|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
OP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,733.75 |
| Max. Negotiated Rate |
$33,931.55 |
| Rate for Payer: Aetna Commercial |
$19,524.93
|
| Rate for Payer: Aetna Medicare |
$21,891.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,364.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,364.15
|
| Rate for Payer: ASR ASR |
$21,043.54
|
| Rate for Payer: ASR Commercial |
$21,043.54
|
| Rate for Payer: BCBS Complete |
$12,320.43
|
| Rate for Payer: BCBS MAPPO |
$21,891.32
|
| Rate for Payer: BCBS Trust/PPO |
$17,765.52
|
| Rate for Payer: BCN Commercial |
$16,819.65
|
| Rate for Payer: BCN Medicare Advantage |
$21,891.32
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$20,392.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$21,694.37
|
| Rate for Payer: Healthscope Whirlpool |
$21,043.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,891.32
|
| Rate for Payer: Mclaren Commercial |
$19,524.93
|
| Rate for Payer: Mclaren Medicaid |
$11,733.75
|
| Rate for Payer: Mclaren Medicare |
$21,891.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,985.89
|
| Rate for Payer: Meridian Medicaid |
$12,320.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,175.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: Nomi Health Commercial |
$17,789.38
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$24,080.45
|
| Rate for Payer: PHP Medicaid |
$11,733.75
|
| Rate for Payer: PHP Medicare Advantage |
$21,891.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,733.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,008.61
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health Narrow Network |
$15,207.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21,891.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,091.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,891.32
|
| Rate for Payer: UHC Exchange |
$33,931.55
|
| Rate for Payer: UHC Medicare Advantage |
$21,891.32
|
| Rate for Payer: UHCCP DNSP |
$21,891.32
|
| Rate for Payer: UHCCP Medicaid |
$11,733.75
|
| Rate for Payer: VA VA |
$21,891.32
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
IP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,101.34 |
| Max. Negotiated Rate |
$21,694.37 |
| Rate for Payer: Aetna Commercial |
$19,524.93
|
| Rate for Payer: ASR ASR |
$21,043.54
|
| Rate for Payer: ASR Commercial |
$21,043.54
|
| Rate for Payer: BCBS Trust/PPO |
$17,678.74
|
| Rate for Payer: BCN Commercial |
$16,819.65
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$20,392.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Healthscope Commercial |
$21,694.37
|
| Rate for Payer: Healthscope Whirlpool |
$21,043.54
|
| Rate for Payer: Mclaren Commercial |
$19,524.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: Nomi Health Commercial |
$17,789.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,091.05
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
IP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,678.70 |
| Max. Negotiated Rate |
$16,428.77 |
| Rate for Payer: Aetna Commercial |
$14,785.89
|
| Rate for Payer: ASR ASR |
$15,935.91
|
| Rate for Payer: ASR Commercial |
$15,935.91
|
| Rate for Payer: BCBS Trust/PPO |
$13,387.80
|
| Rate for Payer: BCN Commercial |
$12,737.23
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$15,443.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Healthscope Commercial |
$16,428.77
|
| Rate for Payer: Healthscope Whirlpool |
$15,935.91
|
| Rate for Payer: Mclaren Commercial |
$14,785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: Nomi Health Commercial |
$13,471.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,457.32
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
OP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,470.75 |
| Max. Negotiated Rate |
$16,428.77 |
| Rate for Payer: Aetna Commercial |
$14,785.89
|
| Rate for Payer: Aetna Medicare |
$10,206.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,758.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,758.29
|
| Rate for Payer: ASR ASR |
$15,935.91
|
| Rate for Payer: ASR Commercial |
$15,935.91
|
| Rate for Payer: BCBS Complete |
$5,744.29
|
| Rate for Payer: BCBS MAPPO |
$10,206.63
|
| Rate for Payer: BCBS Trust/PPO |
$13,453.52
|
| Rate for Payer: BCN Commercial |
$12,737.23
|
| Rate for Payer: BCN Medicare Advantage |
$10,206.63
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$15,443.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,206.63
|
| Rate for Payer: Healthscope Commercial |
$16,428.77
|
| Rate for Payer: Healthscope Whirlpool |
$15,935.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,206.63
|
| Rate for Payer: Mclaren Commercial |
$14,785.89
|
| Rate for Payer: Mclaren Medicaid |
$5,470.75
|
| Rate for Payer: Mclaren Medicare |
$10,206.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,716.96
|
| Rate for Payer: Meridian Medicaid |
