|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,401.96
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,160.78 |
| Max. Negotiated Rate |
$5,401.96 |
| Rate for Payer: Aetna Commercial |
$4,861.76
|
| Rate for Payer: Aetna Medicare |
$2,700.98
|
| Rate for Payer: ASR ASR |
$5,239.90
|
| Rate for Payer: ASR Commercial |
$5,239.90
|
| Rate for Payer: BCBS Complete |
$2,160.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,423.67
|
| Rate for Payer: BCN Commercial |
$4,188.14
|
| Rate for Payer: Cash Price |
$4,321.57
|
| Rate for Payer: Cofinity Commercial |
$5,077.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,321.57
|
| Rate for Payer: Healthscope Commercial |
$5,401.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,239.90
|
| Rate for Payer: Mclaren Commercial |
$4,861.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,591.67
|
| Rate for Payer: Nomi Health Commercial |
$4,429.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,511.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,733.20
|
| Rate for Payer: Priority Health Narrow Network |
$3,786.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,753.72
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,112.73 |
| Max. Negotiated Rate |
$10,281.82 |
| Rate for Payer: Aetna Commercial |
$9,253.64
|
| Rate for Payer: Aetna Medicare |
$5,140.91
|
| Rate for Payer: ASR ASR |
$9,973.37
|
| Rate for Payer: ASR Commercial |
$9,973.37
|
| Rate for Payer: BCBS Complete |
$4,112.73
|
| Rate for Payer: BCBS Trust/PPO |
$8,419.78
|
| Rate for Payer: BCN Commercial |
$7,971.50
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$9,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$10,281.82
|
| Rate for Payer: Healthscope Whirlpool |
$9,973.37
|
| Rate for Payer: Mclaren Commercial |
$9,253.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: Nomi Health Commercial |
$8,431.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,008.93
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,048.00
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,281.82
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,683.18 |
| Max. Negotiated Rate |
$10,281.82 |
| Rate for Payer: Aetna Commercial |
$9,253.64
|
| Rate for Payer: ASR ASR |
$9,973.37
|
| Rate for Payer: ASR Commercial |
$9,973.37
|
| Rate for Payer: BCBS Trust/PPO |
$8,378.66
|
| Rate for Payer: BCN Commercial |
$7,971.50
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$9,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$10,281.82
|
| Rate for Payer: Healthscope Whirlpool |
$9,973.37
|
| Rate for Payer: Mclaren Commercial |
$9,253.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: Nomi Health Commercial |
$8,431.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,048.00
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,112.73 |
| Max. Negotiated Rate |
$10,281.82 |
| Rate for Payer: Aetna Commercial |
$9,253.64
|
| Rate for Payer: Aetna Medicare |
$5,140.91
|
| Rate for Payer: ASR ASR |
$9,973.37
|
| Rate for Payer: ASR Commercial |
$9,973.37
|
| Rate for Payer: BCBS Complete |
$4,112.73
|
| Rate for Payer: BCBS Trust/PPO |
$8,419.78
|
| Rate for Payer: BCN Commercial |
$7,971.50
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$9,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$10,281.82
|
| Rate for Payer: Healthscope Whirlpool |
$9,973.37
|
| Rate for Payer: Mclaren Commercial |
$9,253.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: Nomi Health Commercial |
$8,431.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,008.93
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,048.00
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,281.82
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,683.18 |
| Max. Negotiated Rate |
$10,281.82 |
| Rate for Payer: Aetna Commercial |
$9,253.64
|
| Rate for Payer: ASR ASR |
$9,973.37
|
| Rate for Payer: ASR Commercial |
$9,973.37
|
| Rate for Payer: BCBS Trust/PPO |
$8,378.66
|
| Rate for Payer: BCN Commercial |
$7,971.50
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$9,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$10,281.82
|
| Rate for Payer: Healthscope Whirlpool |
$9,973.37
|
| Rate for Payer: Mclaren Commercial |
$9,253.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: Nomi Health Commercial |
$8,431.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,048.00
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,306.79 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$1,809.40
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$1,950.13
|
| Rate for Payer: ASR Commercial |
$1,950.13
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.35
|
| Rate for Payer: BCN Commercial |
$1,558.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cofinity Commercial |
$1,889.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,010.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,950.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$1,809.40
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.87
|
| Rate for Payer: Nomi Health Commercial |
$1,648.56
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,761.55
