|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,352.52
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,352.52 |
| Rate for Payer: Aetna Commercial |
$1,217.27
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$1,311.94
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,115.15
|
| Rate for Payer: BCN Commercial |
$1,115.15
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,082.02
|
| Rate for Payer: Cash Price |
$1,082.02
|
| Rate for Payer: Cofinity Commercial |
$1,271.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,311.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,352.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$1,217.27
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,149.64
|
| Rate for Payer: Nomi Health Commercial |
$1,109.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,014.39
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,185.08
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$948.12
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,190.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,229.56
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,229.56 |
| Rate for Payer: Aetna Commercial |
$7,406.60
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$7,982.67
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,785.27
|
| Rate for Payer: BCN Commercial |
$6,785.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,583.65
|
| Rate for Payer: Cash Price |
$6,583.65
|
| Rate for Payer: Cofinity Commercial |
$7,735.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,583.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,982.67
|
| Rate for Payer: Healthscope Whirlpool |
$8,229.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,406.60
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,995.13
|
| Rate for Payer: Nomi Health Commercial |
$6,748.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,172.17
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,210.74
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,768.92
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,242.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,229.56
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,172.17 |
| Max. Negotiated Rate |
$8,229.56 |
| Rate for Payer: Aetna Commercial |
$7,406.60
|
| Rate for Payer: ASR ASR |
$7,982.67
|
| Rate for Payer: BCBS Trust/PPO |
$6,758.11
|
| Rate for Payer: BCN Commercial |
$6,758.11
|
| Rate for Payer: Cash Price |
$6,583.65
|
| Rate for Payer: Cofinity Commercial |
$7,735.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,583.65
|
| Rate for Payer: Healthscope Commercial |
$7,982.67
|
| Rate for Payer: Healthscope Whirlpool |
$8,229.56
|
| Rate for Payer: Mclaren Commercial |
$7,406.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,995.13
|
| Rate for Payer: Nomi Health Commercial |
$6,748.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,172.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,242.01
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$517.69
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$388.27 |
| Max. Negotiated Rate |
$517.69 |
| Rate for Payer: Aetna Commercial |
$465.92
|
| Rate for Payer: ASR ASR |
$502.16
|
| Rate for Payer: BCBS Trust/PPO |
$425.13
|
| Rate for Payer: BCN Commercial |
$425.13
|
| Rate for Payer: Cash Price |
$414.15
|
| Rate for Payer: Cofinity Commercial |
$486.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.15
|
| Rate for Payer: Healthscope Commercial |
$502.16
|
| Rate for Payer: Healthscope Whirlpool |
$517.69
|
| Rate for Payer: Mclaren Commercial |
$465.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.04
|
| Rate for Payer: Nomi Health Commercial |
$424.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$388.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.57
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$517.69
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$191.55 |
| Max. Negotiated Rate |
$517.69 |
| Rate for Payer: Aetna Commercial |
$465.92
|
| Rate for Payer: Aetna Medicare |
$191.55
|
| Rate for Payer: ASR ASR |
$502.16
|
| Rate for Payer: BCBS Complete |
$207.08
|
| Rate for Payer: BCBS Trust/PPO |
$426.84
|
| Rate for Payer: BCN Commercial |
$426.84
|
| Rate for Payer: Cash Price |
$414.15
|
| Rate for Payer: Cofinity Commercial |
$486.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.15
|
| Rate for Payer: Healthscope Commercial |
$502.16
|
| Rate for Payer: Healthscope Whirlpool |
$517.69
|
| Rate for Payer: Mclaren Commercial |
$465.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.04
|
| Rate for Payer: Nomi Health Commercial |
$424.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$388.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$453.60
|
| Rate for Payer: Priority Health Narrow Network |
$362.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.57
