|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
OP
|
$4,484.14
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,484.14 |
| Rate for Payer: Aetna Commercial |
$4,035.73
|
| 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 |
$4,349.62
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.55
|
| Rate for Payer: BCN Commercial |
$3,476.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,587.31
|
| 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: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,484.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,349.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$4,035.73
|
| 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 |
$3,811.52
|
| 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 |
$3,138.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,080.57
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,183.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
OP
|
$4,484.14
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,671.93 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$4,035.73
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$4,349.62
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.55
|
| Rate for Payer: BCN Commercial |
$3,476.55
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$3,587.31
|
| 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: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$4,484.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,349.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$4,035.73
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,811.52
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,138.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,080.57
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,183.74
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.04
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
IP
|
$4,484.14
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
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
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$3,228.32
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,905.49
|
| 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 |
$3,131.47
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,502.92
|
| Rate for Payer: BCN Commercial |
$2,502.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,582.66
|
| Rate for Payer: Cash Price |
$2,582.66
|
| Rate for Payer: Cofinity Commercial |
$3,034.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,228.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,131.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,905.49
|
| 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 |
$2,744.07
|
| 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 |
$2,259.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,937.77
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,292.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$3,228.32
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,259.82 |
| Max. Negotiated Rate |
$3,228.32 |
| Rate for Payer: Aetna Commercial |
$2,905.49
|
| Rate for Payer: ASR ASR |
$3,131.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,502.92
|
| Rate for Payer: BCN Commercial |
$2,502.92
|
| Rate for Payer: Cash Price |
$2,582.66
|
| Rate for Payer: Cofinity Commercial |
$3,034.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.66
|
| Rate for Payer: Healthscope Commercial |
$3,228.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,131.47
|
| Rate for Payer: Mclaren Commercial |
$2,905.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,744.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.92
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
OP
|
$1,931.55
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,931.55 |
| Rate for Payer: Aetna Commercial |
$1,738.40
|
| 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 |
$1,873.60
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,497.53
|
| Rate for Payer: BCN Commercial |
$1,497.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,545.24
|
| Rate for Payer: Cash Price |
$1,545.24
|
| Rate for Payer: Cofinity Commercial |
$1,815.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,545.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,931.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,873.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,738.40
|
| 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 |
$1,641.82
|
| 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 |
$1,352.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.71
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,371.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,699.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
IP
|
$1,931.55
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,352.08 |
| Max. Negotiated Rate |
$1,931.55 |
| Rate for Payer: Aetna Commercial |
$1,738.40
|
| Rate for Payer: ASR ASR |
$1,873.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,497.53
|
| Rate for Payer: BCN Commercial |
