|
HC BALLOONS CATH TRANSLUMINAL LVL 1
|
Facility
|
IP
|
$82.47
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.96 |
| Max. Negotiated Rate |
$74.22 |
| Rate for Payer: Aetna Commercial |
$70.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.61
|
| Rate for Payer: Cash Price |
$65.98
|
| Rate for Payer: Cofinity Advantage |
$57.73
|
| Rate for Payer: Cofinity Commercial |
$70.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.98
|
| Rate for Payer: Healthscope Commercial |
$74.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.85
|
| Rate for Payer: PHP Commercial |
$70.10
|
| Rate for Payer: Priority Health SBD |
$51.96
|
|
|
HC BALLOONS CATH TRANSLUMINAL LVL 2
|
Facility
|
OP
|
$249.07
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$224.16 |
| Rate for Payer: Aetna Commercial |
$211.71
|
| Rate for Payer: Aetna Medicare |
$124.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.90
|
| Rate for Payer: BCBS Complete |
$99.63
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$199.26
|
| Rate for Payer: Cash Price |
$199.26
|
| Rate for Payer: Cofinity Advantage |
$174.35
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.26
|
| Rate for Payer: Healthscope Commercial |
$224.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.80
|
| Rate for Payer: PHP Commercial |
$211.71
|
| Rate for Payer: Priority Health SBD |
$156.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.90
|
| Rate for Payer: UHC Core |
$129.77
|
| Rate for Payer: UHC Exchange |
$97.88
|
|
|
HC BALLOONS CATH TRANSLUMINAL LVL 2
|
Facility
|
IP
|
$249.07
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$224.16 |
| Rate for Payer: Aetna Commercial |
$211.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.90
|
| Rate for Payer: Cash Price |
$199.26
|
| Rate for Payer: Cofinity Advantage |
$174.35
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.26
|
| Rate for Payer: Healthscope Commercial |
$224.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.80
|
| Rate for Payer: PHP Commercial |
$211.71
|
| Rate for Payer: Priority Health SBD |
$156.91
|
|
|
HC BALLOON STONE EXTRACTION
|
Facility
|
IP
|
$3,253.01
|
|
| Hospital Charge Code |
36000008
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,049.40 |
| Max. Negotiated Rate |
$2,927.71 |
| Rate for Payer: Aetna Commercial |
$2,765.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,114.46
|
| Rate for Payer: Cash Price |
$2,602.41
|
| Rate for Payer: Cofinity Advantage |
$2,277.11
|
| Rate for Payer: Cofinity Commercial |
$2,797.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,602.41
|
| Rate for Payer: Healthscope Commercial |
$2,927.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,765.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,439.76
|
| Rate for Payer: PHP Commercial |
$2,765.06
|
| Rate for Payer: Priority Health SBD |
$2,049.40
|
|
|
HC BALLOON STONE EXTRACTION
|
Facility
|
OP
|
$3,253.01
|
|
| Hospital Charge Code |
36000008
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,301.20 |
| Max. Negotiated Rate |
$2,927.71 |
| Rate for Payer: Aetna Commercial |
$2,765.06
|
| Rate for Payer: Aetna Medicare |
$1,626.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,114.46
|
| Rate for Payer: BCBS Complete |
$1,301.20
|
| Rate for Payer: Cash Price |
$2,602.41
|
| Rate for Payer: Cofinity Advantage |
$2,277.11
|
| Rate for Payer: Cofinity Commercial |
$2,797.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,602.41
|
| Rate for Payer: Healthscope Commercial |
$2,927.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,602.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,765.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,439.76
|
| Rate for Payer: PHP Commercial |
$2,765.06
|
| Rate for Payer: Priority Health SBD |
$2,049.40
|
|
|
HC BANANA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200073
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BANANA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200073
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC BANDAGE SCISSORS
|
Facility
|
IP
|
$13.96
|
|
| Hospital Charge Code |
27000029
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: Priority Health SBD |
$8.79
|
|
|
HC BANDAGE SCISSORS
|
Facility
|
OP
|
$13.96
|
|
| Hospital Charge Code |
27000029
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: Aetna Medicare |
$6.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: Priority Health SBD |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.07
|
| Rate for Payer: UHC Core |
$7.27
|
| Rate for Payer: UHC Exchange |
$5.49
|
|
|
HC BANDING
|
Facility
|
OP
|
$984.95
|
|
| Hospital Charge Code |
36000009
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$393.98 |
| Max. Negotiated Rate |
$886.46 |
| Rate for Payer: Aetna Commercial |
$837.21
|
| Rate for Payer: Aetna Medicare |
$492.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.22
|
| Rate for Payer: BCBS Complete |
$393.98
|
| Rate for Payer: Cash Price |
$787.96
|
| Rate for Payer: Cofinity Advantage |
$689.47
|
| Rate for Payer: Cofinity Commercial |
$847.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.96
|
| Rate for Payer: Healthscope Commercial |
