|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
IP
|
$7,411.20
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,558.40 |
| Max. Negotiated Rate |
$7,411.20 |
| Rate for Payer: Aetna Commercial |
$6,670.08
|
| Rate for Payer: ASR ASR |
$7,188.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,086.08
|
| Rate for Payer: BCN Commercial |
$6,086.08
|
| Rate for Payer: Cash Price |
$5,928.96
|
| Rate for Payer: Cofinity Commercial |
$6,966.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,928.96
|
| Rate for Payer: Healthscope Commercial |
$7,188.86
|
| Rate for Payer: Healthscope Whirlpool |
$7,411.20
|
| Rate for Payer: Mclaren Commercial |
$6,670.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,299.52
|
| Rate for Payer: Nomi Health Commercial |
$6,077.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,521.86
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
IP
|
$1,040.40
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$780.30 |
| Max. Negotiated Rate |
$1,040.40 |
| Rate for Payer: Aetna Commercial |
$936.36
|
| Rate for Payer: ASR ASR |
$1,009.19
|
| Rate for Payer: BCBS Trust/PPO |
$854.38
|
| Rate for Payer: BCN Commercial |
$854.38
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$977.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Healthscope Commercial |
$1,009.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,040.40
|
| Rate for Payer: Mclaren Commercial |
$936.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$915.55
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
OP
|
$1,040.40
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$384.95 |
| Max. Negotiated Rate |
$1,040.40 |
| Rate for Payer: Aetna Commercial |
$936.36
|
| Rate for Payer: Aetna Medicare |
$384.95
|
| Rate for Payer: ASR ASR |
$1,009.19
|
| Rate for Payer: BCBS Complete |
$416.16
|
| Rate for Payer: BCBS Trust/PPO |
$857.81
|
| Rate for Payer: BCN Commercial |
$857.81
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$977.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Healthscope Commercial |
$1,009.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,040.40
|
| Rate for Payer: Mclaren Commercial |
$936.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$832.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$911.60
|
| Rate for Payer: Priority Health Narrow Network |
$729.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$915.55
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
IP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.84 |
| Max. Negotiated Rate |
$862.45 |
| Rate for Payer: Aetna Commercial |
$776.21
|
| Rate for Payer: ASR ASR |
$836.58
|
| Rate for Payer: BCBS Trust/PPO |
$708.24
|
| Rate for Payer: BCN Commercial |
$708.24
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Commercial |
$810.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Healthscope Commercial |
$836.58
|
| Rate for Payer: Healthscope Whirlpool |
$862.45
|
| Rate for Payer: Mclaren Commercial |
$776.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Nomi Health Commercial |
$707.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$758.96
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$319.11 |
| Max. Negotiated Rate |
$862.45 |
| Rate for Payer: Aetna Commercial |
$776.21
|
| Rate for Payer: Aetna Medicare |
$319.11
|
| Rate for Payer: ASR ASR |
$836.58
|
| Rate for Payer: BCBS Complete |
$344.98
|
| Rate for Payer: BCBS Trust/PPO |
$711.09
|
| Rate for Payer: BCN Commercial |
$711.09
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Commercial |
$810.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Healthscope Commercial |
$836.58
|
| Rate for Payer: Healthscope Whirlpool |
$862.45
|
| Rate for Payer: Mclaren Commercial |
$776.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Nomi Health Commercial |
$707.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$755.68
|
| Rate for Payer: Priority Health Narrow Network |
$604.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$758.96
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$858.99 |
| Max. Negotiated Rate |
$1,145.32 |
| Rate for Payer: Aetna Commercial |
$1,030.79
|
| Rate for Payer: ASR ASR |
$1,110.96
|
| Rate for Payer: BCBS Trust/PPO |
$940.54
|
| Rate for Payer: BCN Commercial |
$940.54
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$1,076.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,110.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.32
|
| Rate for Payer: Mclaren Commercial |
$1,030.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.88
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$423.77 |
| Max. Negotiated Rate |
$1,145.32 |
| Rate for Payer: Aetna Commercial |
$1,030.79
|
| Rate for Payer: Aetna Medicare |
$423.77
|
| Rate for Payer: ASR ASR |
$1,110.96
|
| Rate for Payer: BCBS Complete |
$458.13
|
| Rate for Payer: BCBS Trust/PPO |
$944.32
|
| Rate for Payer: BCN Commercial |
$944.32
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$1,076.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,110.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.32