$1,497.53
|
| Rate for Payer: Cash Price |
$1,545.24
|
| Rate for Payer: Cofinity Commercial |
$1,815.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,545.24
|
| Rate for Payer: Healthscope Commercial |
$1,931.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,873.60
|
| Rate for Payer: Mclaren Commercial |
$1,738.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,641.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,352.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,699.76
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
IP
|
$1,043.46
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.42 |
| Max. Negotiated Rate |
$1,043.46 |
| Rate for Payer: Aetna Commercial |
$939.11
|
| Rate for Payer: ASR ASR |
$1,012.16
|
| Rate for Payer: BCBS Trust/PPO |
$808.99
|
| Rate for Payer: BCN Commercial |
$808.99
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$980.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Healthscope Commercial |
$1,043.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.16
|
| Rate for Payer: Mclaren Commercial |
$939.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$886.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.24
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
OP
|
$1,043.46
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,043.46 |
| Rate for Payer: Aetna Commercial |
$939.11
|
| Rate for Payer: Aetna Medicare |
$558.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: ASR ASR |
$1,012.16
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$808.99
|
| Rate for Payer: BCN Commercial |
$808.99
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$980.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$1,043.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$939.11
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$886.94
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$614.24
|
| Rate for Payer: PHP Medicaid |
$305.44
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$949.55
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$740.86
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.24
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$19,921.38
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,944.97 |
| Max. Negotiated Rate |
$19,921.38 |
| Rate for Payer: Aetna Commercial |
$17,929.24
|
| Rate for Payer: ASR ASR |
$19,323.74
|
| Rate for Payer: BCBS Trust/PPO |
$15,445.05
|
| Rate for Payer: BCN Commercial |
$15,445.05
|
| Rate for Payer: Cash Price |
$15,937.10
|
| Rate for Payer: Cofinity Commercial |
$18,726.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,937.10
|
| Rate for Payer: Healthscope Commercial |
$19,921.38
|
| Rate for Payer: Healthscope Whirlpool |
$19,323.74
|
| Rate for Payer: Mclaren Commercial |
$17,929.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,933.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,944.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,530.81
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
OP
|
$19,921.38
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,944.97 |
| Max. Negotiated Rate |
$36,554.11 |
| Rate for Payer: Aetna Commercial |
$17,929.24
|
| Rate for Payer: Aetna Medicare |
$29,243.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,554.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,554.11
|
| Rate for Payer: ASR ASR |
$19,323.74
|
| Rate for Payer: BCBS Complete |
$16,797.35
|
| Rate for Payer: BCBS MAPPO |
$29,243.29
|
| Rate for Payer: BCBS Trust/PPO |
$15,445.05
|
| Rate for Payer: BCN Commercial |
$15,445.05
|
| Rate for Payer: BCN Medicare Advantage |
$29,243.29
|
| Rate for Payer: Cash Price |
$15,937.10
|
| Rate for Payer: Cash Price |
$15,937.10
|
| Rate for Payer: Cofinity Commercial |
$18,726.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,937.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,243.29
|
| Rate for Payer: Healthscope Commercial |
$19,921.38
|
| Rate for Payer: Healthscope Whirlpool |
$19,323.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,243.29
|
| Rate for Payer: Mclaren Commercial |
$17,929.24
|
| Rate for Payer: Mclaren Medicaid |
$15,996.08
|
| Rate for Payer: Mclaren Medicare |
$29,243.29
|
| Rate for Payer: Meridian Medicaid |
$16,797.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,705.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,629.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,933.17
|
| Rate for Payer: PACE Medicare |
$27,781.13
|
| Rate for Payer: PACE SWMI |
$29,243.29
|
| Rate for Payer: PHP Commercial |
$32,167.62
|
| Rate for Payer: PHP Medicaid |
$15,996.08
|
| Rate for Payer: PHP Medicare Advantage |
$29,243.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,996.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,944.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,128.46
|
| Rate for Payer: Priority Health Medicare |
$29,243.29
|
| Rate for Payer: Priority Health Narrow Network |
$14,144.18
|
| Rate for Payer: Railroad Medicare Medicare |
$29,243.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,530.81
|
