|
HC REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$190.11
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$190.11 |
| Rate for Payer: Aetna Commercial |
$171.10
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$184.41
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$147.39
|
| Rate for Payer: BCN Commercial |
$147.39
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$190.11
|
| Rate for Payer: Healthscope Whirlpool |
$184.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$171.10
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.00
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$134.98
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.30
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$190.11
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$133.08 |
| Max. Negotiated Rate |
$190.11 |
| Rate for Payer: Aetna Commercial |
$171.10
|
| Rate for Payer: ASR ASR |
$184.41
|
| Rate for Payer: BCBS Trust/PPO |
$147.39
|
| Rate for Payer: BCN Commercial |
$147.39
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Healthscope Commercial |
$190.11
|
| Rate for Payer: Healthscope Whirlpool |
$184.41
|
| Rate for Payer: Mclaren Commercial |
$171.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.30
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,132.31
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,652.92 |
| Max. Negotiated Rate |
$4,132.31 |
| Rate for Payer: Aetna Commercial |
$3,719.08
|
| Rate for Payer: ASR ASR |
$4,008.34
|
| Rate for Payer: BCBS Complete |
$1,652.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.78
|
| Rate for Payer: BCN Commercial |
$3,203.78
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,884.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Healthscope Commercial |
$4,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,008.34
|
| Rate for Payer: Mclaren Commercial |
$3,719.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,760.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,933.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,636.43
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
IP
|
$4,132.31
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,892.62 |
| Max. Negotiated Rate |
$4,132.31 |
| Rate for Payer: Aetna Commercial |
$3,719.08
|
| Rate for Payer: ASR ASR |
$4,008.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.78
|
| Rate for Payer: BCN Commercial |
$3,203.78
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,884.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Healthscope Commercial |
$4,132.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,008.34
|
| Rate for Payer: Mclaren Commercial |
$3,719.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,636.43
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
IP
|
$1,610.04
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,127.03 |
| Max. Negotiated Rate |
$1,610.04 |
| Rate for Payer: Aetna Commercial |
$1,449.04
|
| Rate for Payer: ASR ASR |
$1,561.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.26
|
| Rate for Payer: BCN Commercial |
$1,248.26
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,513.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Healthscope Commercial |
$1,610.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.74
|
| Rate for Payer: Mclaren Commercial |
$1,449.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.84
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
OP
|
$1,610.04
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,449.04
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,561.74
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.26
|
| Rate for Payer: BCN Commercial |
$1,248.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,513.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,610.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,449.04
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,465.14
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,143.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
IP
|
$65,453.40
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$45,817.38 |
| Max. Negotiated Rate |
$65,453.40 |
| Rate for Payer: Aetna Commercial |
$58,908.06
|
| Rate for Payer: ASR ASR |
$63,489.80
|
| Rate for Payer: BCBS Trust/PPO |
$50,746.02
|
| Rate for Payer: BCN Commercial |
$50,746.02
|
| Rate for Payer: Cash Price |
$52,362.72
|
| Rate for Payer: Cofinity Commercial |
$61,526.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52,362.72
|
| Rate for Payer: Healthscope Commercial |
$65,453.40
|
| Rate for Payer: Healthscope Whirlpool |
$63,489.80
|
| Rate for Payer: Mclaren Commercial |
$58,908.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55,635.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,817.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57,598.99
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
OP
|
$65,453.40
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$65,453.40 |
| Rate for Payer: Aetna Commercial |
$58,908.06
|
| Rate for Payer: ASR ASR |
$63,489.80
|
| Rate for Payer: BCBS Complete |
$26,181.36
|
| Rate for Payer: BCBS Trust/PPO |
$50,746.02
|
| Rate for Payer: BCN Commercial |
$50,746.02
|
| Rate for Payer: Cash Price |
$52,362.72
|
| Rate for Payer: Cash Price |
$52,362.72
|
| Rate for Payer: Cofinity Commercial |
$61,526.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52,362.72
|
| Rate for Payer: Healthscope Commercial |
$65,453.40
|
| Rate for Payer: Healthscope Whirlpool |
$63,489.80
|
| Rate for Payer: Mclaren Commercial |
$58,908.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55,635.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,817.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57,598.99
