|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
OP
|
$17,250.21
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,446.74 |
| Max. Negotiated Rate |
$17,250.21 |
| Rate for Payer: Aetna Commercial |
$15,525.19
|
| Rate for Payer: Aetna Medicare |
$10,414.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,018.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,018.01
|
| Rate for Payer: ASR ASR |
$16,732.70
|
| Rate for Payer: BCBS Complete |
$5,719.59
|
| Rate for Payer: BCBS MAPPO |
$10,414.41
|
| Rate for Payer: BCBS Trust/PPO |
$14,222.80
|
| Rate for Payer: BCN Commercial |
$14,222.80
|
| Rate for Payer: BCN Medicare Advantage |
$10,414.41
|
| Rate for Payer: Cash Price |
$13,800.17
|
| Rate for Payer: Cash Price |
$13,800.17
|
| Rate for Payer: Cofinity Commercial |
$16,215.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,800.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,414.41
|
| Rate for Payer: Healthscope Commercial |
$16,732.70
|
| Rate for Payer: Healthscope Whirlpool |
$17,250.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,414.41
|
| Rate for Payer: Mclaren Commercial |
$15,525.19
|
| Rate for Payer: Mclaren Medicaid |
$10,414.41
|
| Rate for Payer: Mclaren Medicare |
$10,414.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,935.13
|
| Rate for Payer: Meridian Medicaid |
$5,719.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,976.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,455.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,662.68
|
| Rate for Payer: Nomi Health Commercial |
$14,145.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,937.66
|
| Rate for Payer: PACE Medicare |
$9,893.69
|
| Rate for Payer: PACE SWMI |
$10,414.41
|
| Rate for Payer: PHP Commercial |
$11,455.85
|
| Rate for Payer: PHP Medicaid |
$5,582.12
|
| Rate for Payer: PHP Medicare Advantage |
$10,414.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,446.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15,114.63
|
| Rate for Payer: Priority Health Medicare |
$10,414.41
|
| Rate for Payer: Priority Health Narrow Network |
$12,092.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10,414.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,180.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,414.41
|
| Rate for Payer: UHC Exchange |
$16,142.34
|
| Rate for Payer: UHC Medicaid |
$5,446.74
|
| Rate for Payer: UHCCP DNSP |
$10,414.41
|
| Rate for Payer: UHCCP Medicaid |
$5,446.74
|
| Rate for Payer: VA VA |
$10,414.41
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
OP
|
$3,113.38
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,802.04
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,019.98
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,566.98
|
| Rate for Payer: BCN Commercial |
$2,566.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,490.70
|
| Rate for Payer: Cash Price |
$2,490.70
|
| Rate for Payer: Cofinity Commercial |
$2,926.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,490.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,019.98
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,802.04
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.37
|
| Rate for Payer: Nomi Health Commercial |
$2,552.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.03
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,280.52
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,424.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,739.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
IP
|
$3,113.38
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,335.03 |
| Max. Negotiated Rate |
$3,113.38 |
| Rate for Payer: Aetna Commercial |
$2,802.04
|
| Rate for Payer: ASR ASR |
$3,019.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,556.71
|
| Rate for Payer: BCN Commercial |
$2,556.71
|
| Rate for Payer: Cash Price |
$2,490.70
|
| Rate for Payer: Cofinity Commercial |
$2,926.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,490.70
|
| Rate for Payer: Healthscope Commercial |
$3,019.98
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.38
|
| Rate for Payer: Mclaren Commercial |
$2,802.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.37
|
| Rate for Payer: Nomi Health Commercial |
$2,552.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,739.77
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
OP
|
$2,719.02
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,447.12
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,637.45
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,241.83
|
| Rate for Payer: BCN Commercial |
$2,241.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,175.22
|
| Rate for Payer: Cash Price |
$2,175.22
|
| Rate for Payer: Cofinity Commercial |
$2,555.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,175.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,637.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,719.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,447.12
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,311.17
|
| Rate for Payer: Nomi Health Commercial |
$2,229.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,039.27
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,382.41
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,906.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,392.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
IP
|
$2,719.02
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,039.27 |
| Max. Negotiated Rate |
$2,719.02 |
| Rate for Payer: Aetna Commercial |
$2,447.12
|
| Rate for Payer: ASR ASR |
$2,637.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.86
|
| Rate for Payer: BCN Commercial |
$2,232.86
|
