|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$408.20 |
| Rate for Payer: Aetna Commercial |
$367.38
|
| Rate for Payer: ASR ASR |
$395.95
|
| Rate for Payer: ASR Commercial |
$395.95
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$316.48
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$383.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$408.20
|
| Rate for Payer: Healthscope Whirlpool |
$395.95
|
| Rate for Payer: Mclaren Commercial |
$367.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.22
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,019.23 |
| Max. Negotiated Rate |
$1,568.04 |
| Rate for Payer: Aetna Commercial |
$1,411.24
|
| Rate for Payer: ASR ASR |
$1,521.00
|
| Rate for Payer: ASR Commercial |
$1,521.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.80
|
| Rate for Payer: BCN Commercial |
$1,215.70
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,473.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,568.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.00
|
| Rate for Payer: Mclaren Commercial |
$1,411.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,379.88
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$627.22 |
| Max. Negotiated Rate |
$1,568.04 |
| Rate for Payer: Aetna Commercial |
$1,411.24
|
| Rate for Payer: Aetna Medicare |
$784.02
|
| Rate for Payer: ASR ASR |
$1,521.00
|
| Rate for Payer: ASR Commercial |
$1,521.00
|
| Rate for Payer: BCBS Complete |
$627.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.07
|
| Rate for Payer: BCN Commercial |
$1,215.70
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,473.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,568.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.00
|
| Rate for Payer: Mclaren Commercial |
$1,411.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,373.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,099.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,379.88
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,471.09 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$3,421.50
|
| 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 |
$3,687.62
|
| Rate for Payer: ASR Commercial |
$3,687.62
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,113.19
|
| Rate for Payer: BCN Commercial |
$2,947.43
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,573.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$3,801.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,687.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$3,421.50
|
| 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 |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| 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 |
$2,471.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,331.02
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,664.97
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,345.47
|
| 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 SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,471.09 |
| Max. Negotiated Rate |
$3,801.67 |
| Rate for Payer: Aetna Commercial |
$3,421.50
|
| Rate for Payer: ASR ASR |
$3,687.62
|
| Rate for Payer: ASR Commercial |
$3,687.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.98
|
| Rate for Payer: BCN Commercial |
$2,947.43
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,573.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Healthscope Commercial |
$3,801.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,687.62
|
| Rate for Payer: Mclaren Commercial |
$3,421.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,345.47
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,725.24 |
| Max. Negotiated Rate |
$2,654.21 |
| Rate for Payer: Aetna Commercial |
$2,388.79
|
| Rate for Payer: ASR ASR |
$2,574.58
|
| Rate for Payer: ASR Commercial |
$2,574.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,162.92
|
| Rate for Payer: BCN Commercial |
$2,057.81
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$2,494.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Healthscope Commercial |
$2,654.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,574.58
|
| Rate for Payer: Mclaren Commercial |
$2,388.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: Nomi Health Commercial |
$2,176.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,335.70
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,654.21 |
| Rate for Payer: Aetna Commercial |
$2,388.79
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$2,574.58
|
| Rate for Payer: ASR Commercial |
$2,574.58
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.53
|
| Rate for Payer: BCN Commercial |
$2,057.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$2,494.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$2,654.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,574.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$2,388.79
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: Nomi Health Commercial |
$2,176.45
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,325.62
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,860.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,335.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,500.92 |
| Max. Negotiated Rate |
$27,270.14 |
| Rate for Payer: Aetna Commercial |
$7,616.66
|
| 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 |
$8,209.07
|
| Rate for Payer: ASR Commercial |
$8,209.07
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$6,930.32
|
| Rate for Payer: BCN Commercial |
$6,561.33
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$7,955.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$8,462.96
|
| Rate for Payer: Healthscope Whirlpool |
$8,209.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$7,616.66
|
| 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 |
$7,193.52
|
| Rate for Payer: Nomi Health Commercial |
$6,939.63
|
| 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 |
$5,500.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,415.25
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$5,932.53
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,447.40
|
| 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 THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,500.92 |
| Max. Negotiated Rate |
$8,462.96 |
| Rate for Payer: Aetna Commercial |
$7,616.66
|
| Rate for Payer: ASR ASR |
$8,209.07
|
| Rate for Payer: ASR Commercial |
$8,209.07
|
| Rate for Payer: BCBS Trust/PPO |
$6,896.47
|
| Rate for Payer: BCN Commercial |
$6,561.33
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$7,955.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Healthscope Commercial |