| Rate for Payer: UHC Medicare Advantage |
$30,120.59
|
| Rate for Payer: VA VA |
$29,243.29
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$16,800.36
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,474.03 |
| Max. Negotiated Rate |
$21,649.99 |
| Rate for Payer: Aetna Commercial |
$15,120.32
|
| Rate for Payer: Aetna Medicare |
$17,319.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,649.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,649.99
|
| Rate for Payer: ASR ASR |
$16,296.35
|
| Rate for Payer: BCBS Complete |
$9,948.60
|
| Rate for Payer: BCBS MAPPO |
$17,319.99
|
| Rate for Payer: BCBS Trust/PPO |
$13,025.32
|
| Rate for Payer: BCN Commercial |
$13,025.32
|
| Rate for Payer: BCN Medicare Advantage |
$17,319.99
|
| Rate for Payer: Cash Price |
$13,440.29
|
| Rate for Payer: Cash Price |
$13,440.29
|
| Rate for Payer: Cofinity Commercial |
$15,792.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,440.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,319.99
|
| Rate for Payer: Healthscope Commercial |
$16,800.36
|
| Rate for Payer: Healthscope Whirlpool |
$16,296.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,319.99
|
| Rate for Payer: Mclaren Commercial |
$15,120.32
|
| Rate for Payer: Mclaren Medicaid |
$9,474.03
|
| Rate for Payer: Mclaren Medicare |
$17,319.99
|
| Rate for Payer: Meridian Medicaid |
$9,948.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,185.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,917.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,280.31
|
| Rate for Payer: PACE Medicare |
$16,453.99
|
| Rate for Payer: PACE SWMI |
$17,319.99
|
| Rate for Payer: PHP Commercial |
$19,051.99
|
| Rate for Payer: PHP Medicaid |
$9,474.03
|
| Rate for Payer: PHP Medicare Advantage |
$17,319.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,474.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,760.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,288.33
|
| Rate for Payer: Priority Health Medicare |
$17,319.99
|
| Rate for Payer: Priority Health Narrow Network |
$11,928.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17,319.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,784.32
|
| Rate for Payer: UHC Medicare Advantage |
$17,839.59
|
| Rate for Payer: VA VA |
$17,319.99
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$16,800.36
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,760.25 |
| Max. Negotiated Rate |
$16,800.36 |
| Rate for Payer: Aetna Commercial |
$15,120.32
|
| Rate for Payer: ASR ASR |
$16,296.35
|
| Rate for Payer: BCBS Trust/PPO |
$13,025.32
|
| Rate for Payer: BCN Commercial |
$13,025.32
|
| Rate for Payer: Cash Price |
$13,440.29
|
| Rate for Payer: Cofinity Commercial |
$15,792.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,440.29
|
| Rate for Payer: Healthscope Commercial |
$16,800.36
|
| Rate for Payer: Healthscope Whirlpool |
$16,296.35
|
| Rate for Payer: Mclaren Commercial |
$15,120.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,280.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,760.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,784.32
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$17,530.81
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,271.57 |
| Max. Negotiated Rate |
$17,530.81 |
| Rate for Payer: Aetna Commercial |
$15,777.73
|
| Rate for Payer: ASR ASR |
$17,004.89
|
| Rate for Payer: BCBS Trust/PPO |
$13,591.64
|
| Rate for Payer: BCN Commercial |
$13,591.64
|
| Rate for Payer: Cash Price |
$14,024.65
|
| Rate for Payer: Cofinity Commercial |
$16,478.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,024.65
|
| Rate for Payer: Healthscope Commercial |
$17,530.81
|
| Rate for Payer: Healthscope Whirlpool |
$17,004.89
|
| Rate for Payer: Mclaren Commercial |
$15,777.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,901.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,271.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,427.11
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$17,530.81
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,460.81 |
| Max. Negotiated Rate |
$26,190.15 |
| Rate for Payer: Aetna Commercial |
$15,777.73
|
| 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 |
$17,004.89
|
| Rate for Payer: BCBS Complete |
$12,034.90
|
| Rate for Payer: BCBS MAPPO |
$20,952.12
|
| Rate for Payer: BCBS Trust/PPO |
$13,591.64
|
| Rate for Payer: BCN Commercial |
$13,591.64
|
| Rate for Payer: BCN Medicare Advantage |
$20,952.12
|
| Rate for Payer: Cash Price |
$14,024.65
|
| Rate for Payer: Cash Price |
$14,024.65
|
| Rate for Payer: Cofinity Commercial |
$16,478.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,024.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,952.12
|
| Rate for Payer: Healthscope Commercial |
$17,530.81
|
| Rate for Payer: Healthscope Whirlpool |
$17,004.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,952.12
|
| Rate for Payer: Mclaren Commercial |
$15,777.73
|
| 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 |
$14,901.19
|
| 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 |