$886.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$787.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$837.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.71
|
| Rate for Payer: PHP Commercial |
$837.21
|
| Rate for Payer: Priority Health SBD |
$620.52
|
|
|
HC BANDING
|
Facility
|
IP
|
$984.95
|
|
| Hospital Charge Code |
36000009
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$620.52 |
| Max. Negotiated Rate |
$886.46 |
| Rate for Payer: Aetna Commercial |
$837.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.22
|
| Rate for Payer: Cash Price |
$787.96
|
| Rate for Payer: Cofinity Advantage |
$689.47
|
| Rate for Payer: Cofinity Commercial |
$847.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.96
|
| Rate for Payer: Healthscope Commercial |
$886.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$837.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.71
|
| Rate for Payer: PHP Commercial |
$837.21
|
| Rate for Payer: Priority Health SBD |
$620.52
|
|
|
HC BARBITURATE URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.09 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health SBD |
$70.09
|
|
|
HC BARBITURATE URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$66.26
|
| Rate for Payer: BCN Commercial |
$66.26
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Mclaren Medicaid |
$32.50
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC BARBITURATE URINE CONFIRM
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100571
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.63 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health SBD |
$40.63
|
|
|
HC BARBITURATE URINE CONFIRM
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100571
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$32.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health SBD |
$40.63
|
|
|
HC BARRIER ADHESION
|
Facility
|
OP
|
$601.76
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
27000463
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$236.49 |
| Max. Negotiated Rate |
$541.58 |
| Rate for Payer: Aetna Commercial |
$511.50
|
| Rate for Payer: Aetna Medicare |
$300.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.14
|
| Rate for Payer: BCBS Complete |
$240.70
|
| Rate for Payer: Cash Price |
$481.41
|
| Rate for Payer: Cofinity Advantage |
$421.23
|
| Rate for Payer: Cofinity Commercial |
$517.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.41
|
| Rate for Payer: Healthscope Commercial |
$541.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$481.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.32
|
| Rate for Payer: PHP Commercial |
$511.50
|
| Rate for Payer: Priority Health SBD |
$379.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.14
|
| Rate for Payer: UHC Core |
$313.52
|
| Rate for Payer: UHC Exchange |
$236.49
|
|
|
HC BARRIER ADHESION
|
Facility
|
IP
|
$601.76
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
27000463
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$379.11 |
| Max. Negotiated Rate |
$541.58 |
| Rate for Payer: Aetna Commercial |
$511.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.14
|
| Rate for Payer: Cash Price |
$481.41
|
| Rate for Payer: Cofinity Advantage |
$421.23
|
| Rate for Payer: Cofinity Commercial |
$517.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.41
|
| Rate for Payer: Healthscope Commercial |
$541.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.32
|
| Rate for Payer: PHP Commercial |
$511.50
|
| Rate for Payer: Priority Health SBD |
$379.11
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
IP
|
$5,835.28
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,676.23 |
| Max. Negotiated Rate |
$5,251.75 |
| Rate for Payer: Aetna Commercial |
$4,959.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,792.93
|
| Rate for Payer: Cash Price |
$4,668.22
|
| Rate for Payer: Cofinity Advantage |
$4,084.70
|
| Rate for Payer: Cofinity Commercial |
$5,018.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,668.22
|
| Rate for Payer: Healthscope Commercial |
$5,251.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,959.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,376.46
|
| Rate for Payer: PHP Commercial |
$4,959.99
|
| Rate for Payer: Priority Health SBD |
$3,676.23
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
OP
|
$5,835.28
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,293.27 |
| Max. Negotiated Rate |
$5,251.75 |
| Rate for Payer: Aetna Commercial |
$4,959.99
|
| Rate for Payer: Aetna Medicare |
$2,917.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,792.93
|
| Rate for Payer: BCBS Complete |
$2,334.11
|
| Rate for Payer: Cash Price |
$4,668.22
|
| Rate for Payer: Cofinity Advantage |
$4,084.70
|
| Rate for Payer: Cofinity Commercial |
$5,018.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,668.22
|
| Rate for Payer: Healthscope Commercial |
$5,251.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,668.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,959.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,376.46
|
| Rate for Payer: PHP Commercial |
$4,959.99
|
| Rate for Payer: Priority Health SBD |
$3,676.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,792.93
