|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$42.02
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.47 |
| Max. Negotiated Rate |
$37.82 |
| Rate for Payer: Aetna Commercial |
$35.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.31
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cofinity Advantage |
$29.41
|
| Rate for Payer: Cofinity Commercial |
$36.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.62
|
| Rate for Payer: Healthscope Commercial |
$37.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.52
|
| Rate for Payer: PHP Commercial |
$35.72
|
| Rate for Payer: Priority Health SBD |
$26.47
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$42.02
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$37.82 |
| Rate for Payer: Aetna Commercial |
$35.72
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$22.19
|
| Rate for Payer: BCN Commercial |
$22.19
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cofinity Advantage |
$29.41
|
| Rate for Payer: Cofinity Commercial |
$36.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$37.82
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$21.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.72
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.52
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$35.72
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.81
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health SBD |
$26.47
|
| Rate for Payer: Priority Health Tiered Network |
$16.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.22
|
| Rate for Payer: UHC Core |
$31.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$31.22
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
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 CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
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 CANNABINOID URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
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 CANNABINOID URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
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 CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$902.03
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$354.50 |
| Max. Negotiated Rate |
$811.83 |
| Rate for Payer: Aetna Commercial |
$766.73
|
| Rate for Payer: Aetna Medicare |
$451.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.32
|
| Rate for Payer: BCBS Complete |
$360.81
|
| Rate for Payer: Cash Price |
$721.62
|
| Rate for Payer: Cofinity Advantage |
$631.42
|
| Rate for Payer: Cofinity Commercial |
$775.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.62
|
| Rate for Payer: Healthscope Commercial |
$811.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.52
|
| Rate for Payer: PHP Commercial |
$766.73
|
| Rate for Payer: Priority Health SBD |
$568.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.32
|
| Rate for Payer: UHC Core |
$469.96
|
| Rate for Payer: UHC Exchange |
$354.50
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$902.03
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$568.28 |
| Max. Negotiated Rate |
$811.83 |
| Rate for Payer: Aetna Commercial |
$766.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.32
|
| Rate for Payer: Cash Price |
$721.62
|
| Rate for Payer: Cofinity Advantage |
$631.42
|
| Rate for Payer: Cofinity Commercial |
$775.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.62
|
| Rate for Payer: Healthscope Commercial |
$811.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.52
|
| Rate for Payer: PHP Commercial |
$766.73
|
| Rate for Payer: Priority Health SBD |
$568.28
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
OP
|
$309.00
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$121.44 |
| Max. Negotiated Rate |
$278.10 |
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.85
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Advantage |
$216.30
|
| Rate for Payer: Cofinity Commercial |
$265.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$278.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: PHP Commercial |
$262.65
|
| Rate for Payer: Priority Health SBD |
$194.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.85
|
| Rate for Payer: UHC Core |
$160.99
|
| Rate for Payer: UHC Exchange |
$121.44
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
IP
|
$309.00
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.67 |
| Max. Negotiated Rate |
$278.10 |
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.85
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Advantage |
$216.30
|
| Rate for Payer: Cofinity Commercial |
$265.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$278.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: PHP Commercial |
$262.65
|
| Rate for Payer: Priority Health SBD |
$194.67
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
IP
|
$118.61
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$74.72 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Advantage |
$83.03
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.96
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: Priority Health SBD |
$74.72
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
OP
|
$118.61
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$59.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: BCBS Complete |
$47.44
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Advantage |
$83.03
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.96
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: Priority Health SBD |
$74.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.10
|
| Rate for Payer: UHC Core |
$61.80
|
| Rate for Payer: UHC Exchange |
$46.61
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
OP
|
$24.97
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.23
|
| Rate for Payer: UHC Core |
$13.01
|
| Rate for Payer: UHC Exchange |
$9.81
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
IP
|
$24.97
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
|
|
HC CANNULA BIOMEDICUS
|
Facility
|
IP
|
$1,502.94
|
|
| Hospital Charge Code |
27006715
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$946.85 |
| Max. Negotiated Rate |
$1,352.65 |
| Rate for Payer: Aetna Commercial |
$1,277.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.91
|
| Rate for Payer: Cash Price |