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
IP
|
$62,393.40
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$43,675.38 |
| Max. Negotiated Rate |
$62,393.40 |
| Rate for Payer: Aetna Commercial |
$56,154.06
|
| Rate for Payer: ASR ASR |
$60,521.60
|
| Rate for Payer: BCBS Trust/PPO |
$48,373.60
|
| Rate for Payer: BCN Commercial |
$48,373.60
|
| Rate for Payer: Cash Price |
$49,914.72
|
| Rate for Payer: Cofinity Commercial |
$58,649.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,914.72
|
| Rate for Payer: Healthscope Commercial |
$62,393.40
|
| Rate for Payer: Healthscope Whirlpool |
$60,521.60
|
| Rate for Payer: Mclaren Commercial |
$56,154.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53,034.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,675.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54,906.19
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
OP
|
$62,393.40
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$62,393.40 |
| Rate for Payer: Aetna Commercial |
$56,154.06
|
| Rate for Payer: ASR ASR |
$60,521.60
|
| Rate for Payer: BCBS Complete |
$24,957.36
|
| Rate for Payer: BCBS Trust/PPO |
$48,373.60
|
| Rate for Payer: BCN Commercial |
$48,373.60
|
| Rate for Payer: Cash Price |
$49,914.72
|
| Rate for Payer: Cash Price |
$49,914.72
|
| Rate for Payer: Cofinity Commercial |
$58,649.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,914.72
|
| Rate for Payer: Healthscope Commercial |
$62,393.40
|
| Rate for Payer: Healthscope Whirlpool |
$60,521.60
|
| Rate for Payer: Mclaren Commercial |
$56,154.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53,034.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,675.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54,906.19
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
OP
|
$68,513.40
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$68,513.40 |
| Rate for Payer: Aetna Commercial |
$61,662.06
|
| Rate for Payer: ASR ASR |
$66,458.00
|
| Rate for Payer: BCBS Complete |
$27,405.36
|
| Rate for Payer: BCBS Trust/PPO |
$53,118.44
|
| Rate for Payer: BCN Commercial |
$53,118.44
|
| Rate for Payer: Cash Price |
$54,810.72
|
| Rate for Payer: Cash Price |
$54,810.72
|
| Rate for Payer: Cofinity Commercial |
$64,402.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54,810.72
|
| Rate for Payer: Healthscope Commercial |
$68,513.40
|
| Rate for Payer: Healthscope Whirlpool |
$66,458.00
|
| Rate for Payer: Mclaren Commercial |
$61,662.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58,236.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47,959.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60,291.79
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
IP
|
$68,513.40
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$47,959.38 |
| Max. Negotiated Rate |
$68,513.40 |
| Rate for Payer: Aetna Commercial |
$61,662.06
|
| Rate for Payer: ASR ASR |
$66,458.00
|
| Rate for Payer: BCBS Trust/PPO |
$53,118.44
|
| Rate for Payer: BCN Commercial |
$53,118.44
|
| Rate for Payer: Cash Price |
$54,810.72
|
| Rate for Payer: Cofinity Commercial |
$64,402.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54,810.72
|
| Rate for Payer: Healthscope Commercial |
$68,513.40
|
| Rate for Payer: Healthscope Whirlpool |
$66,458.00
|
| Rate for Payer: Mclaren Commercial |
$61,662.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58,236.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47,959.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60,291.79
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
OP
|
$59,333.40
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$59,333.40 |
| Rate for Payer: Aetna Commercial |
$53,400.06
|
| Rate for Payer: ASR ASR |
$57,553.40
|
| Rate for Payer: BCBS Complete |
$23,733.36
|
| Rate for Payer: BCBS Trust/PPO |
$46,001.19
|
| Rate for Payer: BCN Commercial |
$46,001.19
|
| Rate for Payer: Cash Price |
$47,466.72
|
| Rate for Payer: Cash Price |
$47,466.72
|
| Rate for Payer: Cofinity Commercial |
$55,773.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47,466.72
|
| Rate for Payer: Healthscope Commercial |
$59,333.40
|
| Rate for Payer: Healthscope Whirlpool |
$57,553.40
|
| Rate for Payer: Mclaren Commercial |
$53,400.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50,433.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,533.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52,213.39
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
IP
|
$59,333.40
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$41,533.38 |
| Max. Negotiated Rate |
$59,333.40 |
| Rate for Payer: Aetna Commercial |
$53,400.06
|
| Rate for Payer: ASR ASR |
$57,553.40
|
| Rate for Payer: BCBS Trust/PPO |
$46,001.19
|
| Rate for Payer: BCN Commercial |
$46,001.19
|
| Rate for Payer: Cash Price |
$47,466.72
|
| Rate for Payer: Cofinity Commercial |
$55,773.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47,466.72
|
| Rate for Payer: Healthscope Commercial |
$59,333.40
|
| Rate for Payer: Healthscope Whirlpool |
$57,553.40
|
| Rate for Payer: Mclaren Commercial |
$53,400.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50,433.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,533.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52,213.39
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
IP
|
$19,722.15
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,805.50 |
| Max. Negotiated Rate |
$19,722.15 |
| Rate for Payer: Aetna Commercial |
$17,749.94
|
| Rate for Payer: ASR ASR |
$19,130.49
|
| Rate for Payer: BCBS Trust/PPO |