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$181.11
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$457.06 |
| Rate for Payer: Aetna Commercial |
$163.00
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$175.68
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$149.33
|
| Rate for Payer: BCN Commercial |
$149.33
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cofinity Commercial |
$170.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$175.68
|
| Rate for Payer: Healthscope Whirlpool |
$181.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$163.00
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.94
|
| Rate for Payer: Nomi Health Commercial |
$148.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.83
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$457.06
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$365.65
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$181.11
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$135.83 |
| Max. Negotiated Rate |
$181.11 |
| Rate for Payer: Aetna Commercial |
$163.00
|
| Rate for Payer: ASR ASR |
$175.68
|
| Rate for Payer: BCBS Trust/PPO |
$148.73
|
| Rate for Payer: BCN Commercial |
$148.73
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cofinity Commercial |
$170.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.89
|
| Rate for Payer: Healthscope Commercial |
$175.68
|
| Rate for Payer: Healthscope Whirlpool |
$181.11
|
| Rate for Payer: Mclaren Commercial |
$163.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.94
|
| Rate for Payer: Nomi Health Commercial |
$148.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.38
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.05 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: Aetna Medicare |
$45.15
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Complete |
$48.82
|
| Rate for Payer: BCBS Trust/PPO |
$100.62
|
| Rate for Payer: BCN Commercial |
$100.62
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.31
|
| Rate for Payer: Priority Health Narrow Network |
$29.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$122.04
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$91.53 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$100.22
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$205.62 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.82
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$132.66
|
| Rate for Payer: BCBS Trust/PPO |
$100.62
|
| Rate for Payer: BCN Commercial |
$100.62
|
| Rate for Payer: BCN Medicare Advantage |
$132.66
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.66
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.66
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: Mclaren Medicaid |
$132.66
|
| Rate for Payer: Mclaren Medicare |
$132.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.29
|
| Rate for Payer: Meridian Medicaid |
$72.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: PACE Medicare |
$126.03
|
| Rate for Payer: PACE SWMI |
$132.66
|
| Rate for Payer: PHP Commercial |
$145.93
|
| Rate for Payer: PHP Medicaid |
$71.11
|
| Rate for Payer: PHP Medicare Advantage |
$132.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.01
|
| Rate for Payer: Priority Health Medicare |
$132.66
|
| Rate for Payer: Priority Health Narrow Network |
$74.41
|
| Rate for Payer: Railroad Medicare Medicare |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.66
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicaid |
$69.38
|
| Rate for Payer: UHCCP DNSP |
$132.66
|
| Rate for Payer: UHCCP Medicaid |
$69.38
|
| Rate for Payer: VA VA |
$132.66
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
IP
|
$122.04
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.53 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$100.22
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$205.62 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.82
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$132.66
|
| Rate for Payer: BCBS Trust/PPO |
$100.62
|
| Rate for Payer: BCN Commercial |
$100.62
|
| Rate for Payer: BCN Medicare Advantage |
$132.66
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.66
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.66
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: Mclaren Medicaid |
$132.66
|
| Rate for Payer: Mclaren Medicare |
$132.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.29
|
| Rate for Payer: Meridian Medicaid |
$72.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: PACE Medicare |
$126.03
|
| Rate for Payer: PACE SWMI |
$132.66
|
| Rate for Payer: PHP Commercial |
$145.93
|
| Rate for Payer: PHP Medicaid |
$71.11
|
| Rate for Payer: PHP Medicare Advantage |
$132.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$122.39
|
| Rate for Payer: Priority Health Medicare |
$132.66
|
| Rate for Payer: Priority Health Narrow Network |
$97.91