|
| Rate for Payer: Mclaren Commercial |
$1,030.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,003.53
|
| Rate for Payer: Priority Health Narrow Network |
$802.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.88
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
OP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,942.63 |
| Max. Negotiated Rate |
$10,655.77 |
| Rate for Payer: Aetna Commercial |
$9,590.19
|
| Rate for Payer: Aetna Medicare |
$3,942.63
|
| Rate for Payer: ASR ASR |
$10,336.10
|
| Rate for Payer: BCBS Complete |
$4,262.31
|
| Rate for Payer: BCBS Trust/PPO |
$8,785.68
|
| Rate for Payer: BCN Commercial |
$8,785.68
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Commercial |
$10,016.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Healthscope Commercial |
$10,336.10
|
| Rate for Payer: Healthscope Whirlpool |
$10,655.77
|
| Rate for Payer: Mclaren Commercial |
$9,590.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,524.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Nomi Health Commercial |
$8,737.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,336.59
|
| Rate for Payer: Priority Health Narrow Network |
$7,469.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,377.08
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
IP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,991.83 |
| Max. Negotiated Rate |
$10,655.77 |
| Rate for Payer: Aetna Commercial |
$9,590.19
|
| Rate for Payer: ASR ASR |
$10,336.10
|
| Rate for Payer: BCBS Trust/PPO |
$8,750.52
|
| Rate for Payer: BCN Commercial |
$8,750.52
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Commercial |
$10,016.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Healthscope Commercial |
$10,336.10
|
| Rate for Payer: Healthscope Whirlpool |
$10,655.77
|
| Rate for Payer: Mclaren Commercial |
$9,590.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Nomi Health Commercial |
$8,737.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,377.08
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,071.82
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$803.87 |
| Max. Negotiated Rate |
$1,071.82 |
| Rate for Payer: Aetna Commercial |
$964.64
|
| Rate for Payer: ASR ASR |
$1,039.67
|
| Rate for Payer: BCBS Trust/PPO |
$880.18
|
| Rate for Payer: BCN Commercial |
$880.18
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cofinity Commercial |
$1,007.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.46
|
| Rate for Payer: Healthscope Commercial |
$1,039.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,071.82
|
| Rate for Payer: Mclaren Commercial |
$964.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.05
|
| Rate for Payer: Nomi Health Commercial |
$878.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$943.20
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,071.82
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.57 |
| Max. Negotiated Rate |
$1,071.82 |
| Rate for Payer: Aetna Commercial |
$964.64
|
| Rate for Payer: Aetna Medicare |
$396.57
|
| Rate for Payer: ASR ASR |
$1,039.67
|
| Rate for Payer: BCBS Complete |
$428.73
|
| Rate for Payer: BCBS Trust/PPO |
$883.72
|
| Rate for Payer: BCN Commercial |
$883.72
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cofinity Commercial |
$1,007.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.46
|
| Rate for Payer: Healthscope Commercial |
$1,039.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,071.82
|
| Rate for Payer: Mclaren Commercial |
$964.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$857.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.05
|
| Rate for Payer: Nomi Health Commercial |
$878.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$939.13
|
| Rate for Payer: Priority Health Narrow Network |
$751.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$943.20
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
OP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.13 |
| Max. Negotiated Rate |
$949.01 |
| Rate for Payer: Aetna Commercial |
$854.11
|
| Rate for Payer: Aetna Medicare |
$351.13
|
| Rate for Payer: ASR ASR |
$920.54
|
| Rate for Payer: BCBS Complete |
$379.60
|
| Rate for Payer: BCBS Trust/PPO |
$782.46
|
| Rate for Payer: BCN Commercial |
$782.46
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Commercial |
$892.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$920.54
|
| Rate for Payer: Healthscope Whirlpool |
$949.01
|
| Rate for Payer: Mclaren Commercial |
$854.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$759.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Nomi Health Commercial |
$778.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$831.52
|
| Rate for Payer: Priority Health Narrow Network |
$665.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$835.13
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
IP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$711.76 |
| Max. Negotiated Rate |
$949.01 |
| Rate for Payer: Aetna Commercial |
$854.11