$8,462.96
|
| Rate for Payer: Healthscope Whirlpool |
$8,209.07
|
| Rate for Payer: Mclaren Commercial |
$7,616.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,193.52
|
| Rate for Payer: Nomi Health Commercial |
$6,939.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,500.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,447.40
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.52 |
| Max. Negotiated Rate |
$2,403.79 |
| Rate for Payer: Aetna Commercial |
$2,163.41
|
| Rate for Payer: Aetna Medicare |
$1,201.90
|
| Rate for Payer: ASR ASR |
$2,331.68
|
| Rate for Payer: ASR Commercial |
$2,331.68
|
| Rate for Payer: BCBS Complete |
$961.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,968.46
|
| Rate for Payer: BCN Commercial |
$1,863.66
|
| Rate for Payer: Cash Price |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$2,259.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.03
|
| Rate for Payer: Healthscope Commercial |
$2,403.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,331.68
|
| Rate for Payer: Mclaren Commercial |
$2,163.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.22
|
| Rate for Payer: Nomi Health Commercial |
$1,971.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,106.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,685.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,115.34
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,562.46 |
| Max. Negotiated Rate |
$2,403.79 |
| Rate for Payer: Aetna Commercial |
$2,163.41
|
| Rate for Payer: ASR ASR |
$2,331.68
|
| Rate for Payer: ASR Commercial |
$2,331.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,958.85
|
| Rate for Payer: BCN Commercial |
$1,863.66
|
| Rate for Payer: Cash Price |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$2,259.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.03
|
| Rate for Payer: Healthscope Commercial |
$2,403.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,331.68
|
| Rate for Payer: Mclaren Commercial |
$2,163.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.22
|
| Rate for Payer: Nomi Health Commercial |
$1,971.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,115.34
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,287.22 |
| Max. Negotiated Rate |
$5,718.04 |
| Rate for Payer: Aetna Commercial |
$5,146.24
|
| Rate for Payer: Aetna Medicare |
$2,859.02
|
| Rate for Payer: ASR ASR |
$5,546.50
|
| Rate for Payer: ASR Commercial |
$5,546.50
|
| Rate for Payer: BCBS Complete |
$2,287.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,682.50
|
| Rate for Payer: BCN Commercial |
$4,433.20
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$5,374.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Healthscope Commercial |
$5,718.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,546.50
|
| Rate for Payer: Mclaren Commercial |
$5,146.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: Nomi Health Commercial |
$4,688.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,010.15
|
| Rate for Payer: Priority Health Narrow Network |
$4,008.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,031.88
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,716.73 |
| Max. Negotiated Rate |
$5,718.04 |
| Rate for Payer: Aetna Commercial |
$5,146.24
|
| Rate for Payer: ASR ASR |
$5,546.50
|
| Rate for Payer: ASR Commercial |
$5,546.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,659.63
|
| Rate for Payer: BCN Commercial |
$4,433.20
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$5,374.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Healthscope Commercial |
$5,718.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,546.50
|
| Rate for Payer: Mclaren Commercial |
$5,146.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: Nomi Health Commercial |
$4,688.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,031.88
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,837.46 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$6,698.02
|
| 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 |
$7,218.98
|
| Rate for Payer: ASR Commercial |
$7,218.98
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,094.46
|
| Rate for Payer: BCN Commercial |
$5,769.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$6,995.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$7,442.25
|
| Rate for Payer: Healthscope Whirlpool |
$7,218.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$6,698.02
|
| 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 |
$6,325.91
|
| Rate for Payer: Nomi Health Commercial |
$6,102.64
|
| 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 |
$4,837.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,520.90
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$5,217.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,549.18
|
| 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 THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,837.46 |
| Max. Negotiated Rate |
$7,442.25 |
| Rate for Payer: Aetna Commercial |
$6,698.02
|
| Rate for Payer: ASR ASR |
$7,218.98
|
| Rate for Payer: ASR Commercial |
$7,218.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,064.69
|
| Rate for Payer: BCN Commercial |
$5,769.98
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$6,995.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Healthscope Commercial |
$7,442.25
|
| Rate for Payer: Healthscope Whirlpool |
$7,218.98
|
| Rate for Payer: Mclaren Commercial |
$6,698.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,325.91
|
| Rate for Payer: Nomi Health Commercial |
$6,102.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,837.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,549.18
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,490.23 |
| Max. Negotiated Rate |
$5,369.59 |
| Rate for Payer: Aetna Commercial |
$4,832.63
|
| Rate for Payer: ASR ASR |
$5,208.50
|
| Rate for Payer: ASR Commercial |
$5,208.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,375.68
|
| Rate for Payer: BCN Commercial |
$4,163.04
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$5,047.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Healthscope Commercial |
$5,369.59
|
| Rate for Payer: Healthscope Whirlpool |
$5,208.50
|
| Rate for Payer: Mclaren Commercial |
$4,832.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,564.15
|
| Rate for Payer: Nomi Health Commercial |
$4,403.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,490.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,725.24
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$5,369.59 |
| Rate for Payer: Aetna Commercial |
$4,832.63
|
| 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 |
