|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,083.13 |
| Max. Negotiated Rate |
$1,666.35 |
| Rate for Payer: Aetna Commercial |
$1,499.71
|
| Rate for Payer: ASR ASR |
$1,616.36
|
| Rate for Payer: ASR Commercial |
$1,616.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,357.91
|
| Rate for Payer: BCN Commercial |
$1,291.92
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,566.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,666.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,616.36
|
| Rate for Payer: Mclaren Commercial |
$1,499.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: Nomi Health Commercial |
$1,366.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.39
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$281.38 |
| Max. Negotiated Rate |
$1,666.35 |
| Rate for Payer: Aetna Commercial |
$1,499.71
|
| Rate for Payer: Aetna Medicare |
$524.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: ASR ASR |
$1,616.36
|
| Rate for Payer: ASR Commercial |
$1,616.36
|
| Rate for Payer: BCBS Complete |
$295.45
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,364.57
|
| Rate for Payer: BCN Commercial |
$1,291.92
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,566.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,666.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,616.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$524.96
|
| Rate for Payer: Mclaren Commercial |
$1,499.71
|
| Rate for Payer: Mclaren Medicaid |
$281.38
|
| Rate for Payer: Mclaren Medicare |
$524.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: Meridian Medicaid |
$295.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: Nomi Health Commercial |
$1,366.41
|
| Rate for Payer: PACE Medicare |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$577.46
|
| Rate for Payer: PHP Medicaid |
$281.38
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,460.06
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.11
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Exchange |
$813.69
|
| Rate for Payer: UHC Medicare Advantage |
$524.96
|
| Rate for Payer: UHCCP DNSP |
$524.96
|
| Rate for Payer: UHCCP Medicaid |
$281.38
|
| Rate for Payer: VA VA |
$524.96
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
IP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$792.47 |
| Max. Negotiated Rate |
$1,219.18 |
| Rate for Payer: Aetna Commercial |
$1,097.26
|
| Rate for Payer: ASR ASR |
$1,182.60
|
| Rate for Payer: ASR Commercial |
$1,182.60
|
| Rate for Payer: BCBS Trust/PPO |
$993.51
|
| Rate for Payer: BCN Commercial |
$945.23
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$1,146.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Healthscope Commercial |
$1,219.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,182.60
|
| Rate for Payer: Mclaren Commercial |
$1,097.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: Nomi Health Commercial |
$999.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,072.88
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
OP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,219.18 |
| Rate for Payer: Aetna Commercial |
$1,097.26
|
| Rate for Payer: Aetna Medicare |
$391.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: ASR ASR |
$1,182.60
|
| Rate for Payer: ASR Commercial |
$1,182.60
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCBS Trust/PPO |
$998.39
|
| Rate for Payer: BCN Commercial |
$945.23
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$1,146.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,219.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,182.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.90
|
| Rate for Payer: Mclaren Commercial |
$1,097.26
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: Nomi Health Commercial |
$999.73
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$431.09
|
| Rate for Payer: PHP Medicaid |
$210.06
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.25
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health Narrow Network |
$854.65
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,072.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$607.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP DNSP |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: VA VA |
$391.90
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,083.13 |
| Max. Negotiated Rate |
$1,666.35 |
| Rate for Payer: Aetna Commercial |
$1,499.71
|
| Rate for Payer: ASR ASR |
$1,616.36
|
| Rate for Payer: ASR Commercial |
$1,616.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,357.91
|
| Rate for Payer: BCN Commercial |
$1,291.92
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,566.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,666.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,616.36
|
| Rate for Payer: Mclaren Commercial |
$1,499.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: Nomi Health Commercial |
$1,366.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.39
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$281.38 |
| Max. Negotiated Rate |
$1,666.35 |
| Rate for Payer: Aetna Commercial |
$1,499.71
|
| Rate for Payer: Aetna Medicare |
$524.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: ASR ASR |
$1,616.36
|
| Rate for Payer: ASR Commercial |
$1,616.36
|
| Rate for Payer: BCBS Complete |
$295.45
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,364.57
|
| Rate for Payer: BCN Commercial |
$1,291.92
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,566.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,666.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,616.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$524.96
|
| Rate for Payer: Mclaren Commercial |
$1,499.71
|
| Rate for Payer: Mclaren Medicaid |
$281.38
|
| Rate for Payer: Mclaren Medicare |
$524.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: Meridian Medicaid |
$295.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: Nomi Health Commercial |
$1,366.41
|
| Rate for Payer: PACE Medicare |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$577.46
|
| Rate for Payer: PHP Medicaid |
$281.38
