|
HC STENT NON COATED W SYS LVL 59
|
Facility
|
IP
|
$5,979.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,484.58 |
| Max. Negotiated Rate |
$5,979.44 |
| Rate for Payer: Aetna Commercial |
$5,381.50
|
| Rate for Payer: ASR ASR |
$5,800.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,910.32
|
| Rate for Payer: BCN Commercial |
$4,910.32
|
| Rate for Payer: Cash Price |
$4,783.55
|
| Rate for Payer: Cofinity Commercial |
$5,620.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,783.55
|
| Rate for Payer: Healthscope Commercial |
$5,800.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,979.44
|
| Rate for Payer: Mclaren Commercial |
$5,381.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,082.52
|
| Rate for Payer: Nomi Health Commercial |
$4,903.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,484.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,261.91
|
|
|
HC STENT NON COATED W SYS LVL 59
|
Facility
|
OP
|
$5,979.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,212.39 |
| Max. Negotiated Rate |
$5,979.44 |
| Rate for Payer: Aetna Commercial |
$5,381.50
|
| Rate for Payer: Aetna Medicare |
$2,212.39
|
| Rate for Payer: ASR ASR |
$5,800.06
|
| Rate for Payer: BCBS Complete |
$2,391.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,930.05
|
| Rate for Payer: BCN Commercial |
$4,930.05
|
| Rate for Payer: Cash Price |
$4,783.55
|
| Rate for Payer: Cofinity Commercial |
$5,620.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,783.55
|
| Rate for Payer: Healthscope Commercial |
$5,800.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,979.44
|
| Rate for Payer: Mclaren Commercial |
$5,381.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,783.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,082.52
|
| Rate for Payer: Nomi Health Commercial |
$4,903.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,484.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,239.19
|
| Rate for Payer: Priority Health Narrow Network |
$4,191.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,261.91
|
|
|
HC STENT NON COATED W SYS LVL 67
|
Facility
|
OP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,508.35 |
| Max. Negotiated Rate |
$6,779.33 |
| Rate for Payer: Aetna Commercial |
$6,101.40
|
| Rate for Payer: Aetna Medicare |
$2,508.35
|
| Rate for Payer: ASR ASR |
$6,575.95
|
| Rate for Payer: BCBS Complete |
$2,711.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,589.56
|
| Rate for Payer: BCN Commercial |
$5,589.56
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$6,372.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,575.95
|
| Rate for Payer: Healthscope Whirlpool |
$6,779.33
|
| Rate for Payer: Mclaren Commercial |
$6,101.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,423.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,762.43
|
| Rate for Payer: Nomi Health Commercial |
$5,559.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,084.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,940.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,752.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,965.81
|
|
|
HC STENT NON COATED W SYS LVL 67
|
Facility
|
IP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,084.50 |
| Max. Negotiated Rate |
$6,779.33 |
| Rate for Payer: Aetna Commercial |
$6,101.40
|
| Rate for Payer: ASR ASR |
$6,575.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,567.19
|
| Rate for Payer: BCN Commercial |
$5,567.19
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$6,372.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,575.95
|
| Rate for Payer: Healthscope Whirlpool |
$6,779.33
|
| Rate for Payer: Mclaren Commercial |
$6,101.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,762.43
|
| Rate for Payer: Nomi Health Commercial |
$5,559.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,084.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,965.81
|
|
|
HC STENT NON CORONARY LVL 2
|
Facility
|
IP
|
$244.19
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.14 |
| Max. Negotiated Rate |
$244.19 |
| Rate for Payer: Aetna Commercial |
$219.77
|
| Rate for Payer: ASR ASR |
$236.86
|
| Rate for Payer: BCBS Trust/PPO |
$200.53
|
| Rate for Payer: BCN Commercial |
$200.53
|
| Rate for Payer: Cash Price |
$195.35
|
| Rate for Payer: Cofinity Commercial |
$229.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.35
|
| Rate for Payer: Healthscope Commercial |
$236.86
|
| Rate for Payer: Healthscope Whirlpool |
$244.19
|
| Rate for Payer: Mclaren Commercial |
$219.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.56
|
| Rate for Payer: Nomi Health Commercial |
$200.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.89
|
|
|
HC STENT NON CORONARY LVL 2
|
Facility
|
OP
|
$244.19
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$244.19 |
| Rate for Payer: Aetna Commercial |
$219.77
|
| Rate for Payer: Aetna Medicare |
$90.35
|
| Rate for Payer: ASR ASR |
$236.86
|
| Rate for Payer: BCBS Complete |
$97.68
|
| Rate for Payer: BCBS Trust/PPO |
$201.33
|
| Rate for Payer: BCN Commercial |
$201.33
|
| Rate for Payer: Cash Price |
$195.35
|
| Rate for Payer: Cofinity Commercial |
$229.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.35
|
| Rate for Payer: Healthscope Commercial |
$236.86
|
| Rate for Payer: Healthscope Whirlpool |
$244.19
|
| Rate for Payer: Mclaren Commercial |