$5,744.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,737.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: Nomi Health Commercial |
$13,471.59
|
| Rate for Payer: PACE Medicare |
$9,696.30
|
| Rate for Payer: PACE SWMI |
$10,206.63
|
| Rate for Payer: PHP Commercial |
$11,227.29
|
| Rate for Payer: PHP Medicaid |
$5,470.75
|
| Rate for Payer: PHP Medicare Advantage |
$10,206.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,470.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,394.89
|
| Rate for Payer: Priority Health Medicare |
$10,206.63
|
| Rate for Payer: Priority Health Narrow Network |
$11,516.57
|
| Rate for Payer: Railroad Medicare Medicare |
$10,206.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,457.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,206.63
|
| Rate for Payer: UHC Exchange |
$15,820.28
|
| Rate for Payer: UHC Medicare Advantage |
$10,206.63
|
| Rate for Payer: UHCCP DNSP |
$10,206.63
|
| Rate for Payer: UHCCP Medicaid |
$5,470.75
|
| Rate for Payer: VA VA |
$10,206.63
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
OP
|
$3,052.33
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$2,747.10
|
| 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 |
$2,960.76
|
| Rate for Payer: ASR Commercial |
$2,960.76
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.55
|
| Rate for Payer: BCN Commercial |
$2,366.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cofinity Commercial |
$2,869.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,441.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,052.33
|
| Rate for Payer: Healthscope Whirlpool |
$2,960.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$2,747.10
|
| 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 |
$2,594.48
|
| Rate for Payer: Nomi Health Commercial |
$2,502.91
|
| 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 |
$1,984.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,674.45
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,139.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.05
|
| 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 REPLACEMENT CATH CVAD
|
Facility
|
IP
|
$3,052.33
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,984.01 |
| Max. Negotiated Rate |
$3,052.33 |
| Rate for Payer: Aetna Commercial |
$2,747.10
|
| Rate for Payer: ASR ASR |
$2,960.76
|
| Rate for Payer: ASR Commercial |
$2,960.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,487.34
|
| Rate for Payer: BCN Commercial |
$2,366.47
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cofinity Commercial |
$2,869.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,441.86
|
| Rate for Payer: Healthscope Commercial |
$3,052.33
|
| Rate for Payer: Healthscope Whirlpool |
$2,960.76
|
| Rate for Payer: Mclaren Commercial |
$2,747.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.48
|
| Rate for Payer: Nomi Health Commercial |
$2,502.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.05
|
|
|
HC REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
OP
|
$2,665.71
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$2,399.14
|
| 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 |
$2,585.74
|
| Rate for Payer: ASR Commercial |
$2,585.74
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,182.95
|
| Rate for Payer: BCN Commercial |
$2,066.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cofinity Commercial |
$2,505.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,132.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,665.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,585.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$2,399.14
|
| 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 |
$2,265.85
|
| Rate for Payer: Nomi Health Commercial |
$2,185.88
|
| 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 |
$1,732.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,335.70
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,868.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,345.82
|
| 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 REPLACEMENT COMPLETE CVAD WITH PORT
|
Facility
|
IP
|
$2,665.71
|
|
|
Service Code
|
CPT 36585
|
| Hospital Charge Code |
36100139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,732.71 |
| Max. Negotiated Rate |
$2,665.71 |
| Rate for Payer: Aetna Commercial |
$2,399.14
|
| Rate for Payer: ASR ASR |
$2,585.74
|
| Rate for Payer: ASR Commercial |
$2,585.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,172.29
|
| Rate for Payer: BCN Commercial |
$2,066.72
|
| Rate for Payer: Cash Price |
$2,132.57
|
| Rate for Payer: Cofinity Commercial |
$2,505.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,132.57
|
| Rate for Payer: Healthscope Commercial |
$2,665.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,585.74
|
| Rate for Payer: Mclaren Commercial |
$2,399.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,265.85
|
| Rate for Payer: Nomi Health Commercial |
$2,185.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,345.82