| Rate for Payer: Cash Price |
$2,175.22
|
| Rate for Payer: Cofinity Commercial |
$2,555.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,175.22
|
| Rate for Payer: Healthscope Commercial |
$2,637.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,719.02
|
| Rate for Payer: Mclaren Commercial |
$2,447.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,311.17
|
| Rate for Payer: Nomi Health Commercial |
$2,229.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,039.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,392.74
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,500.31
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,125.23 |
| Max. Negotiated Rate |
$1,500.31 |
| Rate for Payer: Aetna Commercial |
$1,350.28
|
| Rate for Payer: ASR ASR |
$1,455.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.05
|
| Rate for Payer: BCN Commercial |
$1,232.05
|
| Rate for Payer: Cash Price |
$1,200.25
|
| Rate for Payer: Cofinity Commercial |
$1,410.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.25
|
| Rate for Payer: Healthscope Commercial |
$1,455.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,500.31
|
| Rate for Payer: Mclaren Commercial |
$1,350.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.26
|
| Rate for Payer: Nomi Health Commercial |
$1,230.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.27
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,500.31
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$1,350.28
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$1,455.30
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.01
|
| Rate for Payer: BCN Commercial |
$1,237.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,200.25
|
| Rate for Payer: Cash Price |
$1,200.25
|
| Rate for Payer: Cofinity Commercial |
$1,410.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,455.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,500.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,350.28
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.26
|
| Rate for Payer: Nomi Health Commercial |
$1,230.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.23
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,314.57
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,051.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
IP
|
$4,665.30
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,498.97 |
| Max. Negotiated Rate |
$4,665.30 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,831.14
|
| Rate for Payer: BCN Commercial |
$3,831.14
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
OP
|
$4,665.30
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,846.54
|
| Rate for Payer: BCN Commercial |
$3,846.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,087.74
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,270.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
OP
|
$4,665.30
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$8,593.94 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: Aetna Medicare |
$5,544.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,846.54
|
| Rate for Payer: BCN Commercial |
$3,846.54
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,544.48
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$3,045.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$6,098.93
|
| Rate for Payer: PHP Medicaid |
$2,971.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,087.74
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,270.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$8,593.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP DNSP |
$5,544.48
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: VA VA |
$5,544.48
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
IP
|
$4,665.30
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,498.97 |
| Max. Negotiated Rate |
$4,665.30 |
| Rate for Payer: Aetna Commercial |
$4,198.77
|
| Rate for Payer: ASR ASR |
$4,525.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,831.14
|
| Rate for Payer: BCN Commercial |
$3,831.14
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Commercial |
$4,385.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Healthscope Commercial |
$4,525.34
|
| Rate for Payer: Healthscope Whirlpool |
$4,665.30
|
| Rate for Payer: Mclaren Commercial |
$4,198.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$3,825.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.46
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$3,457.53
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,111.78
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,353.80
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,850.73
|
| Rate for Payer: BCN Commercial |
$2,850.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,766.02
|
| Rate for Payer: Cash Price |
$2,766.02
|
| Rate for Payer: Cofinity Commercial |
$3,250.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,353.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,457.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,111.78
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.90
|
| Rate for Payer: Nomi Health Commercial |
$2,835.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,593.15
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,029.49
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$3,457.53
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,593.15 |
| Max. Negotiated Rate |
$3,457.53 |
| Rate for Payer: Aetna Commercial |
$3,111.78
|
| Rate for Payer: ASR ASR |
$3,353.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,839.32
|
| Rate for Payer: BCN Commercial |
$2,839.32
|
| Rate for Payer: Cash Price |
$2,766.02
|
| Rate for Payer: Cofinity Commercial |