$219.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.56
|
| Rate for Payer: Nomi Health Commercial |
$200.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$213.96
|
| Rate for Payer: Priority Health Narrow Network |
$171.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.89
|
|
|
HC STENT NON CORONARY LVL 3
|
Facility
|
IP
|
$501.23
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$375.92 |
| Max. Negotiated Rate |
$501.23 |
| Rate for Payer: Aetna Commercial |
$451.11
|
| Rate for Payer: ASR ASR |
$486.19
|
| Rate for Payer: BCBS Trust/PPO |
$411.61
|
| Rate for Payer: BCN Commercial |
$411.61
|
| Rate for Payer: Cash Price |
$400.98
|
| Rate for Payer: Cofinity Commercial |
$471.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$486.19
|
| Rate for Payer: Healthscope Whirlpool |
$501.23
|
| Rate for Payer: Mclaren Commercial |
$451.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.05
|
| Rate for Payer: Nomi Health Commercial |
$411.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$441.08
|
|
|
HC STENT NON CORONARY LVL 3
|
Facility
|
OP
|
$501.23
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.46 |
| Max. Negotiated Rate |
$501.23 |
| Rate for Payer: Aetna Commercial |
$451.11
|
| Rate for Payer: Aetna Medicare |
$185.46
|
| Rate for Payer: ASR ASR |
$486.19
|
| Rate for Payer: BCBS Complete |
$200.49
|
| Rate for Payer: BCBS Trust/PPO |
$413.26
|
| Rate for Payer: BCN Commercial |
$413.26
|
| Rate for Payer: Cash Price |
$400.98
|
| Rate for Payer: Cofinity Commercial |
$471.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$486.19
|
| Rate for Payer: Healthscope Whirlpool |
$501.23
|
| Rate for Payer: Mclaren Commercial |
$451.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.05
|
| Rate for Payer: Nomi Health Commercial |
$411.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$439.18
|
| Rate for Payer: Priority Health Narrow Network |
$351.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$441.08
|
|
|
HC STENT NON CORONARY LVL 4
|
Facility
|
IP
|
$838.73
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27200103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$838.73 |
| Rate for Payer: Aetna Commercial |
$754.86
|
| Rate for Payer: ASR ASR |
$813.57
|
| Rate for Payer: BCBS Trust/PPO |
$688.77
|
| Rate for Payer: BCN Commercial |
$688.77
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$813.57
|
| Rate for Payer: Healthscope Whirlpool |
$838.73
|
| Rate for Payer: Mclaren Commercial |
$754.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.08
|
|
|
HC STENT NON CORONARY LVL 4
|
Facility
|
OP
|
$838.73
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27200103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$310.33 |
| Max. Negotiated Rate |
$838.73 |
| Rate for Payer: Aetna Commercial |
$754.86
|
| Rate for Payer: Aetna Medicare |
$310.33
|
| Rate for Payer: ASR ASR |
$813.57
|
| Rate for Payer: BCBS Complete |
$335.49
|
| Rate for Payer: BCBS Trust/PPO |
$691.53
|
| Rate for Payer: BCN Commercial |
$691.53
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$813.57
|
| Rate for Payer: Healthscope Whirlpool |
$838.73
|
| Rate for Payer: Mclaren Commercial |
$754.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$734.90
|
| Rate for Payer: Priority Health Narrow Network |
$587.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.08
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CER CAROTID INTRACRAN EA ADDLL
|
Facility
|
OP
|
$10,828.91
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
36100425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,006.70 |
| Max. Negotiated Rate |
$10,828.91 |
| Rate for Payer: Aetna Commercial |
$9,746.02
|
| Rate for Payer: Aetna Medicare |
$4,006.70
|
| Rate for Payer: ASR ASR |
$10,504.04
|
| Rate for Payer: BCBS Complete |
$4,331.56
|
| Rate for Payer: BCBS Trust/PPO |
$8,928.44
|
| Rate for Payer: BCN Commercial |
$8,928.44
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Commercial |
$10,179.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$10,504.04
|
| Rate for Payer: Healthscope Whirlpool |
$10,828.91
|
| Rate for Payer: Mclaren Commercial |
$9,746.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Nomi Health Commercial |
$8,879.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,567.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,453.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,529.44
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CER CAROTID INTRACRAN EA ADDLL
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
36100425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,121.68 |
| Max. Negotiated Rate |
$10,828.91 |
| Rate for Payer: Aetna Commercial |
$9,746.02
|
| Rate for Payer: ASR ASR |
$10,504.04
|
| Rate for Payer: BCBS Trust/PPO |
$8,892.70
|
| Rate for Payer: BCN Commercial |
$8,892.70
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Commercial |
$10,179.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$10,504.04
|
| Rate for Payer: Healthscope Whirlpool |
$10,828.91
|
| Rate for Payer: Mclaren Commercial |
$9,746.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Nomi Health Commercial |
$8,879.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,529.44
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
IP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,548.68 |
| Max. Negotiated Rate |
