,075.10
|
| Rate for Payer: Nomi Health Commercial |
$16,472.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,057.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,677.75
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$20,088.35
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$27,270.14 |
| Rate for Payer: Aetna Commercial |
$18,079.52
|
| Rate for Payer: Aetna Medicare |
$17,593.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: ASR ASR |
$19,485.70
|
| Rate for Payer: ASR Commercial |
$19,485.70
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$16,450.35
|
| Rate for Payer: BCN Commercial |
$15,574.50
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cofinity Commercial |
$18,883.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,070.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$20,088.35
|
| Rate for Payer: Healthscope Whirlpool |
$19,485.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$18,079.52
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,075.10
|
| Rate for Payer: Nomi Health Commercial |
$16,472.45
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$19,353.00
|
| Rate for Payer: PHP Medicaid |
$9,430.19
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,057.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,601.41
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$14,081.93
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,677.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$27,270.14
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP DNSP |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$44.74
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Complete |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.20
|
| Rate for Payer: Priority Health Narrow Network |
$31.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$44.74
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Trust/PPO |
$36.46
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.64 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: Aetna Medicare |
$117.04
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: ASR Commercial |
$227.07
|
| Rate for Payer: BCBS Complete |
$93.64
|
| Rate for Payer: BCBS Trust/PPO |
$191.70
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$220.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Healthscope Whirlpool |
$227.07
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.11
|
| Rate for Payer: Priority Health Narrow Network |
$164.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.00
|
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: ASR Commercial |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$190.76
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$220.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Healthscope Whirlpool |
$227.07
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.00
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$555.66
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$361.18 |
| Max. Negotiated Rate |
$555.66 |
| Rate for Payer: Aetna Commercial |
$500.09
|
| Rate for Payer: ASR ASR |
$538.99
|
| Rate for Payer: ASR Commercial |
$538.99
|
| Rate for Payer: BCBS Trust/PPO |
$452.81
|
| Rate for Payer: BCN Commercial |
$430.80
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$522.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Healthscope Commercial |
$555.66
|
| Rate for Payer: Healthscope Whirlpool |
$538.99
|
| Rate for Payer: Mclaren Commercial |
$500.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.98
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$555.66
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$555.66 |
| Rate for Payer: Aetna Commercial |
$500.09
|
| Rate for Payer: Aetna Medicare |
$206.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: ASR ASR |
$538.99
|
| Rate for Payer: ASR Commercial |
$538.99
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$455.03
|
| Rate for Payer: BCN Commercial |
$430.80
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$522.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$555.66
|
| Rate for Payer: Healthscope Whirlpool |
$538.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$206.43
|
| Rate for Payer: Mclaren Commercial |
$500.09
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$227.07
|
| Rate for Payer: PHP Medicaid |
$110.65
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$354.65
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$283.72
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$319.97
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP DNSP |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: VA VA |
$206.43
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,560.77
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,560.77 |
| Rate for Payer: Aetna Commercial |
$3,204.69
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$3,453.95
|
| Rate for Payer: ASR Commercial |
$3,453.95
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,915.91
|
| Rate for Payer: BCN Commercial |
$2,760.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cofinity Commercial |
$3,347.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$3,560.77
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$3,204.69
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.65
|
| Rate for Payer: Nomi Health Commercial |
$2,919.83
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,119.95
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,496.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,560.77
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,314.50 |
| Max. Negotiated Rate |
$3,560.77 |
| Rate for Payer: Aetna Commercial |
$3,204.69
|
| Rate for Payer: ASR ASR |
$3,453.95
|
| Rate for Payer: ASR Commercial |
$3,453.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,901.67
|
| Rate for Payer: BCN Commercial |
$2,760.66
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cofinity Commercial |
$3,347.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.62
|
| Rate for Payer: Healthscope Commercial |
$3,560.77
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.95
|
| Rate for Payer: Mclaren Commercial |
$3,204.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.65
|
| Rate for Payer: Nomi Health Commercial |
$2,919.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.48
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,558.14
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,662.79 |
| Max. Negotiated Rate |
$2,558.14 |
| Rate for Payer: Aetna Commercial |
$2,302.33
|
| Rate for Payer: ASR ASR |
$2,481.40
|
| Rate for Payer: ASR Commercial |
$2,481.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.63
|
| Rate for Payer: BCN Commercial |
$1,983.33
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cofinity Commercial |
$2,404.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,046.51
|
| Rate for Payer: Healthscope Commercial |
$2,558.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,481.40
|
| Rate for Payer: Mclaren Commercial |
$2,302.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,174.42
|
| Rate for Payer: Nomi Health Commercial |
$2,097.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,251.16
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,558.14
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$2,965.58 |
| Rate for Payer: Aetna Commercial |
$2,302.33
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$2,481.40
|
| Rate for Payer: ASR Commercial |
$2,481.40
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.86
