|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,736.85
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Advantage |
$1,915.80
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Mclaren Medicaid |
$1,017.60
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,724.22
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,736.85
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.22 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.95
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Advantage |
$1,915.80
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: Priority Health SBD |
$1,724.22
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.36 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health SBD |
$814.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.47 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.47
|
| Rate for Payer: BCN Commercial |
$84.47
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Mclaren Medicaid |
$460.91
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$814.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.36 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health SBD |
$814.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.47 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.47
|
| Rate for Payer: BCN Commercial |
$84.47
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Mclaren Medicaid |
$460.91
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$814.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.36 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health SBD |
$814.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.47 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS Trust/PPO |
$84.47
|
| Rate for Payer: BCN Commercial |
$84.47
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Mclaren Medicaid |
$460.91
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$814.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$814.36 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health SBD |
$814.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.47 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.47
|
| Rate for Payer: BCN Commercial |
$84.47
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Advantage |
$904.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Mclaren Medicaid |
$460.91
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$814.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,729.88
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,499.82 |
| Max. Negotiated Rate |
$7,856.89 |
| Rate for Payer: Aetna Commercial |
$7,420.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,674.42
|
| Rate for Payer: Cash Price |
$6,983.90
|
| Rate for Payer: Cofinity Advantage |
$6,110.92
|
| Rate for Payer: Cofinity Commercial |
$7,507.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,983.90
|
| Rate for Payer: Healthscope Commercial |
$7,856.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,420.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,547.41
|
| Rate for Payer: PHP Commercial |
$7,420.40
|
| Rate for Payer: Priority Health SBD |
$5,499.82
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,729.88
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$666.21 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna Commercial |
$7,420.40
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,674.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$666.21
|
| Rate for Payer: BCN Commercial |
$666.21
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$6,983.90
|
| Rate for Payer: Cash Price |
$6,983.90
|
| Rate for Payer: Cofinity Advantage |
$6,110.92
|
| Rate for Payer: Cofinity Commercial |
$7,507.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,983.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$7,856.89
|
| Rate for Payer: Mclaren Medicaid |
$4,064.56
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,420.40
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,547.41
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$7,420.40
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$5,499.82
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,911.45
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,354.21 |
| Max. Negotiated Rate |
$6,220.31 |
| Rate for Payer: Aetna Commercial |
$5,874.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,492.44
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cofinity Advantage |
$4,838.02
|
| Rate for Payer: Cofinity Commercial |
$5,943.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,529.16
|
| Rate for Payer: Healthscope Commercial |
$6,220.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,874.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,183.59
|
| Rate for Payer: PHP Commercial |
$5,874.73
|
| Rate for Payer: Priority Health SBD |
$4,354.21
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,911.45
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,033.67 |
| Max. Negotiated Rate |
$56,498.90 |
| Rate for Payer: Aetna Commercial |
$5,874.73
|
| Rate for Payer: Aetna Medicare |
$18,169.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,492.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,838.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,838.46
|
| Rate for Payer: BCBS Complete |
$9,594.95
|
| Rate for Payer: BCBS MAPPO |
$17,470.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,033.67
|
| Rate for Payer: BCN Commercial |
$3,033.67
|
| Rate for Payer: BCN Medicare Advantage |
$17,470.77
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cofinity Advantage |
$4,838.02
|
| Rate for Payer: Cofinity Commercial |
$5,943.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,529.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,470.77
|
| Rate for Payer: Healthscope Commercial |
$6,220.31
|
| Rate for Payer: Mclaren Medicaid |
$9,137.21
|
| Rate for Payer: Mclaren Medicare |
$17,470.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,344.31
|
| Rate for Payer: Meridian Medicaid |
$18,344.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,091.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,217.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,874.73
|
| Rate for Payer: Nomi Health Commercial |
$52,412.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,183.59
|
| Rate for Payer: PACE Medicare |
$16,597.23
|
| Rate for Payer: PACE SWMI |
$17,470.77
|
| Rate for Payer: PHP Commercial |
$5,874.73
|
| Rate for Payer: PHP Medicare Advantage |
$17,470.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,137.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56,498.90
|
| Rate for Payer: Priority Health Medicare |
$17,470.77
|
| Rate for Payer: Priority Health SBD |
$4,354.21
|
| Rate for Payer: Priority Health Tiered Network |
$45,199.12
|
| Rate for Payer: Railroad Medicare Medicare |
$17,470.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,470.77
|
| Rate for Payer: UHC Medicaid |
$9,137.21
|
| Rate for Payer: UHCCP Medicaid |
$9,137.21
|
| Rate for Payer: VA VA |
$17,470.77
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$701.99 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$445.71 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$557.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: BCBS Complete |
$445.71
|
| Rate for Payer: BCBS Trust/PPO |
$494.12
|
| Rate for Payer: BCN Commercial |
$494.12
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.23 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.86 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.86
|
| Rate for Payer: BCN Commercial |
$1,012.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Mclaren Medicaid |
$1,017.60
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$445.71 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$557.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: BCBS Complete |
$445.71
|
| Rate for Payer: BCBS Trust/PPO |
$449.53
|
| Rate for Payer: BCN Commercial |
$449.53
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$701.99 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.73
|
| Rate for Payer: BCN Commercial |
$1,134.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Mclaren Medicaid |
$1,017.60
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.23 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,433.70
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,990.33 |
| Rate for Payer: Aetna Commercial |
$3,768.64
|
| Rate for Payer: Aetna Medicare |
$2,216.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.91
|
| Rate for Payer: BCBS Complete |
$1,773.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,546.96
|
| Rate for Payer: Cash Price |
$3,546.96
|
| Rate for Payer: Cofinity Advantage |
$3,103.59
|
| Rate for Payer: Cofinity Commercial |
$3,812.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.96
|
| Rate for Payer: Healthscope Commercial |
$3,990.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,325.28
|
| Rate for Payer: PHP Commercial |
$3,768.64
|
| Rate for Payer: Priority Health SBD |
$2,793.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,881.91
|
| Rate for Payer: UHC Core |
$2,309.96
|
| Rate for Payer: UHC Exchange |
$1,742.44
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,433.70
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,793.23 |
| Max. Negotiated Rate |
$3,990.33 |
| Rate for Payer: Aetna Commercial |
$3,768.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.91
|
| Rate for Payer: Cash Price |
$3,546.96
|
| Rate for Payer: Cofinity Advantage |
$3,103.59
|
| Rate for Payer: Cofinity Commercial |
$3,812.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.96
|
| Rate for Payer: Healthscope Commercial |
$3,990.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,325.28
|
| Rate for Payer: PHP Commercial |
$3,768.64
|
| Rate for Payer: Priority Health SBD |
$2,793.23
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$6,030.46
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,799.19 |
| Max. Negotiated Rate |
$5,427.41 |
| Rate for Payer: Aetna Commercial |
$5,125.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,919.80
|
| Rate for Payer: Cash Price |
$4,824.37
|
| Rate for Payer: Cofinity Advantage |
$4,221.32
|
| Rate for Payer: Cofinity Commercial |
$5,186.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,824.37
|
| Rate for Payer: Healthscope Commercial |
$5,427.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,125.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,522.85
|
| Rate for Payer: PHP Commercial |
$5,125.89
|
| Rate for Payer: Priority Health SBD |
$3,799.19
|
|