|
| Rate for Payer: Railroad Medicare Medicare |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.66
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicaid |
$69.38
|
| Rate for Payer: UHCCP DNSP |
$132.66
|
| Rate for Payer: UHCCP Medicaid |
$69.38
|
| Rate for Payer: VA VA |
$132.66
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
IP
|
$122.04
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.53 |
| Max. Negotiated Rate |
$122.04 |
| Rate for Payer: Aetna Commercial |
$109.84
|
| Rate for Payer: ASR ASR |
$118.38
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$100.22
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$114.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$118.38
|
| Rate for Payer: Healthscope Whirlpool |
$122.04
|
| Rate for Payer: Mclaren Commercial |
$109.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.40
|
|
|
HC TRANSCATH INSERT/REPLACE LDLS PACEMAKER DUAL CHAMBER
|
Facility
|
OP
|
$47,677.90
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
48100139
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,037.64 |
| Max. Negotiated Rate |
$47,677.90 |
| Rate for Payer: Aetna Commercial |
$42,910.11
|
| 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 |
$46,247.56
|
| Rate for Payer: BCBS Complete |
$10,540.48
|
| Rate for Payer: BCBS MAPPO |
$19,192.43
|
| Rate for Payer: BCBS Trust/PPO |
$39,310.43
|
| Rate for Payer: BCN Commercial |
$39,310.43
|
| Rate for Payer: BCN Medicare Advantage |
$19,192.43
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cofinity Commercial |
$44,817.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38,142.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,192.43
|
| Rate for Payer: Healthscope Commercial |
$46,247.56
|
| Rate for Payer: Healthscope Whirlpool |
$47,677.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,192.43
|
| Rate for Payer: Mclaren Commercial |
$42,910.11
|
| 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 |
$40,526.21
|
| Rate for Payer: Nomi Health Commercial |
$39,095.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,758.43
|
| 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 |
$41,775.38
|
| Rate for Payer: Priority Health Medicare |
$19,192.43
|
| Rate for Payer: Priority Health Narrow Network |
$33,422.21
|
| Rate for Payer: Railroad Medicare Medicare |
$19,192.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,956.55
|
| 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 TRANSCATH INSERT/REPLACE LDLS PACEMAKER DUAL CHAMBER
|
Facility
|
IP
|
$47,677.90
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
48100139
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,758.43 |
| Max. Negotiated Rate |
$47,677.90 |
| Rate for Payer: Aetna Commercial |
$42,910.11
|
| Rate for Payer: ASR ASR |
$46,247.56
|
| Rate for Payer: BCBS Trust/PPO |
$39,153.09
|
| Rate for Payer: BCN Commercial |
$39,153.09
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cofinity Commercial |
$44,817.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38,142.32
|
| Rate for Payer: Healthscope Commercial |
$46,247.56
|
| Rate for Payer: Healthscope Whirlpool |
$47,677.90
|
| Rate for Payer: Mclaren Commercial |
$42,910.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,526.21
|
| Rate for Payer: Nomi Health Commercial |
$39,095.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,758.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,956.55
|
|
|
HC TRANSCATH INSERT/REPLACE LDLS PACEMAKER VENTRICULAR
|
Facility
|
OP
|
$25,468.99
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,037.64 |
| Max. Negotiated Rate |
$29,748.27 |
| Rate for Payer: Aetna Commercial |
$22,922.09
|
| 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 |
$24,704.92
|
| Rate for Payer: BCBS Complete |
$10,540.48
|
| Rate for Payer: BCBS MAPPO |
$19,192.43
|
| Rate for Payer: BCBS Trust/PPO |
$20,999.18
|
| Rate for Payer: BCN Commercial |
$20,999.18
|
| Rate for Payer: BCN Medicare Advantage |
$19,192.43
|
| Rate for Payer: Cash Price |
$20,375.19
|
| Rate for Payer: Cash Price |
$20,375.19
|
| Rate for Payer: Cofinity Commercial |
$23,940.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,375.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,192.43
|
| Rate for Payer: Healthscope Commercial |
$24,704.92
|
| Rate for Payer: Healthscope Whirlpool |
$25,468.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,192.43
|
| Rate for Payer: Mclaren Commercial |
$22,922.09
|
| 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 |
$21,648.64
|
| Rate for Payer: Nomi Health Commercial |
$20,884.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,101.74
|
| 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 |
$19,381.26
|
| Rate for Payer: Priority Health Medicare |
$19,192.43
|
| Rate for Payer: Priority Health Narrow Network |
$15,505.01
|
| Rate for Payer: Railroad Medicare Medicare |
