|
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
|
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 |
$6,102.65
|
| 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
|
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 |
$17,143.36 |
| Rate for Payer: Aetna Commercial |
$6,698.02
|
| 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 |
$7,218.98
|
| Rate for Payer: ASR Commercial |
$7,218.98
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$6,094.46
|
| Rate for Payer: BCN Commercial |
$5,769.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| 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 |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$7,442.25
|
| Rate for Payer: Healthscope Whirlpool |
$7,218.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$6,698.02
|
| 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 |
$6,325.91
|
| Rate for Payer: Nomi Health Commercial |
$6,102.65
|
| 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 |
$4,837.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,520.90
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$5,217.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,549.18
|
| 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 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 |
$1,645.35 |
| Max. Negotiated Rate |
$5,369.59 |
| Rate for Payer: Aetna Commercial |
$4,832.63
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$5,208.50
|
| Rate for Payer: ASR Commercial |
$5,208.50
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,397.16
|
| Rate for Payer: BCN Commercial |
$4,163.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| 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 |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$5,369.59
|
| Rate for Payer: Healthscope Whirlpool |
$5,208.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,832.63
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| 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 |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| 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 |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,764.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,725.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
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 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 |
$127.14 |
| Max. Negotiated Rate |
$2,172.48 |
| Rate for Payer: Aetna Commercial |
$1,955.23
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$2,107.31
|
| Rate for Payer: ASR Commercial |
$2,107.31
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.04
|
| Rate for Payer: BCN Commercial |
$1,684.32
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| 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 |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$2,172.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,107.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$1,955.23
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| 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 |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| 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 |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.91
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,911.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
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 UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$539.87 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$449.53
|
| Rate for Payer: ASR Commercial |
$449.53
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$379.50
|
| Rate for Payer: BCN Commercial |
$359.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| 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 |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$463.43
|
| Rate for Payer: Healthscope Whirlpool |
$449.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$417.09
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: Nomi Health Commercial |
$380.01
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$406.06
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$324.86
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
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: 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 |
$313.14
|
| Rate for Payer: Priority Health Narrow Network |
$250.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
|
|
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 VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.16 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: Aetna Medicare |
$245.20
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Complete |
$196.16
|
| Rate for Payer: BCBS Trust/PPO |
$401.59
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.69
|
| Rate for Payer: Priority Health Narrow Network |
$343.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Trust/PPO |
$399.63
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,010.42
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$1,089.01
|
| Rate for Payer: ASR Commercial |
$1,089.01
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$919.37
|
| Rate for Payer: BCN Commercial |
$870.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$1,055.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,122.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,010.42
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.70
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$787.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$1,122.69 |
| Rate for Payer: Aetna Commercial |
$1,010.42
|
| Rate for Payer: ASR ASR |
$1,089.01
|
| Rate for Payer: ASR Commercial |
$1,089.01
|
| Rate for Payer: BCBS Trust/PPO |
$914.88
|
| Rate for Payer: BCN Commercial |
$870.42
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$1,055.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,122.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.01
|
| Rate for Payer: Mclaren Commercial |
$1,010.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.97
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,285.96
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$1,385.98
|
| Rate for Payer: ASR Commercial |
$1,385.98
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.09
|
| Rate for Payer: BCN Commercial |
$1,107.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,343.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,428.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,385.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,285.96
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,251.96
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,001.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$928.75 |
| Max. Negotiated Rate |
$1,428.85 |
| Rate for Payer: Aetna Commercial |
$1,285.96
|
| Rate for Payer: ASR ASR |
$1,385.98
|
| Rate for Payer: ASR Commercial |
$1,385.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.37
|
| Rate for Payer: BCN Commercial |
$1,107.79
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,343.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Healthscope Commercial |
$1,428.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,385.98
|
| Rate for Payer: Mclaren Commercial |
$1,285.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.39
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,421.50
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,687.62
|
| Rate for Payer: ASR Commercial |
$3,687.62
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,113.19
|
| Rate for Payer: BCN Commercial |
$2,947.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| 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 |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,801.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,687.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,421.50
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| 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 |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| 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 |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,664.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,345.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,320.61 |
| Max. Negotiated Rate |
$3,570.17 |
| Rate for Payer: Aetna Commercial |
$3,213.15
|
| Rate for Payer: ASR ASR |
$3,463.06
|
| Rate for Payer: ASR Commercial |
$3,463.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.33
|
| Rate for Payer: BCN Commercial |
$2,767.95
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,355.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Healthscope Commercial |
$3,570.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.06
|
| Rate for Payer: Mclaren Commercial |
$3,213.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.75
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,213.15
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,463.06
|
| Rate for Payer: ASR Commercial |
$3,463.06
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: BCN Commercial |
$2,767.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,355.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,570.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,213.15
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,128.18
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
