|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health SBD |
$47.85
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Exchange |
$56.20
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$20.48
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$47.85 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.37
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health SBD |
$47.85
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$7.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health SBD |
$17.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.01
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.95
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.26
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health SBD |
$17.70
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.33 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.08
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$61.47
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health SBD |
$55.33
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Medicare |
$7.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Cofinity Commercial |
$61.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health SBD |
$55.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.01
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.95
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,984.50 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,047.50
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,205.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,205.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health SBD |
$1,984.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
OP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,260.00 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna Medicare |
$1,575.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,047.50
|
| Rate for Payer: BCBS Complete |
$1,260.00
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,205.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,205.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health SBD |
$1,984.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
OP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,595.20 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna Medicare |
$1,994.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.20
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$2,791.60
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,791.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health SBD |
$2,512.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
IP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,512.44 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.20
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$2,791.60
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,791.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health SBD |
$2,512.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
OP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,848.00 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna Medicare |
$2,310.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,003.00
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,234.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,234.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health SBD |
$2,910.60
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
IP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,910.60 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,003.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,234.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,234.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health SBD |
$2,910.60
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
OP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,915.20 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna Medicare |
$2,394.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,112.20
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$3,351.60
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,351.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health SBD |
$3,016.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
IP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,016.44 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,112.20
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$3,351.60
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,351.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health SBD |
$3,016.44
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
IP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$704.97 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.35
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$783.30
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$783.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health SBD |
$704.97
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
OP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna Medicare |
$559.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.35
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$783.30
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$783.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health SBD |
$704.97
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
OP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: Aetna Medicare |
$671.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.62
|
| Rate for Payer: BCBS Complete |
$537.00
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Cofinity Commercial |
$939.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health SBD |
$845.77
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
IP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$845.77 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.62
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Cofinity Commercial |
$939.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health SBD |
$845.77
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
IP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$968.62 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.38
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,076.25
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,076.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health SBD |
$968.62
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
OP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$615.00 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: Aetna Medicare |
$768.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.38
|
| Rate for Payer: BCBS Complete |
$615.00
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,076.25
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,076.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health SBD |
$968.62
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna Medicare |
$1,875.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: BCBS Complete |
$1,500.00
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,625.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,362.50 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,625.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.32 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.09
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health SBD |
$276.32
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.44 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna Medicare |
$219.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.09
|
| Rate for Payer: BCBS Complete |
$175.44
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health SBD |
$276.32
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$2,125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,750.00
|
| Rate for Payer: Cofinity Commercial |
$2,150.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,750.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Healthscope Commercial |
$2,250.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: PHP Commercial |
$2,125.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health SBD |
$1,575.00
|
|