$16,731.58 |
| Rate for Payer: Aetna Commercial |
$15,058.42
|
| Rate for Payer: ASR ASR |
$16,229.63
|
| Rate for Payer: BCBS Trust/PPO |
$13,739.97
|
| Rate for Payer: BCN Commercial |
$13,739.97
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Commercial |
$15,727.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Healthscope Commercial |
$16,229.63
|
| Rate for Payer: Healthscope Whirlpool |
$16,731.58
|
| Rate for Payer: Mclaren Commercial |
$15,058.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Nomi Health Commercial |
$13,719.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,723.79
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
OP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$17,829.15 |
| Rate for Payer: Aetna Commercial |
$15,058.42
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$16,229.63
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$13,795.19
|
| Rate for Payer: BCN Commercial |
$13,795.19
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Commercial |
$15,727.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$16,229.63
|
| Rate for Payer: Healthscope Whirlpool |
$16,731.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$15,058.42
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Nomi Health Commercial |
$13,719.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,511.37
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$9,209.10
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,723.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
OP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$19,121.79 |
| Rate for Payer: Aetna Commercial |
$17,209.61
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$18,548.14
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$15,765.92
|
| Rate for Payer: BCN Commercial |
$15,765.92
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Commercial |
$17,974.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$18,548.14
|
| Rate for Payer: Healthscope Whirlpool |
$19,121.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$17,209.61
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Nomi Health Commercial |
$15,679.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,511.37
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$9,209.10
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,827.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
IP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,341.34 |
| Max. Negotiated Rate |
$19,121.79 |
| Rate for Payer: Aetna Commercial |
$17,209.61
|
| Rate for Payer: ASR ASR |
$18,548.14
|
| Rate for Payer: BCBS Trust/PPO |
$15,702.81
|
| Rate for Payer: BCN Commercial |
$15,702.81
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Commercial |
$17,974.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Healthscope Commercial |
$18,548.14
|
| Rate for Payer: Healthscope Whirlpool |
$19,121.79
|
| Rate for Payer: Mclaren Commercial |
$17,209.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Nomi Health Commercial |
$15,679.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,827.18
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
OP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,006.70 |
| Max. Negotiated Rate |
$10,828.91 |
| Rate for Payer: Aetna Commercial |
$9,746.02
|
| Rate for Payer: Aetna Medicare |
$4,006.70
|
| Rate for Payer: ASR ASR |
$10,504.04
|
| Rate for Payer: BCBS Complete |
$4,331.56
|
| Rate for Payer: BCBS Trust/PPO |
$8,928.44
|
| Rate for Payer: BCN Commercial |
$8,928.44
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Commercial |
$10,179.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$10,504.04
|
| Rate for Payer: Healthscope Whirlpool |
$10,828.91
|
| Rate for Payer: Mclaren Commercial |
$9,746.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Nomi Health Commercial |
$8,879.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,567.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,453.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,529.44
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,121.68 |
| Max. Negotiated Rate |
$10,828.91 |
| Rate for Payer: Aetna Commercial |
$9,746.02
|
| Rate for Payer: ASR ASR |
$10,504.04
|
| Rate for Payer: BCBS Trust/PPO |
$8,892.70
|
| Rate for Payer: BCN Commercial |
$8,892.70
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Commercial |
$10,179.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$10,504.04
|
| Rate for Payer: Healthscope Whirlpool |
$10,828.91
|
| Rate for Payer: Mclaren Commercial |
$9,746.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Nomi Health Commercial |
$8,879.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,529.44
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
IP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,244.32 |
| Max. Negotiated Rate |
$6,992.43 |
| Rate for Payer: Aetna Commercial |
$6,293.19
|
| Rate for Payer: ASR ASR |
$6,782.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,742.18
|
| Rate for Payer: BCN Commercial |
$5,742.18
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Commercial |
$6,572.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,782.66
|
| Rate for Payer: Healthscope Whirlpool |
$6,992.43
|
| Rate for Payer: Mclaren Commercial |
$6,293.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Nomi Health Commercial |