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,470.89
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$956.08 |
| Max. Negotiated Rate |
$1,470.89 |
| Rate for Payer: Aetna Commercial |
$1,323.80
|
| Rate for Payer: ASR ASR |
$1,426.76
|
| Rate for Payer: ASR Commercial |
$1,426.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.63
|
| Rate for Payer: BCN Commercial |
$1,140.38
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cofinity Commercial |
$1,382.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.71
|
| Rate for Payer: Healthscope Commercial |
$1,470.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.76
|
| Rate for Payer: Mclaren Commercial |
$1,323.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.26
|
| Rate for Payer: Nomi Health Commercial |
$1,206.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,294.38
|
|
|
HC REPLACEMENT COMPLETE NON TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,470.89
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
36100134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,323.80
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$1,426.76
|
| Rate for Payer: ASR Commercial |
$1,426.76
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.51
|
| Rate for Payer: BCN Commercial |
$1,140.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cash Price |
$1,176.71
|
| Rate for Payer: Cofinity Commercial |
$1,382.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,470.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,323.80
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.26
|
| Rate for Payer: Nomi Health Commercial |
$1,206.13
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.79
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,294.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| 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 |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,745.50
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| 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 |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| 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 |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,007.58
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,206.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
| 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 REPLACEMENT COMPLETE TUNNELED CVAD WITH PORT
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36582
|
| Hospital Charge Code |
36100136
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$4,573.82 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,727.21
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$4,573.82 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,727.21
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVAD WITH PUMP
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36583
|
| Hospital Charge Code |
36100137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,745.50
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,007.58
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,206.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$3,292.89
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,140.38 |
| Max. Negotiated Rate |
$3,292.89 |
| Rate for Payer: Aetna Commercial |
$2,963.60
|
| Rate for Payer: ASR ASR |
$3,194.10
|
| Rate for Payer: ASR Commercial |
$3,194.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.38
|
| Rate for Payer: BCN Commercial |
$2,552.98
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cofinity Commercial |
$3,095.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.31
|
| Rate for Payer: Healthscope Commercial |
$3,292.89
|
| Rate for Payer: Healthscope Whirlpool |
$3,194.10
|
| Rate for Payer: Mclaren Commercial |
$2,963.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.96
|
| Rate for Payer: Nomi Health Commercial |
$2,700.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,897.74
|
|
|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$3,292.89
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$2,963.60
|
| 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 |
$3,194.10
|
| Rate for Payer: ASR Commercial |
$3,194.10
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,696.55
|
| Rate for Payer: BCN Commercial |
$2,552.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cofinity Commercial |
$3,095.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,292.89
|
| Rate for Payer: Healthscope Whirlpool |
$3,194.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$2,963.60
|
| 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 |
$2,798.96
|
| Rate for Payer: Nomi Health Commercial |
$2,700.17
|
| 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 |
$2,140.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,885.23
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,308.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,897.74
|
| 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 REPLACEMENT OF PICC W IMAGING
