|
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
|
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 |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$3,136.91
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$3,380.90
|
| Rate for Payer: ASR Commercial |
$3,380.90
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,854.24
|
| Rate for Payer: BCN Commercial |
$2,702.28
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| 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 |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,485.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,380.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$3,136.91
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| 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 |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| 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 |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,443.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,067.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
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 REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$11,023.53 |
| Rate for Payer: Aetna Commercial |
$9,921.18
|
| Rate for Payer: Aetna Medicare |
$5,560.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: ASR ASR |
$10,692.82
|
| Rate for Payer: ASR Commercial |
$10,692.82
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCBS Trust/PPO |
$9,027.17
|
| Rate for Payer: BCN Commercial |
$8,546.54
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| 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 |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$11,023.53
|
| Rate for Payer: Healthscope Whirlpool |
$10,692.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,560.58
|
| Rate for Payer: Mclaren Commercial |
$9,921.18
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| 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 |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$6,116.64
|
| Rate for Payer: PHP Medicaid |
$2,980.47
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| 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 |
$5,560.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,727.49
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,700.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$8,618.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP DNSP |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
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
|
OP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$11,114.61 |
| Rate for Payer: Aetna Commercial |
$10,003.15
|
| Rate for Payer: Aetna Medicare |
$5,560.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: ASR ASR |
$10,781.17
|
| Rate for Payer: ASR Commercial |
$10,781.17
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCBS Trust/PPO |
$9,101.75
|
| Rate for Payer: BCN Commercial |
$8,617.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| 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 |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$11,114.61
|
| Rate for Payer: Healthscope Whirlpool |
$10,781.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,560.58
|
| Rate for Payer: Mclaren Commercial |
$10,003.15
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| 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 |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$6,116.64
|
| Rate for Payer: PHP Medicaid |
$2,980.47
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| 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 |
$5,560.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,791.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,780.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$8,618.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP DNSP |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
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 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 |
$6,139.47
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| 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 EACH ADDITIONAL
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,694.89 |
| 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 |
$6,139.47
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| 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 |
$5,928.28 |
| Max. Negotiated Rate |
$17,143.36 |
| Rate for Payer: Aetna Commercial |
$11,176.19
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$12,045.45
|
| Rate for Payer: ASR Commercial |
$12,045.45
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$10,169.09
|
| Rate for Payer: BCN Commercial |
$9,627.67
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| 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 |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$12,417.99
|
| Rate for Payer: Healthscope Whirlpool |
$12,045.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$11,176.19
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| 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 |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| 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 |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,705.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,927.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
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
|
OP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$17,143.36 |
| Rate for Payer: Aetna Commercial |
$12,335.81
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$13,295.27
|
| Rate for Payer: ASR Commercial |
$13,295.27
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$11,224.22
|
| Rate for Payer: BCN Commercial |
$10,626.62
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| 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 |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$13,706.46
|
| Rate for Payer: Healthscope Whirlpool |
$13,295.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$12,335.81
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| 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 |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| 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 |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$9,608.23
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,061.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
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 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
|
|
|
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 STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,044.54 |
| Max. Negotiated Rate |
$12,376.21 |
| Rate for Payer: Aetna Commercial |
$11,138.59
|
| Rate for Payer: ASR ASR |
$12,004.92
|
| Rate for Payer: ASR Commercial |
$12,004.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,085.37
|
| Rate for Payer: BCN Commercial |
$9,595.28
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$11,633.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$12,376.21
|
| Rate for Payer: Healthscope Whirlpool |
$12,004.92
|
| Rate for Payer: Mclaren Commercial |