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,409.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,769.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,306.79 |
| Max. Negotiated Rate |
$2,010.44 |
| Rate for Payer: Aetna Commercial |
$1,809.40
|
| Rate for Payer: ASR ASR |
$1,950.13
|
| Rate for Payer: ASR Commercial |
$1,950.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,638.31
|
| Rate for Payer: BCN Commercial |
$1,558.69
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cofinity Commercial |
$1,889.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.35
|
| Rate for Payer: Healthscope Commercial |
$2,010.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,950.13
|
| Rate for Payer: Mclaren Commercial |
$1,809.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.87
|
| Rate for Payer: Nomi Health Commercial |
$1,648.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,769.19
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,149.58
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$3,394.54
|
| Rate for Payer: ASR Commercial |
$3,394.54
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,865.77
|
| Rate for Payer: BCN Commercial |
$2,713.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,799.62
|
| 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: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,499.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,394.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,149.58
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$2,869.61
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| 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 Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,453.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,079.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
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 IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.61 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Aetna Commercial |
$111.36
|
| Rate for Payer: Aetna Medicare |
$38.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: ASR ASR |
$120.02
|
| Rate for Payer: ASR Commercial |
$120.02
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$101.32
|
| Rate for Payer: BCN Commercial |
$95.93
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$123.73
|
| Rate for Payer: Healthscope Whirlpool |
$120.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.46
|
| Rate for Payer: Mclaren Commercial |
$111.36
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: Nomi Health Commercial |
$101.46
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: PHP Medicaid |
$20.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.41
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$86.73
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$59.61
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP DNSP |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: VA VA |
$38.46
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.42 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Aetna Commercial |
$111.36
|
| Rate for Payer: ASR ASR |
$120.02
|
| Rate for Payer: ASR Commercial |
$120.02
|
| Rate for Payer: BCBS Trust/PPO |
$100.83
|
| Rate for Payer: BCN Commercial |
$95.93
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Healthscope Commercial |
$123.73
|
| Rate for Payer: Healthscope Whirlpool |
$120.02
|
| Rate for Payer: Mclaren Commercial |
$111.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: Nomi Health Commercial |
$101.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.88
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,265.55 |
| Max. Negotiated Rate |
$3,485.46 |
| Rate for Payer: Aetna Commercial |
$3,136.91
|
| Rate for Payer: ASR ASR |
$3,380.90
|
| Rate for Payer: ASR Commercial |
$3,380.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,840.30
|
| Rate for Payer: BCN Commercial |
$2,702.28
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$3,276.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Healthscope Commercial |
$3,485.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,380.90
|
| Rate for Payer: Mclaren Commercial |
$3,136.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.64
|
| Rate for Payer: Nomi Health Commercial |
$2,858.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,067.20
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,265.55 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$3,136.91
|
| Rate for Payer: Aetna Medicare |
$5,296.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: ASR ASR |
$3,380.90
|
| Rate for Payer: ASR Commercial |
$3,380.90
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,854.24
|
| Rate for Payer: BCN Commercial |
$2,702.28
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$3,276.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$3,485.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,380.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$3,136.91
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.64
|
| Rate for Payer: Nomi Health Commercial |
$2,858.08
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$5,826.04
|
| Rate for Payer: PHP Medicaid |
$2,838.87