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,460.06
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.11
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Exchange |
$813.69
|
| Rate for Payer: UHC Medicare Advantage |
$524.96
|
| Rate for Payer: UHCCP DNSP |
$524.96
|
| Rate for Payer: UHCCP Medicaid |
$281.38
|
| Rate for Payer: VA VA |
$524.96
|
|
|
HC NM VOID CYSTO
|
Facility
|
IP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$695.03 |
| Max. Negotiated Rate |
$1,069.28 |
| Rate for Payer: Aetna Commercial |
$962.35
|
| Rate for Payer: ASR ASR |
$1,037.20
|
| Rate for Payer: ASR Commercial |
$1,037.20
|
| Rate for Payer: BCBS Trust/PPO |
$871.36
|
| Rate for Payer: BCN Commercial |
$829.01
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$1,005.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Healthscope Commercial |
$1,069.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.20
|
| Rate for Payer: Mclaren Commercial |
$962.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.89
|
| Rate for Payer: Nomi Health Commercial |
$876.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.97
|
|
|
HC NM VOID CYSTO
|
Facility
|
OP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,069.28 |
| Rate for Payer: Aetna Commercial |
$962.35
|
| Rate for Payer: Aetna Medicare |
$391.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: ASR ASR |
$1,037.20
|
| Rate for Payer: ASR Commercial |
$1,037.20
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCBS Trust/PPO |
$875.63
|
| Rate for Payer: BCN Commercial |
$829.01
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$1,005.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,069.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.90
|
| Rate for Payer: Mclaren Commercial |
$962.35
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.89
|
| Rate for Payer: Nomi Health Commercial |
$876.81
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$431.09
|
| Rate for Payer: PHP Medicaid |
$210.06
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.90
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health Narrow Network |
$749.57
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$607.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP DNSP |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: VA VA |
$391.90
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
IP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,260.92 |
| Max. Negotiated Rate |
$1,939.87 |
| Rate for Payer: Aetna Commercial |
$1,745.88
|
| Rate for Payer: ASR ASR |
$1,881.67
|
| Rate for Payer: ASR Commercial |
$1,881.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.80
|
| Rate for Payer: BCN Commercial |
$1,503.98
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,823.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Healthscope Commercial |
$1,939.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,881.67
|
| Rate for Payer: Mclaren Commercial |
$1,745.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: Nomi Health Commercial |
$1,590.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,707.09
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
OP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$117.16 |
| Max. Negotiated Rate |
$1,939.87 |
| Rate for Payer: Aetna Commercial |
$1,745.88
|
| Rate for Payer: Aetna Medicare |
$218.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.24
|
| Rate for Payer: ASR ASR |
$1,881.67
|
| Rate for Payer: ASR Commercial |
$1,881.67
|
| Rate for Payer: BCBS Complete |
$123.02
|
| Rate for Payer: BCBS MAPPO |
$218.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.56
|
| Rate for Payer: BCN Commercial |
$1,503.98
|
| Rate for Payer: BCN Medicare Advantage |
$218.59
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,823.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.59
|
| Rate for Payer: Healthscope Commercial |
$1,939.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,881.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.59
|
| Rate for Payer: Mclaren Commercial |
$1,745.88
|
| Rate for Payer: Mclaren Medicaid |
$117.16
|
| Rate for Payer: Mclaren Medicare |
$218.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.52
|
| Rate for Payer: Meridian Medicaid |
$123.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: Nomi Health Commercial |
$1,590.69
|
| Rate for Payer: PACE Medicare |
$207.66
|
| Rate for Payer: PACE SWMI |
$218.59
|
| Rate for Payer: PHP Commercial |
$240.45
|
| Rate for Payer: PHP Medicaid |
$117.16
|
| Rate for Payer: PHP Medicare Advantage |
$218.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,699.71
|
| Rate for Payer: Priority Health Medicare |
$218.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.85
|
| Rate for Payer: Railroad Medicare Medicare |
$218.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,707.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.59
|
| Rate for Payer: UHC Exchange |
$338.81
|
| Rate for Payer: UHC Medicare Advantage |
$218.59
|
| Rate for Payer: UHCCP DNSP |
$218.59
|
| Rate for Payer: UHCCP Medicaid |
$117.16
|
| Rate for Payer: VA VA |
$218.59
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
OP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: ASR ASR |
$0.99
|
| Rate for Payer: ASR Commercial |
$0.99
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Trust/PPO |
$0.84
|
| Rate for Payer: BCN Commercial |
$0.79
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$1.02
|
| Rate for Payer: Healthscope Whirlpool |
$0.99
|
| Rate for Payer: Mclaren Commercial |
$0.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.89
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.90
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
IP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: ASR ASR |
$0.99
|
| Rate for Payer: ASR Commercial |
$0.99
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.79
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$1.02
|
| Rate for Payer: Healthscope Whirlpool |
$0.99
|
| Rate for Payer: Mclaren Commercial |
$0.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.90
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
OP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna Commercial |