$11,138.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: Nomi Health Commercial |
$10,148.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,891.06
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,950.48 |
| Max. Negotiated Rate |
$12,376.21 |
| Rate for Payer: Aetna Commercial |
$11,138.59
|
| Rate for Payer: Aetna Medicare |
$6,188.10
|
| Rate for Payer: ASR ASR |
$12,004.92
|
| Rate for Payer: ASR Commercial |
$12,004.92
|
| Rate for Payer: BCBS Complete |
$4,950.48
|
| Rate for Payer: BCBS Trust/PPO |
$10,134.88
|
| Rate for Payer: BCN Commercial |
$9,595.28
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$11,633.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$12,376.21
|
| Rate for Payer: Healthscope Whirlpool |
$12,004.92
|
| Rate for Payer: Mclaren Commercial |
$11,138.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: Nomi Health Commercial |
$10,148.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,844.04
|
| Rate for Payer: Priority Health Narrow Network |
$8,675.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,891.06
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,837.32 |
| Max. Negotiated Rate |
$10,518.95 |
| Rate for Payer: Aetna Commercial |
$9,467.06
|
| Rate for Payer: ASR ASR |
$10,203.38
|
| Rate for Payer: ASR Commercial |
$10,203.38
|
| Rate for Payer: BCBS Trust/PPO |
$8,571.89
|
| Rate for Payer: BCN Commercial |
$8,155.34
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$9,887.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$10,518.95
|
| Rate for Payer: Healthscope Whirlpool |
$10,203.38
|
| Rate for Payer: Mclaren Commercial |
$9,467.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Nomi Health Commercial |
$8,625.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,256.68
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,207.58 |
| Max. Negotiated Rate |
$10,518.95 |
| Rate for Payer: Aetna Commercial |
$9,467.06
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: ASR ASR |
$10,203.38
|
| Rate for Payer: ASR Commercial |
$10,203.38
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: BCBS Trust/PPO |
$8,613.97
|
| Rate for Payer: BCN Commercial |
$8,155.34
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$9,887.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$10,518.95
|
| Rate for Payer: Healthscope Whirlpool |
$10,203.38
|
| Rate for Payer: Mclaren Commercial |
$9,467.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Nomi Health Commercial |
$8,625.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,216.70
|
| Rate for Payer: Priority Health Narrow Network |
$7,373.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,256.68
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,399.59 |
| Max. Negotiated Rate |
$11,383.98 |
| Rate for Payer: Aetna Commercial |
$10,245.58
|
| Rate for Payer: ASR ASR |
$11,042.46
|
| Rate for Payer: ASR Commercial |
$11,042.46
|
| Rate for Payer: BCBS Trust/PPO |
$9,276.81
|
| Rate for Payer: BCN Commercial |
$8,826.00
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$10,700.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Healthscope Commercial |
$11,383.98
|
| Rate for Payer: Healthscope Whirlpool |
$11,042.46
|
| Rate for Payer: Mclaren Commercial |
$10,245.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: Nomi Health Commercial |
$9,334.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,017.90
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$11,383.98 |
| Rate for Payer: Aetna Commercial |
$10,245.58
|
| Rate for Payer: Aetna Medicare |
$5,560.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: ASR ASR |
$11,042.46
|
| Rate for Payer: ASR Commercial |
$11,042.46
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCBS Trust/PPO |
$9,322.34
|
| Rate for Payer: BCN Commercial |
$8,826.00
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$10,700.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$11,383.98
|
| Rate for Payer: Healthscope Whirlpool |
$11,042.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,560.58
|
| Rate for Payer: Mclaren Commercial |
$10,245.58
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: Nomi Health Commercial |
$9,334.86
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$6,116.64
|
| Rate for Payer: PHP Medicaid |
$2,980.47
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,974.64
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,980.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,017.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$8,618.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP DNSP |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$164.03
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$176.78
|
| Rate for Payer: ASR Commercial |
$176.78
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$149.24
|
| Rate for Payer: BCN Commercial |
$141.30
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$171.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$182.25
|
| Rate for Payer: Healthscope Whirlpool |
$176.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$164.03
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.69
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$127.76
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$118.46 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$164.03
|
| Rate for Payer: ASR ASR |
$176.78
|
| Rate for Payer: ASR Commercial |
$176.78
|
| Rate for Payer: BCBS Trust/PPO |
$148.52
|
| Rate for Payer: BCN Commercial |
$141.30
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$171.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Healthscope Commercial |
$182.25
|
| Rate for Payer: Healthscope Whirlpool |
$176.78
|
| Rate for Payer: Mclaren Commercial |
$164.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.38
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.44 |
| Max. Negotiated Rate |
$43.61 |
| Rate for Payer: Aetna Commercial |
$39.25
|
| Rate for Payer: Aetna Medicare |
$21.80
|
| Rate for Payer: ASR ASR |
$42.30
|
| Rate for Payer: ASR Commercial |
$42.30
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS Trust/PPO |
$35.71
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$40.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Healthscope Commercial |
$43.61
|
| Rate for Payer: Healthscope Whirlpool |
$42.30
|
| Rate for Payer: Mclaren Commercial |
$39.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: Nomi Health Commercial |
$35.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.21
|
| Rate for Payer: Priority Health Narrow Network |
$30.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.38
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$43.61 |
| Rate for Payer: Aetna Commercial |
$39.25
|
| Rate for Payer: ASR ASR |
$42.30
|
| Rate for Payer: ASR Commercial |
$42.30
|
| Rate for Payer: BCBS Trust/PPO |
$35.54
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$40.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Healthscope Commercial |
$43.61
|
| Rate for Payer: Healthscope Whirlpool |
$42.30
|
| Rate for Payer: Mclaren Commercial |
$39.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: Nomi Health Commercial |
$35.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.38
|
|