|
Facility
|
IP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.62 |
| Max. Negotiated Rate |
$1,970.18 |
| Rate for Payer: Aetna Commercial |
$1,773.16
|
| Rate for Payer: ASR ASR |
$1,911.07
|
| Rate for Payer: ASR Commercial |
$1,911.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,605.50
|
| Rate for Payer: BCN Commercial |
$1,527.48
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,851.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Healthscope Commercial |
$1,970.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.07
|
| Rate for Payer: Mclaren Commercial |
$1,773.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,674.65
|
| Rate for Payer: Nomi Health Commercial |
$1,615.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,733.76
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
OP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,773.16
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$1,911.07
|
| Rate for Payer: ASR Commercial |
$1,911.07
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.38
|
| Rate for Payer: BCN Commercial |
$1,527.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,851.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,970.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,773.16
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,674.65
|
| Rate for Payer: Nomi Health Commercial |
$1,615.55
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.27
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,733.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
OP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna Commercial |
$957.90
|
| Rate for Payer: Aetna Medicare |
$602.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: ASR ASR |
$1,032.40
|
| Rate for Payer: ASR Commercial |
$1,032.40
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCBS Trust/PPO |
$871.58
|
| Rate for Payer: BCN Commercial |
$825.18
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$1,000.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$1,064.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,032.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$602.98
|
| Rate for Payer: Mclaren Commercial |
$957.90
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$663.28
|
| Rate for Payer: PHP Medicaid |
$323.20
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$932.57
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health Narrow Network |
$746.10
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$936.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$934.62
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP DNSP |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: VA VA |
$602.98
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
IP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$691.81 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna Commercial |
$957.90
|
| Rate for Payer: ASR ASR |
$1,032.40
|
| Rate for Payer: ASR Commercial |
$1,032.40
|
| Rate for Payer: BCBS Trust/PPO |
$867.32
|
| Rate for Payer: BCN Commercial |
$825.18
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$1,000.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Healthscope Commercial |
$1,064.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,032.40
|
| Rate for Payer: Mclaren Commercial |
$957.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$936.61
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,243.79 |
| Max. Negotiated Rate |
$21,913.52 |
| Rate for Payer: Aetna Commercial |
$19,722.17
|
| Rate for Payer: ASR ASR |
$21,256.11
|
| Rate for Payer: ASR Commercial |
$21,256.11
|
| Rate for Payer: BCBS Trust/PPO |
$17,857.33
|
| Rate for Payer: BCN Commercial |
$16,989.55
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$20,598.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Healthscope Commercial |
$21,913.52
|
| Rate for Payer: Healthscope Whirlpool |
$21,256.11
|
| Rate for Payer: Mclaren Commercial |
$19,722.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: Nomi Health Commercial |
$17,969.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,283.90
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
OP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,243.79 |
| Max. Negotiated Rate |
$48,466.98 |
| Rate for Payer: Aetna Commercial |
$19,722.17
|
| Rate for Payer: Aetna Medicare |
$31,269.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,086.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,086.28
|
| Rate for Payer: ASR ASR |
$21,256.11
|
| Rate for Payer: ASR Commercial |
$21,256.11
|
| Rate for Payer: BCBS Complete |
$17,598.20
|
| Rate for Payer: BCBS MAPPO |
$31,269.02
|
| Rate for Payer: BCBS Trust/PPO |
$17,944.98
|
| Rate for Payer: BCN Commercial |
$16,989.55
|
| Rate for Payer: BCN Medicare Advantage |
$31,269.02
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$20,598.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,269.02
|