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,053.96
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,443.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,067.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$8,209.42
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP DNSP |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: VA VA |
$5,296.40
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,994.22 |
| Max. Negotiated Rate |
$11,023.53 |
| Rate for Payer: Aetna Commercial |
$9,921.18
|
| Rate for Payer: Aetna Medicare |
$5,586.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: ASR ASR |
$10,692.82
|
| Rate for Payer: ASR Commercial |
$10,692.82
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$9,027.17
|
| Rate for Payer: BCN Commercial |
$8,546.54
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$10,362.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$11,023.53
|
| Rate for Payer: Healthscope Whirlpool |
$10,692.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,586.24
|
| Rate for Payer: Mclaren Commercial |
$9,921.18
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: Nomi Health Commercial |
$9,039.29
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$6,144.86
|
| Rate for Payer: PHP Medicaid |
$2,994.22
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,658.82
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,727.49
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,700.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$8,658.67
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP DNSP |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: VA VA |
$5,586.24
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,165.29 |
| Max. Negotiated Rate |
$11,023.53 |
| Rate for Payer: Aetna Commercial |
$9,921.18
|
| Rate for Payer: ASR ASR |
$10,692.82
|
| Rate for Payer: ASR Commercial |
$10,692.82
|
| Rate for Payer: BCBS Trust/PPO |
$8,983.07
|
| Rate for Payer: BCN Commercial |
$8,546.54
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$10,362.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Healthscope Commercial |
$11,023.53
|
| Rate for Payer: Healthscope Whirlpool |
$10,692.82
|
| Rate for Payer: Mclaren Commercial |
$9,921.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: Nomi Health Commercial |
$9,039.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,700.71
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,224.50 |
| Max. Negotiated Rate |
$11,114.61 |
| Rate for Payer: Aetna Commercial |
$10,003.15
|
| Rate for Payer: ASR ASR |
$10,781.17
|
| Rate for Payer: ASR Commercial |
$10,781.17
|
| Rate for Payer: BCBS Trust/PPO |
$9,057.30
|
| Rate for Payer: BCN Commercial |
$8,617.16
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$10,447.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Healthscope Commercial |
$11,114.61
|
| Rate for Payer: Healthscope Whirlpool |
$10,781.17
|
| Rate for Payer: Mclaren Commercial |
$10,003.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: Nomi Health Commercial |
$9,113.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,780.86
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,994.22 |
| Max. Negotiated Rate |
$11,114.61 |
| Rate for Payer: Aetna Commercial |
$10,003.15
|
| Rate for Payer: Aetna Medicare |
$5,586.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: ASR ASR |
$10,781.17
|
| Rate for Payer: ASR Commercial |
$10,781.17
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$9,101.75
|
| Rate for Payer: BCN Commercial |
$8,617.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$10,447.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$11,114.61
|
| Rate for Payer: Healthscope Whirlpool |
$10,781.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,586.24
|
| Rate for Payer: Mclaren Commercial |
$10,003.15
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: Nomi Health Commercial |
$9,113.98
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$6,144.86
|
| Rate for Payer: PHP Medicaid |
$2,994.22
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,738.62
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,791.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,780.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$8,658.67
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP DNSP |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: VA VA |
$5,586.24
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,694.88 |
| Max. Negotiated Rate |
$7,222.90 |
| Rate for Payer: Aetna Commercial |
$6,500.61
|
| Rate for Payer: ASR ASR |
$7,006.21
|
| Rate for Payer: ASR Commercial |
$7,006.21
|
| Rate for Payer: BCBS Trust/PPO |
$5,885.94
|
| Rate for Payer: BCN Commercial |
$5,599.91
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$6,789.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$7,222.90
|
| Rate for Payer: Healthscope Whirlpool |
$7,006.21
|
| Rate for Payer: Mclaren Commercial |
$6,500.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.46
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,356.15
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,889.16 |
| Max. Negotiated Rate |
$7,222.90 |
| Rate for Payer: Aetna Commercial |
$6,500.61