$19,192.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,412.71
|
| 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 TRANSCATH INSERT/REPLACE LDLS PACEMAKER VENTRICULAR
|
Facility
|
IP
|
$25,468.99
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,101.74 |
| Max. Negotiated Rate |
$25,468.99 |
| Rate for Payer: Aetna Commercial |
$22,922.09
|
| Rate for Payer: ASR ASR |
$24,704.92
|
| Rate for Payer: BCBS Trust/PPO |
$20,915.13
|
| Rate for Payer: BCN Commercial |
$20,915.13
|
| Rate for Payer: Cash Price |
$20,375.19
|
| Rate for Payer: Cofinity Commercial |
$23,940.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,375.19
|
| Rate for Payer: Healthscope Commercial |
$24,704.92
|
| Rate for Payer: Healthscope Whirlpool |
$25,468.99
|
| Rate for Payer: Mclaren Commercial |
$22,922.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,648.64
|
| Rate for Payer: Nomi Health Commercial |
$20,884.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,101.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,412.71
|
|
|
HC TRANSCATH INSERT SINGLE CHAMBER LDLS PACEMAKER ATRIAL
|
Facility
|
IP
|
$47,677.90
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
48100140
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,758.43 |
| Max. Negotiated Rate |
$47,677.90 |
| Rate for Payer: Aetna Commercial |
$42,910.11
|
| Rate for Payer: ASR ASR |
$46,247.56
|
| Rate for Payer: BCBS Trust/PPO |
$39,153.09
|
| Rate for Payer: BCN Commercial |
$39,153.09
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cofinity Commercial |
$44,817.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38,142.32
|
| Rate for Payer: Healthscope Commercial |
$46,247.56
|
| Rate for Payer: Healthscope Whirlpool |
$47,677.90
|
| Rate for Payer: Mclaren Commercial |
$42,910.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,526.21
|
| Rate for Payer: Nomi Health Commercial |
$39,095.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,758.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,956.55
|
|
|
HC TRANSCATH INSERT SINGLE CHAMBER LDLS PACEMAKER ATRIAL
|
Facility
|
OP
|
$47,677.90
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
48100140
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,591.56 |
| Max. Negotiated Rate |
$47,677.90 |
| Rate for Payer: Aetna Commercial |
$42,910.11
|
| 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 |
$46,247.56
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$39,310.43
|
| Rate for Payer: BCN Commercial |
$39,310.43
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cash Price |
$38,142.32
|
| Rate for Payer: Cofinity Commercial |
$44,817.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38,142.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$46,247.56
|
| Rate for Payer: Healthscope Whirlpool |
$47,677.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,163.59
|
| Rate for Payer: Mclaren Commercial |
$42,910.11
|
| 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 |
$40,526.21
|
| Rate for Payer: Nomi Health Commercial |
$39,095.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,758.43
|
| 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 |
$41,775.38
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health Narrow Network |
$33,422.21
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,956.55
|
| 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 TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
OP
|
$44,085.77
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,311.73 |
| Max. Negotiated Rate |
$44,085.77 |
| Rate for Payer: Aetna Commercial |
$39,677.19
|
| Rate for Payer: Aetna Medicare |
$16,311.73
|
| Rate for Payer: ASR ASR |
$42,763.20
|
| Rate for Payer: BCBS Complete |
$17,634.31
|
| Rate for Payer: BCBS Trust/PPO |
$36,348.72
|
| Rate for Payer: BCN Commercial |
$36,348.72
|
| Rate for Payer: Cash Price |
$35,268.62
|
| Rate for Payer: Cofinity Commercial |
$41,440.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35,268.62
|
| Rate for Payer: Healthscope Commercial |
$42,763.20
|
| Rate for Payer: Healthscope Whirlpool |
$44,085.77
|
| Rate for Payer: Mclaren Commercial |
$39,677.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,268.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,472.90
|
| Rate for Payer: Nomi Health Commercial |
$36,150.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33,064.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38,627.95
|
| Rate for Payer: Priority Health Narrow Network |
$30,904.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38,795.48
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
IP
|
$44,085.77
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$33,064.33 |
| Max. Negotiated Rate |
$44,085.77 |
| Rate for Payer: Aetna Commercial |
$39,677.19
|
| Rate for Payer: ASR ASR |
$42,763.20
|
| Rate for Payer: BCBS Trust/PPO |
$36,203.23
|
| Rate for Payer: BCN Commercial |