$3,250.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.02
|
| Rate for Payer: Healthscope Commercial |
$3,353.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,457.53
|
| Rate for Payer: Mclaren Commercial |
$3,111.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.90
|
| Rate for Payer: Nomi Health Commercial |
$2,835.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,593.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.63
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
OP
|
$2,009.58
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$1,808.62
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$1,949.29
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.90
|
| Rate for Payer: BCN Commercial |
$1,656.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,607.66
|
| Rate for Payer: Cash Price |
$1,607.66
|
| Rate for Payer: Cofinity Commercial |
$1,889.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,607.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,949.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,009.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,808.62
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.14
|
| Rate for Payer: Nomi Health Commercial |
$1,647.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,507.18
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,760.79
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,768.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
IP
|
$2,009.58
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,507.18 |
| Max. Negotiated Rate |
$2,009.58 |
| Rate for Payer: Aetna Commercial |
$1,808.62
|
| Rate for Payer: ASR ASR |
$1,949.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.27
|
| Rate for Payer: BCN Commercial |
$1,650.27
|
| Rate for Payer: Cash Price |
$1,607.66
|
| Rate for Payer: Cofinity Commercial |
$1,889.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,607.66
|
| Rate for Payer: Healthscope Commercial |
$1,949.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,009.58
|
| Rate for Payer: Mclaren Commercial |
$1,808.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.14
|
| Rate for Payer: Nomi Health Commercial |
$1,647.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,507.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,768.43
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
OP
|
$1,117.55
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$1,117.55 |
| Rate for Payer: Aetna Commercial |
$1,005.79
|
| Rate for Payer: Aetna Medicare |
$625.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: ASR ASR |
$1,084.02
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$921.42
|
| Rate for Payer: BCN Commercial |
$921.42
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$894.04
|
| Rate for Payer: Cash Price |
$894.04
|
| Rate for Payer: Cofinity Commercial |
$1,050.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,084.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.05
|
| Rate for Payer: Mclaren Commercial |
$1,005.79
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$343.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$949.92
|
| Rate for Payer: Nomi Health Commercial |
$916.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.16
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$687.55
|
| Rate for Payer: PHP Medicaid |
$335.03
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$979.20
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health Narrow Network |
$783.40
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$983.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$968.83
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP DNSP |
$625.05
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: VA VA |
$625.05
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
IP
|
$1,117.55
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$838.16 |
| Max. Negotiated Rate |
$1,117.55 |
| Rate for Payer: Aetna Commercial |
$1,005.79
|
| Rate for Payer: ASR ASR |
$1,084.02
|
| Rate for Payer: BCBS Trust/PPO |
$917.73
|
| Rate for Payer: BCN Commercial |
$917.73
|
| Rate for Payer: Cash Price |
$894.04
|
| Rate for Payer: Cofinity Commercial |
$1,050.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.04
|
| Rate for Payer: Healthscope Commercial |
$1,084.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.55
|
| Rate for Payer: Mclaren Commercial |
$1,005.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$949.92
|
| Rate for Payer: Nomi Health Commercial |
$916.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$983.44
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$23,009.20
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$17,256.90 |
| Max. Negotiated Rate |
$23,009.20 |
| Rate for Payer: Aetna Commercial |
$20,708.28
|
| Rate for Payer: ASR ASR |
$22,318.92
|
| Rate for Payer: BCBS Trust/PPO |
$18,895.16
|
| Rate for Payer: BCN Commercial |
$18,895.16
|
| Rate for Payer: Cash Price |
$18,407.36
|
| Rate for Payer: Cofinity Commercial |
$21,628.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,407.36
|
| Rate for Payer: Healthscope Commercial |
$22,318.92
|
| Rate for Payer: Healthscope Whirlpool |
$23,009.20
|
| Rate for Payer: Mclaren Commercial |
$20,708.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,557.82
|
| Rate for Payer: Nomi Health Commercial |
$18,867.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17,256.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20,248.10
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
OP
|
$23,009.20
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,129.45 |
| Max. Negotiated Rate |
$48,477.78 |
| Rate for Payer: Aetna Commercial |
$20,708.28
|