| Rate for Payer: Healthscope Commercial |
$21,913.52
|
| Rate for Payer: Healthscope Whirlpool |
$21,256.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,269.02
|
| Rate for Payer: Mclaren Commercial |
$19,722.17
|
| Rate for Payer: Mclaren Medicaid |
$16,760.19
|
| Rate for Payer: Mclaren Medicare |
$31,269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,832.47
|
| Rate for Payer: Meridian Medicaid |
$17,598.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,959.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: Nomi Health Commercial |
$17,969.09
|
| Rate for Payer: PACE Medicare |
$29,705.57
|
| Rate for Payer: PACE SWMI |
$31,269.02
|
| Rate for Payer: PHP Commercial |
$34,395.92
|
| Rate for Payer: PHP Medicaid |
$16,760.19
|
| Rate for Payer: PHP Medicare Advantage |
$31,269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,760.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,200.63
|
| Rate for Payer: Priority Health Medicare |
$31,269.02
|
| Rate for Payer: Priority Health Narrow Network |
$15,361.38
|
| Rate for Payer: Railroad Medicare Medicare |
$31,269.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,283.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,269.02
|
| Rate for Payer: UHC Exchange |
$48,466.98
|
| Rate for Payer: UHC Medicare Advantage |
$31,269.02
|
| Rate for Payer: UHCCP DNSP |
$31,269.02
|
| Rate for Payer: UHCCP Medicaid |
$16,760.19
|
| Rate for Payer: VA VA |
$31,269.02
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,969.45 |
| Max. Negotiated Rate |
$28,829.57 |
| Rate for Payer: Aetna Commercial |
$16,632.36
|
| Rate for Payer: Aetna Medicare |
$18,599.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,249.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,249.65
|
| Rate for Payer: ASR ASR |
$17,925.99
|
| Rate for Payer: ASR Commercial |
$17,925.99
|
| Rate for Payer: BCBS Complete |
$10,467.92
|
| Rate for Payer: BCBS MAPPO |
$18,599.72
|
| Rate for Payer: BCBS Trust/PPO |
$15,133.60
|
| Rate for Payer: BCN Commercial |
$14,327.85
|
| Rate for Payer: BCN Medicare Advantage |
$18,599.72
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$17,371.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,599.72
|
| Rate for Payer: Healthscope Commercial |
$18,480.40
|
| Rate for Payer: Healthscope Whirlpool |
$17,925.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,599.72
|
| Rate for Payer: Mclaren Commercial |
$16,632.36
|
| Rate for Payer: Mclaren Medicaid |
$9,969.45
|
| Rate for Payer: Mclaren Medicare |
$18,599.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,529.71
|
| Rate for Payer: Meridian Medicaid |
$10,467.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,389.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: PACE Medicare |
$17,669.73
|
| Rate for Payer: PACE SWMI |
$18,599.72
|
| Rate for Payer: PHP Commercial |
$20,459.69
|
| Rate for Payer: PHP Medicaid |
$9,969.45
|
| Rate for Payer: PHP Medicare Advantage |
$18,599.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,969.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,192.53
|
| Rate for Payer: Priority Health Medicare |
$18,599.72
|
| Rate for Payer: Priority Health Narrow Network |
$12,954.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,599.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,262.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,599.72
|
| Rate for Payer: UHC Exchange |
$28,829.57
|
| Rate for Payer: UHC Medicare Advantage |
$18,599.72
|
| Rate for Payer: UHCCP DNSP |
$18,599.72
|
| Rate for Payer: UHCCP Medicaid |
$9,969.45
|
| Rate for Payer: VA VA |
$18,599.72
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,012.26 |
| Max. Negotiated Rate |
$18,480.40 |
| Rate for Payer: Aetna Commercial |
$16,632.36
|
| Rate for Payer: ASR ASR |
$17,925.99
|
| Rate for Payer: ASR Commercial |
$17,925.99
|
| Rate for Payer: BCBS Trust/PPO |
$15,059.68
|
| Rate for Payer: BCN Commercial |
$14,327.85
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$17,371.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Healthscope Commercial |
$18,480.40
|
| Rate for Payer: Healthscope Whirlpool |
$17,925.99
|
| Rate for Payer: Mclaren Commercial |
$16,632.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,262.75
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,622.93 |
| Max. Negotiated Rate |
$17,881.43 |
| Rate for Payer: Aetna Commercial |
$16,093.29
|
| Rate for Payer: ASR ASR |
$17,344.99
|
| Rate for Payer: ASR Commercial |
$17,344.99
|
| Rate for Payer: BCBS Trust/PPO |
$14,571.58
|
| Rate for Payer: BCN Commercial |
$13,863.47
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$16,808.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Healthscope Commercial |
$17,881.43
|
| Rate for Payer: Healthscope Whirlpool |
$17,344.99
|
| Rate for Payer: Mclaren Commercial |
$16,093.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: Nomi Health Commercial |
$14,662.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,735.66
|
|