|
| Rate for Payer: ASR ASR |
$920.54
|
| Rate for Payer: BCBS Trust/PPO |
$779.33
|
| Rate for Payer: BCN Commercial |
$779.33
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Commercial |
$892.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$920.54
|
| Rate for Payer: Healthscope Whirlpool |
$949.01
|
| Rate for Payer: Mclaren Commercial |
$854.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Nomi Health Commercial |
$778.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$835.13
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
IP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,228.57 |
| Max. Negotiated Rate |
$6,971.43 |
| Rate for Payer: Aetna Commercial |
$6,274.29
|
| Rate for Payer: ASR ASR |
$6,762.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,724.94
|
| Rate for Payer: BCN Commercial |
$5,724.94
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Commercial |
$6,553.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,762.29
|
| Rate for Payer: Healthscope Whirlpool |
$6,971.43
|
| Rate for Payer: Mclaren Commercial |
$6,274.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Nomi Health Commercial |
$5,716.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,134.86
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
OP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,579.43 |
| Max. Negotiated Rate |
$6,971.43 |
| Rate for Payer: Aetna Commercial |
$6,274.29
|
| Rate for Payer: Aetna Medicare |
$2,579.43
|
| Rate for Payer: ASR ASR |
$6,762.29
|
| Rate for Payer: BCBS Complete |
$2,788.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,747.94
|
| Rate for Payer: BCN Commercial |
$5,747.94
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Commercial |
$6,553.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,762.29
|
| Rate for Payer: Healthscope Whirlpool |
$6,971.43
|
| Rate for Payer: Mclaren Commercial |
$6,274.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,577.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Nomi Health Commercial |
$5,716.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,108.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,886.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,134.86
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
IP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,345.30 |
| Max. Negotiated Rate |
$5,793.73 |
| Rate for Payer: Aetna Commercial |
$5,214.36
|
| Rate for Payer: ASR ASR |
$5,619.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,757.81
|
| Rate for Payer: BCN Commercial |
$4,757.81
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Commercial |
$5,446.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,619.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,793.73
|
| Rate for Payer: Mclaren Commercial |
$5,214.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Nomi Health Commercial |
$4,750.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,098.48
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
OP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,143.68 |
| Max. Negotiated Rate |
$5,793.73 |
| Rate for Payer: Aetna Commercial |
$5,214.36
|
| Rate for Payer: Aetna Medicare |
$2,143.68
|
| Rate for Payer: ASR ASR |
$5,619.92
|
| Rate for Payer: BCBS Complete |
$2,317.49
|
| Rate for Payer: BCBS Trust/PPO |
$4,776.93
|
| Rate for Payer: BCN Commercial |
$4,776.93
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Commercial |
$5,446.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,619.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,793.73
|
| Rate for Payer: Mclaren Commercial |
$5,214.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,634.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Nomi Health Commercial |
$4,750.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,076.47
|
| Rate for Payer: Priority Health Narrow Network |
$4,061.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,098.48
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,636.72 |
| Max. Negotiated Rate |
$3,515.62 |
| Rate for Payer: Aetna Commercial |
$3,164.06
|
| Rate for Payer: ASR ASR |
$3,410.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,887.03
|
| Rate for Payer: BCN Commercial |
$2,887.03
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Commercial |
$3,304.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Healthscope Commercial |
$3,410.15
|
| Rate for Payer: Healthscope Whirlpool |
$3,515.62
|
| Rate for Payer: Mclaren Commercial |
$3,164.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Nomi Health Commercial |
$2,882.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,093.75
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,515.62 |
| Rate for Payer: Aetna Commercial |
$3,164.06
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$3,410.15
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,898.63
|
| Rate for Payer: BCN Commercial |
$2,898.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Commercial |
$3,304.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,410.15