|
| Rate for Payer: BCN Commercial |
$1,983.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cofinity Commercial |
$2,404.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,046.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,558.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,481.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$2,302.33
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,174.42
|
| Rate for Payer: Nomi Health Commercial |
$2,097.67
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,241.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,793.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,251.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,929.03
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,903.87 |
| Max. Negotiated Rate |
$2,929.03 |
| Rate for Payer: Aetna Commercial |
$2,636.13
|
| Rate for Payer: ASR ASR |
$2,841.16
|
| Rate for Payer: ASR Commercial |
$2,841.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,386.87
|
| Rate for Payer: BCN Commercial |
$2,270.88
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cofinity Commercial |
$2,753.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,343.22
|
| Rate for Payer: Healthscope Commercial |
$2,929.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,841.16
|
| Rate for Payer: Mclaren Commercial |
$2,636.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,401.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,577.55
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,929.03
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,025.52 |
| Max. Negotiated Rate |
$2,965.58 |
| Rate for Payer: Aetna Commercial |
$2,636.13
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$2,841.16
|
| Rate for Payer: ASR Commercial |
$2,841.16
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,398.58
|
| Rate for Payer: BCN Commercial |
$2,270.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cofinity Commercial |
$2,753.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,343.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,929.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,841.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$2,636.13
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,401.80
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,566.42
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,053.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,577.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,399.81 |
| Max. Negotiated Rate |
$3,499.53 |
| Rate for Payer: Aetna Commercial |
$3,149.58
|
| Rate for Payer: Aetna Medicare |
$1,749.76
|
| Rate for Payer: ASR ASR |
$3,394.54
|
| Rate for Payer: ASR Commercial |
$3,394.54
|
| Rate for Payer: BCBS Complete |
$1,399.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,865.77
|
| Rate for Payer: BCN Commercial |
$2,713.19
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,289.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Healthscope Commercial |
$3,499.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,394.54
|
| Rate for Payer: Mclaren Commercial |
$3,149.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$2,869.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,066.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,453.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,079.59
|
|
|
HC IR EMBOLIZATION
|
Facility
|
IP
|
$3,499.53
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,274.69 |
| Max. Negotiated Rate |
$3,499.53 |
| Rate for Payer: Aetna Commercial |
$3,149.58
|
| Rate for Payer: ASR ASR |
$3,394.54
|
| Rate for Payer: ASR Commercial |
$3,394.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,851.77
|
| Rate for Payer: BCN Commercial |
$2,713.19
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,289.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Healthscope Commercial |
$3,499.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,394.54
|
| Rate for Payer: Mclaren Commercial |
$3,149.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$2,869.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,079.59
|
|
|
HC IR ERCP
|
Facility
|
IP
|
$816.66
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$530.83 |
| Max. Negotiated Rate |
$816.66 |
| Rate for Payer: Aetna Commercial |
$734.99
|
| Rate for Payer: ASR ASR |
$792.16
|
| Rate for Payer: ASR Commercial |
$792.16
|
| Rate for Payer: BCBS Trust/PPO |
$665.50
|
| Rate for Payer: BCN Commercial |
$633.16
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$767.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Healthscope Commercial |
$816.66
|
| Rate for Payer: Healthscope Whirlpool |
$792.16
|
| Rate for Payer: Mclaren Commercial |
$734.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.66
|
|
|
HC IR ERCP
|
Facility
|
OP
|
$816.66
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.66 |
| Max. Negotiated Rate |
$816.66 |
| Rate for Payer: Aetna Commercial |
$734.99
|
| Rate for Payer: Aetna Medicare |
$408.33
|
| Rate for Payer: ASR ASR |
$792.16
|
| Rate for Payer: ASR Commercial |
$792.16
|
| Rate for Payer: BCBS Complete |
$326.66
|
| Rate for Payer: BCBS Trust/PPO |
$668.76
|
| Rate for Payer: BCN Commercial |
$633.16
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$767.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Healthscope Commercial |
$816.66
|
| Rate for Payer: Healthscope Whirlpool |
$792.16
|
| Rate for Payer: Mclaren Commercial |
$734.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.56
|
| Rate for Payer: Priority Health Narrow Network |
$572.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.66
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
OP
|
$628.94
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$251.58 |
| Max. Negotiated Rate |
$628.94 |
| Rate for Payer: Aetna Commercial |
$566.05
|
| Rate for Payer: Aetna Medicare |
$314.47
|
| Rate for Payer: ASR ASR |
$610.07
|
| Rate for Payer: ASR Commercial |
$610.07
|
| Rate for Payer: BCBS Complete |
$251.58
|
| Rate for Payer: BCBS Trust/PPO |
$515.04
|
| Rate for Payer: BCN Commercial |
$487.62
|
| Rate for Payer: Cash Price |
$503.15
|
| Rate for Payer: Cofinity Commercial |
$591.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.15
|
| Rate for Payer: Healthscope Commercial |
$628.94
|
| Rate for Payer: Healthscope Whirlpool |
$610.07
|
| Rate for Payer: Mclaren Commercial |
$566.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.60
|
| Rate for Payer: Nomi Health Commercial |
$515.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$551.08
|
| Rate for Payer: Priority Health Narrow Network |
$440.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$553.47
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
IP
|
$628.94
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.81 |
| Max. Negotiated Rate |
$628.94 |
| Rate for Payer: Aetna Commercial |
$566.05
|
| Rate for Payer: ASR ASR |
$610.07
|
| Rate for Payer: ASR Commercial |
$610.07
|
| Rate for Payer: BCBS Trust/PPO |
$512.52
|
| Rate for Payer: BCN Commercial |
$487.62
|
| Rate for Payer: Cash Price |
$503.15
|
| Rate for Payer: Cofinity Commercial |
$591.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.15
|
| Rate for Payer: Healthscope Commercial |
$628.94
|
| Rate for Payer: Healthscope Whirlpool |
$610.07
|
| Rate for Payer: Mclaren Commercial |
$566.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.60
|
| Rate for Payer: Nomi Health Commercial |
$515.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$553.47
|
|