$5,208.50
|
| Rate for Payer: ASR Commercial |
$5,208.50
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,397.16
|
| Rate for Payer: BCN Commercial |
$4,163.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$5,047.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$5,369.59
|
| Rate for Payer: Healthscope Whirlpool |
$5,208.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,832.63
|
| 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 |
$4,564.15
|
| Rate for Payer: Nomi Health Commercial |
$4,403.06
|
| 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 |
$3,490.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,704.83
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,764.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,725.24
|
| 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 TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$719.38 |
| Max. Negotiated Rate |
$1,798.46 |
| Rate for Payer: Aetna Commercial |
$1,618.61
|
| Rate for Payer: Aetna Medicare |
$899.23
|
| Rate for Payer: ASR ASR |
$1,744.51
|
| Rate for Payer: ASR Commercial |
$1,744.51
|
| Rate for Payer: BCBS Complete |
$719.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,472.76
|
| Rate for Payer: BCN Commercial |
$1,394.35
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,690.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Healthscope Commercial |
$1,798.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,744.51
|
| Rate for Payer: Mclaren Commercial |
$1,618.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: Nomi Health Commercial |
$1,474.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,575.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,582.64
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,169.00 |
| Max. Negotiated Rate |
$1,798.46 |
| Rate for Payer: Aetna Commercial |
$1,618.61
|
| Rate for Payer: ASR ASR |
$1,744.51
|
| Rate for Payer: ASR Commercial |
$1,744.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,465.57
|
| Rate for Payer: BCN Commercial |
$1,394.35
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,690.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Healthscope Commercial |
$1,798.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,744.51
|
| Rate for Payer: Mclaren Commercial |
$1,618.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: Nomi Health Commercial |
$1,474.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,582.64
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,412.11 |
| Max. Negotiated Rate |
$2,172.48 |
| Rate for Payer: Aetna Commercial |
$1,955.23
|
| Rate for Payer: ASR ASR |
$2,107.31
|
| Rate for Payer: ASR Commercial |
$2,107.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.35
|
| Rate for Payer: BCN Commercial |
$1,684.32
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$2,042.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Healthscope Commercial |
$2,172.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,107.31
|
| Rate for Payer: Mclaren Commercial |
$1,955.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,846.61
|
| Rate for Payer: Nomi Health Commercial |
$1,781.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,412.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,911.78
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$2,172.48 |
| Rate for Payer: Aetna Commercial |
$1,955.23
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$2,107.31
|
| Rate for Payer: ASR Commercial |
$2,107.31
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.04
|
| Rate for Payer: BCN Commercial |
$1,684.32
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$2,042.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$2,172.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,107.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$1,955.23
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,846.61
|
| Rate for Payer: Nomi Health Commercial |
$1,781.43
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,412.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.53
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.91
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,911.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$542.36 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$449.53
|
| Rate for Payer: ASR Commercial |
$449.53
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$379.50
|
| Rate for Payer: BCN Commercial |
$359.30
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$435.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$463.43
|
| Rate for Payer: Healthscope Whirlpool |
$449.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$417.09
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: Nomi Health Commercial |
$380.01
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.49
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$309.19
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$301.23 |
| Max. Negotiated Rate |
$463.43 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: ASR ASR |
$449.53
|
| Rate for Payer: ASR Commercial |
$449.53
|
| Rate for Payer: BCBS Trust/PPO |
$377.65
|
| Rate for Payer: BCN Commercial |
$359.30
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$435.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Healthscope Commercial |
$463.43
|
| Rate for Payer: Healthscope Whirlpool |
$449.53
|
| Rate for Payer: Mclaren Commercial |
$417.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: Nomi Health Commercial |
$380.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.82
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$321.64
|
| Rate for Payer: ASR ASR |
$346.66
|
| Rate for Payer: ASR Commercial |
$346.66
|
| Rate for Payer: BCBS Trust/PPO |
$291.23
|
| Rate for Payer: BCN Commercial |
$277.08
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$357.38
|
| Rate for Payer: Healthscope Whirlpool |
$346.66
|
| Rate for Payer: Mclaren Commercial |
$321.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$142.95 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$321.64
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: ASR ASR |
$346.66
|
| Rate for Payer: ASR Commercial |
$346.66
|
| Rate for Payer: BCBS Complete |
$142.95
|
| Rate for Payer: BCBS Trust/PPO |
$292.66
|
| Rate for Payer: BCN Commercial |
$277.08
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$357.38
|
| Rate for Payer: Healthscope Whirlpool |
$346.66
|
| Rate for Payer: Mclaren Commercial |
$321.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.57
|
| Rate for Payer: Priority Health Narrow Network |
$215.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
|