$1,202.35
|
| Rate for Payer: Cofinity Advantage |
$1,052.06
|
| Rate for Payer: Cofinity Commercial |
$1,292.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,202.35
|
| Rate for Payer: Healthscope Commercial |
$1,352.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,277.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,127.20
|
| Rate for Payer: PHP Commercial |
$1,277.50
|
| Rate for Payer: Priority Health SBD |
$946.85
|
|
|
HC CANNULA BIOMEDICUS
|
Facility
|
OP
|
$1,502.94
|
|
| Hospital Charge Code |
27006715
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$590.66 |
| Max. Negotiated Rate |
$1,352.65 |
| Rate for Payer: Aetna Commercial |
$1,277.50
|
| Rate for Payer: Aetna Medicare |
$751.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.91
|
| Rate for Payer: BCBS Complete |
$601.18
|
| Rate for Payer: Cash Price |
$1,202.35
|
| Rate for Payer: Cofinity Advantage |
$1,052.06
|
| Rate for Payer: Cofinity Commercial |
$1,292.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,202.35
|
| Rate for Payer: Healthscope Commercial |
$1,352.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,202.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,277.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,127.20
|
| Rate for Payer: PHP Commercial |
$1,277.50
|
| Rate for Payer: Priority Health SBD |
$946.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$976.91
|
| Rate for Payer: UHC Core |
$783.03
|
| Rate for Payer: UHC Exchange |
$590.66
|
|
|
HC CANNULA CARDIOPLEGIA
|
Facility
|
IP
|
$48.38
|
|
| Hospital Charge Code |
27000092
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
|
|
HC CANNULA CARDIOPLEGIA
|
Facility
|
OP
|
$48.38
|
|
| Hospital Charge Code |
27000092
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$24.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: BCBS Complete |
$19.35
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.45
|
| Rate for Payer: UHC Core |
$25.21
|
| Rate for Payer: UHC Exchange |
$19.01
|
|
|
HC CANNULA CARDIOPLEGIA ANTEGRADE 14G
|
Facility
|
IP
|
$45.00
|
|
| Hospital Charge Code |
27000720
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.25
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Advantage |
$31.50
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health SBD |
$28.35
|
|
|
HC CANNULA CARDIOPLEGIA ANTEGRADE 14G
|
Facility
|
OP
|
$45.00
|
|
| Hospital Charge Code |
27000720
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.25
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Advantage |
$31.50
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health SBD |
$28.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.25
|
| Rate for Payer: UHC Core |
$23.45
|
| Rate for Payer: UHC Exchange |
$17.68
|
|
|
HC CANNULA COR ART 7MM ST
|
Facility
|
IP
|
$329.52
|
|
| Hospital Charge Code |
27006707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$207.60 |
| Max. Negotiated Rate |
$296.57 |
| Rate for Payer: Aetna Commercial |
$280.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.19
|
| Rate for Payer: Cash Price |
$263.62
|
| Rate for Payer: Cofinity Advantage |
$230.66
|
| Rate for Payer: Cofinity Commercial |
$283.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.62
|
| Rate for Payer: Healthscope Commercial |
$296.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.14
|
| Rate for Payer: PHP Commercial |
$280.09
|
| Rate for Payer: Priority Health SBD |
$207.60
|
|
|
HC CANNULA COR ART 7MM ST
|
Facility
|
OP
|
$329.52
|
|
| Hospital Charge Code |
27006707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$296.57 |
| Rate for Payer: Aetna Commercial |
$280.09
|
| Rate for Payer: Aetna Medicare |
$164.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.19
|
| Rate for Payer: BCBS Complete |
$131.81
|
| Rate for Payer: Cash Price |
$263.62
|
| Rate for Payer: Cofinity Advantage |
$230.66
|
| Rate for Payer: Cofinity Commercial |
$283.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.62
|
| Rate for Payer: Healthscope Commercial |
$296.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$263.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.14
|
| Rate for Payer: PHP Commercial |
$280.09
|
| Rate for Payer: Priority Health SBD |
$207.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.19
|
| Rate for Payer: UHC Core |
$171.68
|
| Rate for Payer: UHC Exchange |
$129.50
|
|
|
HC CANNULA COR ART 8 MM ST
|
Facility
|
IP
|
$319.92
|
|
| Hospital Charge Code |
27006708
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$201.55 |
| Max. Negotiated Rate |
$287.93 |
| Rate for Payer: Aetna Commercial |
$271.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.95
|
| Rate for Payer: Cash Price |
$255.94
|
| Rate for Payer: Cofinity Advantage |
$223.94
|
| Rate for Payer: Cofinity Commercial |
$275.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.94
|
| Rate for Payer: Healthscope Commercial |
$287.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.94
|
| Rate for Payer: PHP Commercial |
$271.93
|
| Rate for Payer: Priority Health SBD |
$201.55
|
|
|
HC CANNULA COR ART 8 MM ST
|
Facility
|
OP
|
$319.92
|
|
| Hospital Charge Code |
27006708
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$287.93 |
| Rate for Payer: Aetna Commercial |
$271.93
|
| Rate for Payer: Aetna Medicare |
$159.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.95
|
| Rate for Payer: BCBS Complete |
$127.97
|
| Rate for Payer: Cash Price |
$255.94
|
| Rate for Payer: Cofinity Advantage |
$223.94
|
| Rate for Payer: Cofinity Commercial |
$275.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.94
|
| Rate for Payer: Healthscope Commercial |
$287.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$255.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.94
|
| Rate for Payer: PHP Commercial |
$271.93
|
| Rate for Payer: Priority Health SBD |
$201.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.95
|
| Rate for Payer: UHC Core |
$166.68
|
| Rate for Payer: UHC Exchange |
$125.73
|
|
|
HC CANNULA CORONARY 14FR
|
Facility
|
IP
|
$72.00
|
|
| Hospital Charge Code |
27000718
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.36 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Advantage |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.00
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health SBD |
$45.36
|
|