| Rate for Payer: Aetna Medicare |
$31,275.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,094.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,094.99
|
| Rate for Payer: ASR ASR |
$22,318.92
|
| Rate for Payer: BCBS Complete |
$17,176.77
|
| Rate for Payer: BCBS MAPPO |
$31,275.99
|
| Rate for Payer: BCBS Trust/PPO |
$18,971.09
|
| Rate for Payer: BCN Commercial |
$18,971.09
|
| Rate for Payer: BCN Medicare Advantage |
$31,275.99
|
| Rate for Payer: Cash Price |
$18,407.36
|
| Rate for Payer: Cash Price |
$18,407.36
|
| Rate for Payer: Cofinity Commercial |
$21,628.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,407.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,275.99
|
| Rate for Payer: Healthscope Commercial |
$22,318.92
|
| Rate for Payer: Healthscope Whirlpool |
$23,009.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,275.99
|
| Rate for Payer: Mclaren Commercial |
$20,708.28
|
| Rate for Payer: Mclaren Medicaid |
$31,275.99
|
| Rate for Payer: Mclaren Medicare |
$31,275.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,839.79
|
| Rate for Payer: Meridian Medicaid |
$17,176.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,967.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,403.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,557.82
|
| Rate for Payer: Nomi Health Commercial |
$18,867.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17,256.90
|
| Rate for Payer: PACE Medicare |
$29,712.19
|
| Rate for Payer: PACE SWMI |
$31,275.99
|
| Rate for Payer: PHP Commercial |
$34,403.59
|
| Rate for Payer: PHP Medicaid |
$16,763.93
|
| Rate for Payer: PHP Medicare Advantage |
$31,275.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,357.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20,160.66
|
| Rate for Payer: Priority Health Medicare |
$31,275.99
|
| Rate for Payer: Priority Health Narrow Network |
$16,129.45
|
| Rate for Payer: Railroad Medicare Medicare |
$31,275.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20,248.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31,275.99
|
| Rate for Payer: UHC Exchange |
$48,477.78
|
| Rate for Payer: UHC Medicaid |
$16,357.34
|
| Rate for Payer: UHCCP DNSP |
$31,275.99
|
| Rate for Payer: UHCCP Medicaid |
$16,357.34
|
| Rate for Payer: VA VA |
$31,275.99
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$19,404.42
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,037.64 |
| Max. Negotiated Rate |
$29,748.27 |
| Rate for Payer: Aetna Commercial |
$17,463.98
|
| Rate for Payer: Aetna Medicare |
$19,192.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,990.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,990.54
|
| Rate for Payer: ASR ASR |
$18,822.29
|
| Rate for Payer: BCBS Complete |
$10,540.48
|
| Rate for Payer: BCBS MAPPO |
$19,192.43
|
| Rate for Payer: BCBS Trust/PPO |
$15,998.94
|
| Rate for Payer: BCN Commercial |
$15,998.94
|
| Rate for Payer: BCN Medicare Advantage |
$19,192.43
|
| Rate for Payer: Cash Price |
$15,523.54
|
| Rate for Payer: Cash Price |
$15,523.54
|
| Rate for Payer: Cofinity Commercial |
$18,240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,523.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,192.43
|
| Rate for Payer: Healthscope Commercial |
$18,822.29
|
| Rate for Payer: Healthscope Whirlpool |
$19,404.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,192.43
|
| Rate for Payer: Mclaren Commercial |
$17,463.98
|
| Rate for Payer: Mclaren Medicaid |
$19,192.43
|
| Rate for Payer: Mclaren Medicare |
$19,192.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,152.05
|
| Rate for Payer: Meridian Medicaid |
$10,540.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,071.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,111.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,493.76
|
| Rate for Payer: Nomi Health Commercial |
$15,911.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,553.32
|
| Rate for Payer: PACE Medicare |
$18,232.81
|
| Rate for Payer: PACE SWMI |
$19,192.43
|
| Rate for Payer: PHP Commercial |
$21,111.67
|
| Rate for Payer: PHP Medicaid |
$10,287.14
|
| Rate for Payer: PHP Medicare Advantage |
$19,192.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,037.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,002.15
|
| Rate for Payer: Priority Health Medicare |
$19,192.43
|
| Rate for Payer: Priority Health Narrow Network |
$13,602.50
|
| Rate for Payer: Railroad Medicare Medicare |
$19,192.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,075.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,192.43
|
| Rate for Payer: UHC Exchange |
$29,748.27
|
| Rate for Payer: UHC Medicaid |
$10,037.64
|
| Rate for Payer: UHCCP DNSP |
$19,192.43
|
| Rate for Payer: UHCCP Medicaid |
$10,037.64
|
| Rate for Payer: VA VA |
$19,192.43
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$19,404.42
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,553.32 |
| Max. Negotiated Rate |
$19,404.42 |
| Rate for Payer: Aetna Commercial |
$17,463.98
|
| Rate for Payer: ASR ASR |
$18,822.29
|
| Rate for Payer: BCBS Trust/PPO |
$15,934.91
|
| Rate for Payer: BCN Commercial |
$15,934.91
|
| Rate for Payer: Cash Price |
$15,523.54
|
| Rate for Payer: Cofinity Commercial |
$18,240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,523.54
|
| Rate for Payer: Healthscope Commercial |
$18,822.29
|
| Rate for Payer: Healthscope Whirlpool |
$19,404.42
|
| Rate for Payer: Mclaren Commercial |
$17,463.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,493.76
|
| Rate for Payer: Nomi Health Commercial |
$15,911.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,553.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,075.89
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$18,775.50