$15,290.58
|
| Rate for Payer: BCN Commercial |
$15,290.58
|
| Rate for Payer: Cash Price |
$15,777.72
|
| Rate for Payer: Cofinity Commercial |
$18,538.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,777.72
|
| Rate for Payer: Healthscope Commercial |
$19,722.15
|
| Rate for Payer: Healthscope Whirlpool |
$19,130.49
|
| Rate for Payer: Mclaren Commercial |
$17,749.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,763.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,805.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,355.49
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
OP
|
$19,722.15
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,460.81 |
| Max. Negotiated Rate |
$26,190.15 |
| Rate for Payer: Aetna Commercial |
$17,749.94
|
| Rate for Payer: Aetna Medicare |
$20,952.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,190.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,190.15
|
| Rate for Payer: ASR ASR |
$19,130.49
|
| Rate for Payer: BCBS Complete |
$12,034.90
|
| Rate for Payer: BCBS MAPPO |
$20,952.12
|
| Rate for Payer: BCBS Trust/PPO |
$15,290.58
|
| Rate for Payer: BCN Commercial |
$15,290.58
|
| Rate for Payer: BCN Medicare Advantage |
$20,952.12
|
| Rate for Payer: Cash Price |
$15,777.72
|
| Rate for Payer: Cash Price |
$15,777.72
|
| Rate for Payer: Cofinity Commercial |
$18,538.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,777.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,952.12
|
| Rate for Payer: Healthscope Commercial |
$19,722.15
|
| Rate for Payer: Healthscope Whirlpool |
$19,130.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,952.12
|
| Rate for Payer: Mclaren Commercial |
$17,749.94
|
| Rate for Payer: Mclaren Medicaid |
$11,460.81
|
| Rate for Payer: Mclaren Medicare |
$20,952.12
|
| Rate for Payer: Meridian Medicaid |
$12,034.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,999.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,094.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,763.83
|
| Rate for Payer: PACE Medicare |
$19,904.51
|
| Rate for Payer: PACE SWMI |
$20,952.12
|
| Rate for Payer: PHP Commercial |
$23,047.33
|
| Rate for Payer: PHP Medicaid |
$11,460.81
|
| Rate for Payer: PHP Medicare Advantage |
$20,952.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,460.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,805.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,947.16
|
| Rate for Payer: Priority Health Medicare |
$20,952.12
|
| Rate for Payer: Priority Health Narrow Network |
$14,002.73
|
| Rate for Payer: Railroad Medicare Medicare |
$20,952.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,355.49
|
| Rate for Payer: UHC Medicare Advantage |
$21,580.68
|
| Rate for Payer: VA VA |
$20,952.12
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
OP
|
$16,106.64
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,191.95 |
| Max. Negotiated Rate |
$16,106.64 |
| Rate for Payer: Aetna Commercial |
$14,495.98
|
| Rate for Payer: Aetna Medicare |
$9,491.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
| Rate for Payer: ASR ASR |
$15,623.44
|
| Rate for Payer: BCBS Complete |
$5,452.02
|
| Rate for Payer: BCBS MAPPO |
$9,491.68
|
| Rate for Payer: BCBS Trust/PPO |
$12,487.48
|
| Rate for Payer: BCN Commercial |
$12,487.48
|
| Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
| Rate for Payer: Cash Price |
$12,885.31
|
| Rate for Payer: Cash Price |
$12,885.31
|
| Rate for Payer: Cofinity Commercial |
$15,140.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,885.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
| Rate for Payer: Healthscope Commercial |
$16,106.64
|
| Rate for Payer: Healthscope Whirlpool |
$15,623.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,491.68
|
| Rate for Payer: Mclaren Commercial |
$14,495.98
|
| Rate for Payer: Mclaren Medicaid |
$5,191.95
|
| Rate for Payer: Mclaren Medicare |
$9,491.68
|
| Rate for Payer: Meridian Medicaid |
$5,452.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,690.64
|
| Rate for Payer: PACE Medicare |
$9,017.10
|
| Rate for Payer: PACE SWMI |
$9,491.68
|
| Rate for Payer: PHP Commercial |
$10,440.85
|
| Rate for Payer: PHP Medicaid |
$5,191.95
|
| Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,274.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,657.04
|
| Rate for Payer: Priority Health Medicare |
$9,491.68
|
| Rate for Payer: Priority Health Narrow Network |
$11,435.71
|
| Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,173.84
|
| Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
| Rate for Payer: VA VA |
$9,491.68
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
IP
|
$16,106.64
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,274.65 |
| Max. Negotiated Rate |
$16,106.64 |
| Rate for Payer: Aetna Commercial |
$14,495.98
|
| Rate for Payer: ASR ASR |
$15,623.44
|
| Rate for Payer: BCBS Trust/PPO |
$12,487.48
|
| Rate for Payer: BCN Commercial |
$12,487.48
|
| Rate for Payer: Cash Price |
$12,885.31
|
| Rate for Payer: Cofinity Commercial |
$15,140.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,885.31
|
| Rate for Payer: Healthscope Commercial |
$16,106.64
|
| Rate for Payer: Healthscope Whirlpool |
$15,623.44
|
| Rate for Payer: Mclaren Commercial |
$14,495.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,690.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,274.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,173.84
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
IP
|
$2,992.48
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,094.74 |
| Max. Negotiated Rate |
$2,992.48 |
| Rate for Payer: Aetna Commercial |