$36,203.23
|
| Rate for Payer: Cash Price |
$35,268.62
|
| Rate for Payer: Cofinity Commercial |
$41,440.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35,268.62
|
| Rate for Payer: Healthscope Commercial |
$42,763.20
|
| Rate for Payer: Healthscope Whirlpool |
$44,085.77
|
| Rate for Payer: Mclaren Commercial |
$39,677.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,472.90
|
| Rate for Payer: Nomi Health Commercial |
$36,150.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33,064.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38,795.48
|
|
|
HC TRANSCATH PERM OCCLS/EMBOL NON CNS HEAD/NECK
|
Facility
|
IP
|
$25,176.45
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,882.34 |
| Max. Negotiated Rate |
$25,176.45 |
| Rate for Payer: Aetna Commercial |
$22,658.81
|
| Rate for Payer: ASR ASR |
$24,421.16
|
| Rate for Payer: BCBS Trust/PPO |
$20,674.90
|
| Rate for Payer: BCN Commercial |
$20,674.90
|
| Rate for Payer: Cash Price |
$20,141.16
|
| Rate for Payer: Cofinity Commercial |
$23,665.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,141.16
|
| Rate for Payer: Healthscope Commercial |
$24,421.16
|
| Rate for Payer: Healthscope Whirlpool |
$25,176.45
|
| Rate for Payer: Mclaren Commercial |
$22,658.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,399.98
|
| Rate for Payer: Nomi Health Commercial |
$20,644.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,882.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,155.28
|
|
|
HC TRANSCATH PERM OCCLS/EMBOL NON CNS HEAD/NECK
|
Facility
|
OP
|
$25,176.45
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$25,176.45 |
| Rate for Payer: Aetna Commercial |
$22,658.81
|
| 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 |
$24,421.16
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$20,757.98
|
| Rate for Payer: BCN Commercial |
$20,757.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$20,141.16
|
| Rate for Payer: Cash Price |
$20,141.16
|
| Rate for Payer: Cofinity Commercial |
$23,665.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,141.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$24,421.16
|
| Rate for Payer: Healthscope Whirlpool |
$25,176.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$22,658.81
|
| 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 |
$21,399.98
|
| Rate for Payer: Nomi Health Commercial |
$20,644.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,882.34
|
| 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 |
$22,059.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$17,648.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,155.28
|
| 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 TRANSCATH PERM OCCLS/EMBOL PERQ CNS
|
Facility
|
OP
|
$11,674.67
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100659
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,183.94 |
| Max. Negotiated Rate |
$28,311.87 |
| Rate for Payer: Aetna Commercial |
$10,507.20
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$11,324.43
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$9,625.77
|
| Rate for Payer: BCN Commercial |
$9,625.77
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$9,339.74
|
| Rate for Payer: Cash Price |
$9,339.74
|
| Rate for Payer: Cofinity Commercial |
$10,974.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,339.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$11,324.43
|
| Rate for Payer: Healthscope Whirlpool |
$11,674.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$10,507.20
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,923.47
|
| Rate for Payer: Nomi Health Commercial |
$9,573.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,756.00
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,229.35
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$8,183.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,273.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC TRANSCATH PERM OCCLS/EMBOL PERQ CNS
|
Facility
|
IP
|
$11,674.67
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100659
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,756.00 |
| Max. Negotiated Rate |
$11,674.67 |
| Rate for Payer: Aetna Commercial |
$10,507.20
|
| Rate for Payer: ASR ASR |
$11,324.43
|
| Rate for Payer: BCBS Trust/PPO |
$9,587.24
|
| Rate for Payer: BCN Commercial |
$9,587.24
|
| Rate for Payer: Cash Price |
$9,339.74
|
| Rate for Payer: Cofinity Commercial |
$10,974.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,339.74
|
| Rate for Payer: Healthscope Commercial |
$11,324.43
|
| Rate for Payer: Healthscope Whirlpool |
$11,674.67
|
| Rate for Payer: Mclaren Commercial |
$10,507.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,923.47
|
| Rate for Payer: Nomi Health Commercial |
$9,573.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,756.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,273.71
|
|