$78.57
|
| Rate for Payer: Aetna Medicare |
$38.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: ASR ASR |
$84.68
|
| Rate for Payer: ASR Commercial |
$84.68
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$71.49
|
| Rate for Payer: BCN Commercial |
$67.68
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$82.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Healthscope Whirlpool |
$84.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.28
|
| Rate for Payer: Mclaren Commercial |
$78.57
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$42.11
|
| Rate for Payer: PHP Medicaid |
$20.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.49
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health Narrow Network |
$61.20
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$59.33
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP DNSP |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
IP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$56.74 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna Commercial |
$78.57
|
| Rate for Payer: ASR ASR |
$84.68
|
| Rate for Payer: ASR Commercial |
$84.68
|
| Rate for Payer: BCBS Trust/PPO |
$71.14
|
| Rate for Payer: BCN Commercial |
$67.68
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$82.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Healthscope Whirlpool |
$84.68
|
| Rate for Payer: Mclaren Commercial |
$78.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.82
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
IP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,605.33 |
| Max. Negotiated Rate |
$2,469.74 |
| Rate for Payer: Aetna Commercial |
$2,222.77
|
| Rate for Payer: ASR ASR |
$2,395.65
|
| Rate for Payer: ASR Commercial |
$2,395.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,012.59
|
| Rate for Payer: BCN Commercial |
$1,914.79
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$2,321.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Healthscope Commercial |
$2,469.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,395.65
|
| Rate for Payer: Mclaren Commercial |
$2,222.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: Nomi Health Commercial |
$2,025.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,173.37
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
OP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.61 |
| Max. Negotiated Rate |
$2,469.74 |
| Rate for Payer: Aetna Commercial |
$2,222.77
|
| Rate for Payer: Aetna Medicare |
$1,183.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,479.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,479.97
|
| Rate for Payer: ASR ASR |
$2,395.65
|
| Rate for Payer: ASR Commercial |
$2,395.65
|
| Rate for Payer: BCBS Complete |
$666.34
|
| Rate for Payer: BCBS MAPPO |
$1,183.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,022.47
|
| Rate for Payer: BCN Commercial |
$1,914.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,183.98
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$2,321.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,183.98
|
| Rate for Payer: Healthscope Commercial |
$2,469.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,395.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,183.98
|
| Rate for Payer: Mclaren Commercial |
$2,222.77
|
| Rate for Payer: Mclaren Medicaid |
$634.61
|
| Rate for Payer: Mclaren Medicare |
$1,183.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.18
|
| Rate for Payer: Meridian Medicaid |
$666.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,361.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: Nomi Health Commercial |
$2,025.19
|
| Rate for Payer: PACE Medicare |
$1,124.78
|
| Rate for Payer: PACE SWMI |
$1,183.98
|
| Rate for Payer: PHP Commercial |
$1,302.38
|
| Rate for Payer: PHP Medicaid |
$634.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,183.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,163.99
|
| Rate for Payer: Priority Health Medicare |
$1,183.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,731.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,173.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,183.98
|
| Rate for Payer: UHC Exchange |
$1,835.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,183.98
|
| Rate for Payer: UHCCP DNSP |
$1,183.98
|
| Rate for Payer: UHCCP Medicaid |
$634.61
|
| Rate for Payer: VA VA |
$1,183.98
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$736.24 |
| Max. Negotiated Rate |
$1,132.67 |
| Rate for Payer: Aetna Commercial |
$1,019.40
|
| Rate for Payer: ASR ASR |
$1,098.69
|
| Rate for Payer: ASR Commercial |
$1,098.69
|
| Rate for Payer: BCBS Trust/PPO |
$923.01
|
| Rate for Payer: BCN Commercial |
$878.16
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$1,064.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,132.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,098.69
|
| Rate for Payer: Mclaren Commercial |
$1,019.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: Nomi Health Commercial |
$928.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$996.75
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$453.07 |
| Max. Negotiated Rate |
$1,132.67 |
| Rate for Payer: Aetna Commercial |
$1,019.40
|
| Rate for Payer: Aetna Medicare |
$566.34
|
| Rate for Payer: ASR ASR |
$1,098.69
|
| Rate for Payer: ASR Commercial |
$1,098.69
|
| Rate for Payer: BCBS Complete |
$453.07
|
| Rate for Payer: BCBS Trust/PPO |
$927.54
|
| Rate for Payer: BCN Commercial |
$878.16
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$1,064.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,132.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,098.69
|
| Rate for Payer: Mclaren Commercial |
$1,019.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: Nomi Health Commercial |
$928.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.45
|
| Rate for Payer: Priority Health Narrow Network |
$794.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$996.75
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
OP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$369.72 |
| Max. Negotiated Rate |
$924.31 |