$12,271.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,953.04
|
| Rate for Payer: Priority Health Medicare |
$20,952.12
|
| Rate for Payer: Priority Health Narrow Network |
$12,446.88
|
| Rate for Payer: Railroad Medicare Medicare |
$20,952.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,427.11
|
| Rate for Payer: UHC Medicare Advantage |
$21,580.68
|
| Rate for Payer: VA VA |
$20,952.12
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
IP
|
$11,942.23
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,359.56 |
| Max. Negotiated Rate |
$11,942.23 |
| Rate for Payer: Aetna Commercial |
$10,748.01
|
| Rate for Payer: ASR ASR |
$11,583.96
|
| Rate for Payer: BCBS Trust/PPO |
$9,258.81
|
| Rate for Payer: BCN Commercial |
$9,258.81
|
| Rate for Payer: Cash Price |
$9,553.78
|
| Rate for Payer: Cofinity Commercial |
$11,225.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,553.78
|
| Rate for Payer: Healthscope Commercial |
$11,942.23
|
| Rate for Payer: Healthscope Whirlpool |
$11,583.96
|
| Rate for Payer: Mclaren Commercial |
$10,748.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,150.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,359.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,509.16
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$11,942.23
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,130.74 |
| Max. Negotiated Rate |
$11,942.23 |
| Rate for Payer: Aetna Commercial |
$10,748.01
|
| Rate for Payer: Aetna Medicare |
$7,551.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.52
|
| Rate for Payer: ASR ASR |
$11,583.96
|
| Rate for Payer: BCBS Complete |
$4,337.65
|
| Rate for Payer: BCBS MAPPO |
$7,551.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,258.81
|
| Rate for Payer: BCN Commercial |
$9,258.81
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.62
|
| Rate for Payer: Cash Price |
$9,553.78
|
| Rate for Payer: Cash Price |
$9,553.78
|
| Rate for Payer: Cofinity Commercial |
$11,225.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,553.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.62
|
| Rate for Payer: Healthscope Commercial |
$11,942.23
|
| Rate for Payer: Healthscope Whirlpool |
$11,583.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,551.62
|
| Rate for Payer: Mclaren Commercial |
$10,748.01
|
| Rate for Payer: Mclaren Medicaid |
$4,130.74
|
| Rate for Payer: Mclaren Medicare |
$7,551.62
|
| Rate for Payer: Meridian Medicaid |
$4,337.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,150.90
|
| Rate for Payer: PACE Medicare |
$7,174.04
|
| Rate for Payer: PACE SWMI |
$7,551.62
|
| Rate for Payer: PHP Commercial |
$8,306.78
|
| Rate for Payer: PHP Medicaid |
$4,130.74
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,359.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.43
|
| Rate for Payer: Priority Health Medicare |
$7,551.62
|
| Rate for Payer: Priority Health Narrow Network |
$8,478.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,509.16
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.17
|
| Rate for Payer: VA VA |
$7,551.62
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
IP
|
$35,520.57
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$24,864.40 |
| Max. Negotiated Rate |
$35,520.57 |
| Rate for Payer: Aetna Commercial |
$31,968.51
|
| Rate for Payer: ASR ASR |
$34,454.95
|
| Rate for Payer: BCBS Trust/PPO |
$27,539.10
|
| Rate for Payer: BCN Commercial |
$27,539.10
|
| Rate for Payer: Cash Price |
$28,416.46
|
| Rate for Payer: Cofinity Commercial |
$33,389.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,416.46
|
| Rate for Payer: Healthscope Commercial |
$35,520.57
|
| Rate for Payer: Healthscope Whirlpool |
$34,454.95
|
| Rate for Payer: Mclaren Commercial |
$31,968.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30,192.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24,864.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31,258.10
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$35,520.57
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,460.81 |
| Max. Negotiated Rate |
$35,520.57 |
| Rate for Payer: Aetna Commercial |
$31,968.51
|
| 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 |
$34,454.95
|
| Rate for Payer: BCBS Complete |
$12,034.90
|
| Rate for Payer: BCBS MAPPO |
$20,952.12
|
| Rate for Payer: BCBS Trust/PPO |
$27,539.10
|
| Rate for Payer: BCN Commercial |
$27,539.10
|
| Rate for Payer: BCN Medicare Advantage |
$20,952.12
|
| Rate for Payer: Cash Price |
$28,416.46
|
| Rate for Payer: Cash Price |
$28,416.46
|
| Rate for Payer: Cofinity Commercial |
$33,389.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,416.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,952.12
|
| Rate for Payer: Healthscope Commercial |
$35,520.57
|
| Rate for Payer: Healthscope Whirlpool |
$34,454.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,952.12
|
| Rate for Payer: Mclaren Commercial |
$31,968.51
|
| 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 |
$30,192.48
|
| 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 |