$2,693.23
|
| Rate for Payer: ASR ASR |
$2,902.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,320.07
|
| Rate for Payer: BCN Commercial |
$2,320.07
|
| Rate for Payer: Cash Price |
$2,393.98
|
| Rate for Payer: Cofinity Commercial |
$2,812.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,393.98
|
| Rate for Payer: Healthscope Commercial |
$2,992.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,902.71
|
| Rate for Payer: Mclaren Commercial |
$2,693.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.38
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
OP
|
$2,992.48
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,628.56 |
| Rate for Payer: Aetna Commercial |
$2,693.23
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,902.71
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,320.07
|
| Rate for Payer: BCN Commercial |
$2,320.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,393.98
|
| Rate for Payer: Cash Price |
$2,393.98
|
| Rate for Payer: Cofinity Commercial |
$2,812.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,393.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,992.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,902.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,693.23
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.61
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,628.56
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,902.85
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
OP
|
$2,613.44
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,352.10
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,535.04
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.20
|
| Rate for Payer: BCN Commercial |
$2,026.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,090.75
|
| Rate for Payer: Cash Price |
$2,090.75
|
| Rate for Payer: Cofinity Commercial |
$2,456.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,090.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,613.44
|
| Rate for Payer: Healthscope Whirlpool |
$2,535.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,352.10
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,221.42
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,829.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,378.23
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,855.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,299.83
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
IP
|
$2,613.44
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,829.41 |
| Max. Negotiated Rate |
$2,613.44 |
| Rate for Payer: Aetna Commercial |
$2,352.10
|
| Rate for Payer: ASR ASR |
$2,535.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.20
|
| Rate for Payer: BCN Commercial |
$2,026.20
|
| Rate for Payer: Cash Price |
$2,090.75
|
| Rate for Payer: Cofinity Commercial |
$2,456.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,090.75
|
| Rate for Payer: Healthscope Commercial |
$2,613.44
|
| Rate for Payer: Healthscope Whirlpool |
$2,535.04
|
| Rate for Payer: Mclaren Commercial |
$2,352.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,221.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,829.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,299.83
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,442.05
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,009.44 |
| Max. Negotiated Rate |
$1,442.05 |
| Rate for Payer: Aetna Commercial |
$1,297.84
|
| Rate for Payer: ASR ASR |
$1,398.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.02
|
| Rate for Payer: BCN Commercial |
$1,118.02
|
| Rate for Payer: Cash Price |
$1,153.64
|
| Rate for Payer: Cofinity Commercial |
$1,355.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.64
|
| Rate for Payer: Healthscope Commercial |
$1,442.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.79
|
| Rate for Payer: Mclaren Commercial |
$1,297.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,009.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,269.00
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,442.05
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,297.84
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,398.79
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.02
|
| Rate for Payer: BCN Commercial |
$1,118.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,153.64
|
| Rate for Payer: Cash Price |
$1,153.64
|
| Rate for Payer: Cofinity Commercial |
$1,355.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,442.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,297.84
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.74
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,009.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,312.27
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,269.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
IP
|
$4,484.14
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,138.90 |
| Max. Negotiated Rate |
$4,484.14 |
| Rate for Payer: Aetna Commercial |
$4,035.73
|
| Rate for Payer: ASR ASR |
$4,349.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.55
|
| Rate for Payer: BCN Commercial |
$3,476.55
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cofinity Commercial |
$4,215.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,587.31
|
| Rate for Payer: Healthscope Commercial |
$4,484.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,349.62
|
| Rate for Payer: Mclaren Commercial |
$4,035.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,811.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,138.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.04
|
|