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,591.56 |
| Max. Negotiated Rate |
$34,353.56 |
| Rate for Payer: Aetna Commercial |
$16,897.95
|
| Rate for Payer: Aetna Medicare |
$22,163.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,704.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,704.49
|
| Rate for Payer: ASR ASR |
$18,212.24
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$15,480.40
|
| Rate for Payer: BCN Commercial |
$15,480.40
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$15,020.40
|
| Rate for Payer: Cash Price |
$15,020.40
|
| Rate for Payer: Cofinity Commercial |
$17,648.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,020.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$18,212.24
|
| Rate for Payer: Healthscope Whirlpool |
$18,775.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,163.59
|
| Rate for Payer: Mclaren Commercial |
$16,897.95
|
| Rate for Payer: Mclaren Medicaid |
$22,163.59
|
| Rate for Payer: Mclaren Medicare |
$22,163.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,271.77
|
| Rate for Payer: Meridian Medicaid |
$12,172.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,488.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,379.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,959.17
|
| Rate for Payer: Nomi Health Commercial |
$15,395.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,081.62
|
| Rate for Payer: PACE Medicare |
$21,055.41
|
| Rate for Payer: PACE SWMI |
$22,163.59
|
| Rate for Payer: PHP Commercial |
$24,379.95
|
| Rate for Payer: PHP Medicaid |
$11,879.68
|
| Rate for Payer: PHP Medicare Advantage |
$22,163.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,591.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16,451.09
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health Narrow Network |
$13,161.63
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,522.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,163.59
|
| Rate for Payer: UHC Exchange |
$34,353.56
|
| Rate for Payer: UHC Medicaid |
$11,591.56
|
| Rate for Payer: UHCCP DNSP |
$22,163.59
|
| Rate for Payer: UHCCP Medicaid |
$11,591.56
|
| Rate for Payer: VA VA |
$22,163.59
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$18,775.50
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,081.62 |
| Max. Negotiated Rate |
$18,775.50 |
| Rate for Payer: Aetna Commercial |
$16,897.95
|
| Rate for Payer: ASR ASR |
$18,212.24
|
| Rate for Payer: BCBS Trust/PPO |
$15,418.44
|
| Rate for Payer: BCN Commercial |
$15,418.44
|
| Rate for Payer: Cash Price |
$15,020.40
|
| Rate for Payer: Cofinity Commercial |
$17,648.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,020.40
|
| Rate for Payer: Healthscope Commercial |
$18,212.24
|
| Rate for Payer: Healthscope Whirlpool |
$18,775.50
|
| Rate for Payer: Mclaren Commercial |
$16,897.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,959.17
|
| Rate for Payer: Nomi Health Commercial |
$15,395.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,081.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,522.44
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$12,424.69
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,312.46 |
| Max. Negotiated Rate |
$12,780.73 |
| Rate for Payer: Aetna Commercial |
$11,182.22
|
| Rate for Payer: Aetna Medicare |
$8,245.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: ASR ASR |
$12,051.95
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$10,244.16
|
| Rate for Payer: BCN Commercial |
$10,244.16
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$9,939.75
|
| Rate for Payer: Cash Price |
$9,939.75
|
| Rate for Payer: Cofinity Commercial |
$11,679.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,939.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$12,051.95
|
| Rate for Payer: Healthscope Whirlpool |
$12,424.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,245.63
|
| Rate for Payer: Mclaren Commercial |
$11,182.22
|
| Rate for Payer: Mclaren Medicaid |
$8,245.63
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$4,528.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,560.99
|
| Rate for Payer: Nomi Health Commercial |
$10,188.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,318.52
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$9,070.19
|
| Rate for Payer: PHP Medicaid |
$4,419.66
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,886.51
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health Narrow Network |
$8,709.71
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,933.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Exchange |
$12,780.73
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP DNSP |
$8,245.63
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: VA VA |
$8,245.63
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
IP
|
$12,424.69
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,318.52 |
| Max. Negotiated Rate |
$12,424.69 |
| Rate for Payer: Aetna Commercial |
$11,182.22
|
| Rate for Payer: ASR ASR |
$12,051.95
|
| Rate for Payer: BCBS Trust/PPO |
$10,203.16
|
| Rate for Payer: BCN Commercial |
$10,203.16
|
| Rate for Payer: Cash Price |
$9,939.75
|
| Rate for Payer: Cofinity Commercial |
$11,679.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,939.75
|
| Rate for Payer: Healthscope Commercial |
$12,051.95
|
| Rate for Payer: Healthscope Whirlpool |
$12,424.69
|
| Rate for Payer: Mclaren Commercial |
$11,182.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,560.99
|
| Rate for Payer: Nomi Health Commercial |
$10,188.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,318.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,933.73
|
|