| Rate for Payer: Aetna Commercial |
$831.88
|
| Rate for Payer: Aetna Medicare |
$462.15
|
| Rate for Payer: ASR ASR |
$896.58
|
| Rate for Payer: ASR Commercial |
$896.58
|
| Rate for Payer: BCBS Complete |
$369.72
|
| Rate for Payer: BCBS Trust/PPO |
$756.92
|
| Rate for Payer: BCN Commercial |
$716.62
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$868.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$924.31
|
| Rate for Payer: Healthscope Whirlpool |
$896.58
|
| Rate for Payer: Mclaren Commercial |
$831.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: Nomi Health Commercial |
$757.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.88
|
| Rate for Payer: Priority Health Narrow Network |
$647.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.39
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
IP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$600.80 |
| Max. Negotiated Rate |
$924.31 |
| Rate for Payer: Aetna Commercial |
$831.88
|
| Rate for Payer: ASR ASR |
$896.58
|
| Rate for Payer: ASR Commercial |
$896.58
|
| Rate for Payer: BCBS Trust/PPO |
$753.22
|
| Rate for Payer: BCN Commercial |
$716.62
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$868.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$924.31
|
| Rate for Payer: Healthscope Whirlpool |
$896.58
|
| Rate for Payer: Mclaren Commercial |
$831.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: Nomi Health Commercial |
$757.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.39
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
OP
|
$358.94
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$358.94 |
| Rate for Payer: Aetna Commercial |
$323.05
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$348.17
|
| Rate for Payer: ASR Commercial |
$348.17
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$293.94
|
| Rate for Payer: BCN Commercial |
$278.29
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$337.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$358.94
|
| Rate for Payer: Healthscope Whirlpool |
$348.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$323.05
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: Nomi Health Commercial |
$294.33
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.50
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$251.62
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
IP
|
$358.94
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.31 |
| Max. Negotiated Rate |
$358.94 |
| Rate for Payer: Aetna Commercial |
$323.05
|
| Rate for Payer: ASR ASR |
$348.17
|
| Rate for Payer: ASR Commercial |
$348.17
|
| Rate for Payer: BCBS Trust/PPO |
$292.50
|
| Rate for Payer: BCN Commercial |
$278.29
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$337.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Healthscope Commercial |
$358.94
|
| Rate for Payer: Healthscope Whirlpool |
$348.17
|
| Rate for Payer: Mclaren Commercial |
$323.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: Nomi Health Commercial |
$294.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.87
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
OP
|
$3,955.19
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,559.67
|
| 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 |
$3,836.53
|
| Rate for Payer: ASR Commercial |
$3,836.53
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,238.91
|
| Rate for Payer: BCN Commercial |
$3,066.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cofinity Commercial |
$3,717.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,955.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,836.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,559.67
|
| 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 |
$3,361.91
|
| Rate for Payer: Nomi Health Commercial |
$3,243.26
|
| 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 |
$2,570.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,465.54
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,772.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,480.57
|
| 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 NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
IP
|
$3,955.19
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,570.87 |
| Max. Negotiated Rate |
$3,955.19 |
| Rate for Payer: Aetna Commercial |
$3,559.67
|
| Rate for Payer: ASR ASR |
$3,836.53
|
| Rate for Payer: ASR Commercial |
$3,836.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,223.08
|
| Rate for Payer: BCN Commercial |
$3,066.46
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cofinity Commercial |
$3,717.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.15
|
| Rate for Payer: Healthscope Commercial |
$3,955.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,836.53
|
| Rate for Payer: Mclaren Commercial |
$3,559.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,361.91
|
| Rate for Payer: Nomi Health Commercial |
$3,243.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,570.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,480.57
|
|
|
HC NON-SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$9,547.08
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
36100380
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$9,547.08 |
| Rate for Payer: Aetna Commercial |
$8,592.37
|
| 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 |
$9,260.67
|
| Rate for Payer: ASR Commercial |
$9,260.67
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$7,818.10
|
| Rate for Payer: BCN Commercial |
$7,401.85
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,974.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$9,547.08
|
| Rate for Payer: Healthscope Whirlpool |
$9,260.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$8,592.37
|
| 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 |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$7,828.61
|
| 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 |
$6,205.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,365.15
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$6,692.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,401.43
|
| 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
|
|