$24,864.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,323.72
|
| Rate for Payer: Priority Health Medicare |
$20,952.12
|
| Rate for Payer: Priority Health Narrow Network |
$25,219.60
|
| Rate for Payer: Railroad Medicare Medicare |
$20,952.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31,258.10
|
| Rate for Payer: UHC Medicare Advantage |
$21,580.68
|
| Rate for Payer: VA VA |
$20,952.12
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,459.63
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$2,459.63 |
| Rate for Payer: Aetna Commercial |
$2,213.67
|
| 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 |
$2,385.84
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,906.95
|
| Rate for Payer: BCN Commercial |
$1,906.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,967.70
|
| Rate for Payer: Cash Price |
$1,967.70
|
| Rate for Payer: Cofinity Commercial |
$2,312.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$2,459.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,385.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$2,213.67
|
| 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 |
$2,090.69
|
| 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 |
$1,721.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,238.26
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,746.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,164.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,459.63
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,721.74 |
| Max. Negotiated Rate |
$2,459.63 |
| Rate for Payer: Aetna Commercial |
$2,213.67
|
| Rate for Payer: ASR ASR |
$2,385.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,906.95
|
| Rate for Payer: BCN Commercial |
$1,906.95
|
| Rate for Payer: Cash Price |
$1,967.70
|
| Rate for Payer: Cofinity Commercial |
$2,312.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.70
|
| Rate for Payer: Healthscope Commercial |
$2,459.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,385.84
|
| Rate for Payer: Mclaren Commercial |
$2,213.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,090.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,721.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,164.47
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$2,883.95
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,595.56
|
| 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 |
$2,797.43
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,235.93
|
| Rate for Payer: BCN Commercial |
$2,235.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,307.16
|
| Rate for Payer: Cash Price |
$2,307.16
|
| Rate for Payer: Cofinity Commercial |
$2,710.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,307.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,883.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,797.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,595.56
|
| 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 |
$2,451.36
|
| 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 |
$2,018.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,624.39
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,047.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,537.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$2,883.95
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,018.76 |
| Max. Negotiated Rate |
$2,883.95 |
| Rate for Payer: Aetna Commercial |
$2,595.56
|
| Rate for Payer: ASR ASR |
$2,797.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,235.93
|
| Rate for Payer: BCN Commercial |
$2,235.93
|
| Rate for Payer: Cash Price |
$2,307.16
|
| Rate for Payer: Cofinity Commercial |
$2,710.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,307.16
|
| Rate for Payer: Healthscope Commercial |
$2,883.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,797.43
|
| Rate for Payer: Mclaren Commercial |
$2,595.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,451.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,018.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,537.88
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: ASR ASR |
$101.85
|
| Rate for Payer: BCBS Trust/PPO |
$81.41
|
| Rate for Payer: BCN Commercial |
$81.41
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$98.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Healthscope Commercial |
$105.00
|
| Rate for Payer: Healthscope Whirlpool |
$101.85
|
| Rate for Payer: Mclaren Commercial |
$94.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.40
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: ASR ASR |
$101.85
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.41
|
| Rate for Payer: BCN Commercial |
$81.41
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$98.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Healthscope Commercial |
$105.00
|
| Rate for Payer: Healthscope Whirlpool |
$101.85
|
| Rate for Payer: Mclaren Commercial |
$94.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.55
|
| Rate for Payer: Priority Health Narrow Network |
$74.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.40
|
|