|
| Rate for Payer: Healthscope Whirlpool |
$3,515.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$3,164.06
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Nomi Health Commercial |
$2,882.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,080.39
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,464.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,093.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,561.38 |
| Max. Negotiated Rate |
$3,415.17 |
| Rate for Payer: Aetna Commercial |
$3,073.65
|
| Rate for Payer: ASR ASR |
$3,312.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,804.54
|
| Rate for Payer: BCN Commercial |
$2,804.54
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Commercial |
$3,210.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Healthscope Commercial |
$3,312.71
|
| Rate for Payer: Healthscope Whirlpool |
$3,415.17
|
| Rate for Payer: Mclaren Commercial |
$3,073.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Nomi Health Commercial |
$2,800.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,005.35
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$5,444.08 |
| Rate for Payer: Aetna Commercial |
$3,073.65
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$3,312.71
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,815.81
|
| Rate for Payer: BCN Commercial |
$2,815.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Commercial |
$3,210.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$3,312.71
|
| Rate for Payer: Healthscope Whirlpool |
$3,415.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$3,073.65
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Nomi Health Commercial |
$2,800.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,992.37
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,394.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,005.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,337.20 |
| Max. Negotiated Rate |
$9,019.47 |
| Rate for Payer: Aetna Commercial |
$8,117.52
|
| Rate for Payer: Aetna Medicare |
$3,337.20
|
| Rate for Payer: ASR ASR |
$8,748.89
|
| Rate for Payer: BCBS Complete |
$3,607.79
|
| Rate for Payer: BCBS Trust/PPO |
$7,436.55
|
| Rate for Payer: BCN Commercial |
$7,436.55
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Commercial |
$8,478.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,748.89
|
| Rate for Payer: Healthscope Whirlpool |
$9,019.47
|
| Rate for Payer: Mclaren Commercial |
$8,117.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,215.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Nomi Health Commercial |
$7,395.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,902.86
|
| Rate for Payer: Priority Health Narrow Network |
$6,322.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.13
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,764.60 |
| Max. Negotiated Rate |
$9,019.47 |
| Rate for Payer: Aetna Commercial |
$8,117.52
|
| Rate for Payer: ASR ASR |
$8,748.89
|
| Rate for Payer: BCBS Trust/PPO |
$7,406.79
|
| Rate for Payer: BCN Commercial |
$7,406.79
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Commercial |
$8,478.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,748.89
|
| Rate for Payer: Healthscope Whirlpool |
$9,019.47
|
| Rate for Payer: Mclaren Commercial |
$8,117.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Nomi Health Commercial |
$7,395.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.13
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,117.69 |
| Max. Negotiated Rate |
$5,490.26 |
| Rate for Payer: Aetna Commercial |
$4,941.23
|
| Rate for Payer: ASR ASR |
$5,325.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,508.60
|
| Rate for Payer: BCN Commercial |
$4,508.60
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Commercial |
$5,160.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$5,325.55
|
| Rate for Payer: Healthscope Whirlpool |
$5,490.26
|
| Rate for Payer: Mclaren Commercial |
$4,941.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Nomi Health Commercial |
$4,502.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,831.43
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,031.40 |
| Max. Negotiated Rate |
$5,490.26 |
| Rate for Payer: Aetna Commercial |
$4,941.23
|
| Rate for Payer: Aetna Medicare |
$2,031.40
|
| Rate for Payer: ASR ASR |
$5,325.55
|
| Rate for Payer: BCBS Complete |
$2,196.10
|
| Rate for Payer: BCBS Trust/PPO |
$4,526.72
|
| Rate for Payer: BCN Commercial |
$4,526.72
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Commercial |
$5,160.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$5,325.55
|
| Rate for Payer: Healthscope Whirlpool |
$5,490.26
|
| Rate for Payer: Mclaren Commercial |
$4,941.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,392.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Nomi Health Commercial |
$4,502.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,810.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,848.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,831.43
|
|