|
| Rate for Payer: UHC Core |
$3,040.18
|
| Rate for Payer: UHC Exchange |
$2,293.27
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,437.90
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,795.88 |
| Max. Negotiated Rate |
$3,994.11 |
| Rate for Payer: Aetna Commercial |
$3,772.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,884.64
|
| Rate for Payer: Cash Price |
$3,550.32
|
| Rate for Payer: Cofinity Advantage |
$3,106.53
|
| Rate for Payer: Cofinity Commercial |
$3,816.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.32
|
| Rate for Payer: Healthscope Commercial |
$3,994.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,772.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,328.43
|
| Rate for Payer: PHP Commercial |
$3,772.22
|
| Rate for Payer: Priority Health SBD |
$2,795.88
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,437.90
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$3,994.11 |
| Rate for Payer: Aetna Commercial |
$3,772.22
|
| Rate for Payer: Aetna Medicare |
$2,218.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,884.64
|
| Rate for Payer: BCBS Complete |
$1,775.16
|
| Rate for Payer: Cash Price |
$3,550.32
|
| Rate for Payer: Cofinity Advantage |
$3,106.53
|
| Rate for Payer: Cofinity Commercial |
$3,816.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.32
|
| Rate for Payer: Healthscope Commercial |
$3,994.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,550.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,772.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,328.43
|
| Rate for Payer: PHP Commercial |
$3,772.22
|
| Rate for Payer: Priority Health SBD |
$2,795.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,884.64
|
| Rate for Payer: UHC Core |
$2,312.15
|
| Rate for Payer: UHC Exchange |
$1,744.09
|
|
|
HC BARRX RFA
|
Facility
|
OP
|
$2,085.28
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$834.11 |
| Max. Negotiated Rate |
$1,876.75 |
| Rate for Payer: Aetna Commercial |
$1,772.49
|
| Rate for Payer: Aetna Medicare |
$1,042.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,355.43
|
| Rate for Payer: BCBS Complete |
$834.11
|
| Rate for Payer: Cash Price |
$1,668.22
|
| Rate for Payer: Cofinity Advantage |
$1,459.70
|
| Rate for Payer: Cofinity Commercial |
$1,793.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,668.22
|
| Rate for Payer: Healthscope Commercial |
$1,876.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,668.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,772.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,563.96
|
| Rate for Payer: PHP Commercial |
$1,772.49
|
| Rate for Payer: Priority Health SBD |
$1,313.73
|
|
|
HC BARRX RFA
|
Facility
|
IP
|
$2,085.28
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,313.73 |
| Max. Negotiated Rate |
$1,876.75 |
| Rate for Payer: Cofinity Commercial |
$1,793.34
|
| Rate for Payer: Aetna Commercial |
$1,772.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,355.43
|
| Rate for Payer: Cash Price |
$1,668.22
|
| Rate for Payer: Cofinity Advantage |
$1,459.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,668.22
|
| Rate for Payer: Healthscope Commercial |
$1,876.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,772.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,563.96
|
| Rate for Payer: PHP Commercial |
$1,772.49
|
| Rate for Payer: Priority Health SBD |
$1,313.73
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,508.53
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,771.85 |
| Max. Negotiated Rate |
$4,057.68 |
| Rate for Payer: Aetna Commercial |
$3,832.25
|
| Rate for Payer: Aetna Medicare |
$2,254.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,930.54
|
| Rate for Payer: BCBS Complete |
$1,803.41
|
| Rate for Payer: Cash Price |
$3,606.82
|
| Rate for Payer: Cofinity Advantage |
$3,155.97
|
| Rate for Payer: Cofinity Commercial |
$3,877.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,606.82
|
| Rate for Payer: Healthscope Commercial |
$4,057.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,606.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,832.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,381.40
|
| Rate for Payer: PHP Commercial |
$3,832.25
|
| Rate for Payer: Priority Health SBD |
$2,840.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,930.54
|
| Rate for Payer: UHC Core |
$2,348.94
|
| Rate for Payer: UHC Exchange |
$1,771.85
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,508.53
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,840.37 |
| Max. Negotiated Rate |
$4,057.68 |
| Rate for Payer: Aetna Commercial |
$3,832.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,930.54
|
| Rate for Payer: Cash Price |
$3,606.82
|
| Rate for Payer: Cofinity Advantage |
$3,155.97
|
| Rate for Payer: Cofinity Commercial |
$3,877.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,606.82
|
| Rate for Payer: Healthscope Commercial |
$4,057.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,832.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,381.40
|
| Rate for Payer: PHP Commercial |
$3,832.25
|
| Rate for Payer: Priority Health SBD |
$2,840.37
|
|