|
| Rate for Payer: Aetna Medicare |
$3,611.45
|
| Rate for Payer: ASR ASR |
$7,006.21
|
| Rate for Payer: ASR Commercial |
$7,006.21
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: BCBS Trust/PPO |
$5,914.83
|
| Rate for Payer: BCN Commercial |
$5,599.91
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$6,789.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$7,222.90
|
| Rate for Payer: Healthscope Whirlpool |
$7,006.21
|
| Rate for Payer: Mclaren Commercial |
$6,500.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.46
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,328.70
|
| Rate for Payer: Priority Health Narrow Network |
$5,063.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,356.15
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$11,176.19
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$12,045.45
|
| Rate for Payer: ASR Commercial |
$12,045.45
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$10,169.09
|
| Rate for Payer: BCN Commercial |
$9,627.67
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$11,672.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$12,417.99
|
| Rate for Payer: Healthscope Whirlpool |
$12,045.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$11,176.19
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,880.64
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$8,705.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,927.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,071.69 |
| Max. Negotiated Rate |
$12,417.99 |
| Rate for Payer: Aetna Commercial |
$11,176.19
|
| Rate for Payer: ASR ASR |
$12,045.45
|
| Rate for Payer: ASR Commercial |
$12,045.45
|
| Rate for Payer: BCBS Trust/PPO |
$10,119.42
|
| Rate for Payer: BCN Commercial |
$9,627.67
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$11,672.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$12,417.99
|
| Rate for Payer: Healthscope Whirlpool |
$12,045.45
|
| Rate for Payer: Mclaren Commercial |
$11,176.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,927.83
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,909.20 |
| Max. Negotiated Rate |
$13,706.46 |
| Rate for Payer: Aetna Commercial |
$12,335.81
|
| Rate for Payer: ASR ASR |
$13,295.27
|
| Rate for Payer: ASR Commercial |
$13,295.27
|
| Rate for Payer: BCBS Trust/PPO |
$11,169.39
|
| Rate for Payer: BCN Commercial |
$10,626.62
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$12,884.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Healthscope Commercial |
$13,706.46
|
| Rate for Payer: Healthscope Whirlpool |
$13,295.27
|
| Rate for Payer: Mclaren Commercial |
$12,335.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: Nomi Health Commercial |
$11,239.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,061.68
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$12,335.81
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$13,295.27
|
| Rate for Payer: ASR Commercial |
$13,295.27
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$11,224.22
|
| Rate for Payer: BCN Commercial |
$10,626.62
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$12,884.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$13,706.46
|
| Rate for Payer: Healthscope Whirlpool |
$13,295.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$12,335.81
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: Nomi Health Commercial |
$11,239.30
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,009.60
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$9,608.23
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,061.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,033.62 |
| Max. Negotiated Rate |
$7,584.04 |
| Rate for Payer: Aetna Commercial |
$6,825.64
|
| Rate for Payer: Aetna Medicare |
$3,792.02
|
| Rate for Payer: ASR ASR |
$7,356.52
|
| Rate for Payer: ASR Commercial |
$7,356.52
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: BCBS Trust/PPO |
$6,210.57
|
| Rate for Payer: BCN Commercial |
$5,879.91
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$7,129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$7,584.04
|
| Rate for Payer: Healthscope Whirlpool |
$7,356.52
|
| Rate for Payer: Mclaren Commercial |
$6,825.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Nomi Health Commercial |
$6,218.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,645.14
|
| Rate for Payer: Priority Health Narrow Network |
$5,316.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,673.96
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,929.63 |
| Max. Negotiated Rate |
$7,584.04 |
| Rate for Payer: Aetna Commercial |
$6,825.64
|
| Rate for Payer: ASR ASR |
$7,356.52
|
| Rate for Payer: ASR Commercial |
$7,356.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,180.23
|
| Rate for Payer: BCN Commercial |
$5,879.91
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$7,129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$7,584.04
|
| Rate for Payer: Healthscope Whirlpool |
$7,356.52
|
| Rate for Payer: Mclaren Commercial |
$6,825.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Nomi Health Commercial |
$6,218.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,673.96
|
|