$5,733.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,153.34
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
OP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,587.20 |
| Max. Negotiated Rate |
$6,992.43 |
| Rate for Payer: Aetna Commercial |
$6,293.19
|
| Rate for Payer: Aetna Medicare |
$2,587.20
|
| Rate for Payer: ASR ASR |
$6,782.66
|
| Rate for Payer: BCBS Complete |
$2,796.97
|
| Rate for Payer: BCBS Trust/PPO |
$5,765.26
|
| Rate for Payer: BCN Commercial |
$5,765.26
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Commercial |
$6,572.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,782.66
|
| Rate for Payer: Healthscope Whirlpool |
$6,992.43
|
| Rate for Payer: Mclaren Commercial |
$6,293.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,593.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Nomi Health Commercial |
$5,733.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,567.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,453.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,153.34
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
IP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,870.70 |
| Max. Negotiated Rate |
$25,160.93 |
| Rate for Payer: Aetna Commercial |
$22,644.84
|
| Rate for Payer: ASR ASR |
$24,406.10
|
| Rate for Payer: BCBS Trust/PPO |
$20,662.16
|
| Rate for Payer: BCN Commercial |
$20,662.16
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Commercial |
$23,651.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Healthscope Commercial |
$24,406.10
|
| Rate for Payer: Healthscope Whirlpool |
$25,160.93
|
| Rate for Payer: Mclaren Commercial |
$22,644.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$20,631.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,141.62
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
OP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$25,160.93 |
| Rate for Payer: Aetna Commercial |
$22,644.84
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$24,406.10
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$20,745.19
|
| Rate for Payer: BCN Commercial |
$20,745.19
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Commercial |
$23,651.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$24,406.10
|
| Rate for Payer: Healthscope Whirlpool |
$25,160.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$22,644.84
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$20,631.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,712.91
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$6,170.33
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,141.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,601.47 |
| Max. Negotiated Rate |
$28,652.62 |
| Rate for Payer: Aetna Commercial |
$25,787.36
|
| Rate for Payer: Aetna Medicare |
$10,601.47
|
| Rate for Payer: ASR ASR |
$27,793.04
|
| Rate for Payer: BCBS Complete |
$11,461.05
|
| Rate for Payer: BCBS Trust/PPO |
$23,624.09
|
| Rate for Payer: BCN Commercial |
$23,624.09
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Commercial |
$26,933.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$27,793.04
|
| Rate for Payer: Healthscope Whirlpool |
$28,652.62
|
| Rate for Payer: Mclaren Commercial |
$25,787.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,922.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Nomi Health Commercial |
$23,495.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25,105.43
|
| Rate for Payer: Priority Health Narrow Network |
$20,085.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,214.31
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$21,489.47 |
| Max. Negotiated Rate |
$28,652.62 |
| Rate for Payer: Aetna Commercial |
$25,787.36
|
| Rate for Payer: ASR ASR |
$27,793.04
|
| Rate for Payer: BCBS Trust/PPO |
$23,529.53
|
| Rate for Payer: BCN Commercial |
$23,529.53
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Commercial |
$26,933.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$27,793.04
|
| Rate for Payer: Healthscope Whirlpool |
$28,652.62
|
| Rate for Payer: Mclaren Commercial |
$25,787.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Nomi Health Commercial |
$23,495.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,214.31
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,942.76
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,198.82 |
| Max. Negotiated Rate |
$5,942.76 |
| Rate for Payer: Aetna Commercial |
$5,348.48
|
| Rate for Payer: Aetna Medicare |
$2,198.82
|
| Rate for Payer: ASR ASR |
$5,764.48
|
| Rate for Payer: BCBS Complete |
$2,377.10
|
| Rate for Payer: BCBS Trust/PPO |
$4,899.81
|
| Rate for Payer: BCN Commercial |
$4,899.81
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cofinity Commercial |
$5,586.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,754.21
|
| Rate for Payer: Healthscope Commercial |
$5,764.48
|
| Rate for Payer: Healthscope Whirlpool |
$5,942.76
|
| Rate for Payer: Mclaren Commercial |
$5,348.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,754.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,051.35
|
| Rate for Payer: Nomi Health Commercial |
$4,873.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,457.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,207.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,165.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,229.63
|
|
