|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$929.25 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.75
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Advantage |
$1,032.50
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: Priority Health SBD |
$929.25
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$579.67 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: Aetna Medicare |
$737.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.75
|
| Rate for Payer: BCBS Complete |
$590.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Advantage |
$1,032.50
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: Priority Health SBD |
$929.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.75
|
| Rate for Payer: UHC Core |
$768.48
|
| Rate for Payer: UHC Exchange |
$579.67
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.33 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.44
|
| Rate for Payer: UHC Core |
$81.31
|
| Rate for Payer: UHC Exchange |
$61.33
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.32 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
OP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.53 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: Aetna Medicare |
$162.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.93
|
| Rate for Payer: BCBS Complete |
$129.80
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Advantage |
$227.16
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: Priority Health SBD |
$204.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.93
|
| Rate for Payer: UHC Core |
$169.07
|
| Rate for Payer: UHC Exchange |
$127.53
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
IP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$204.44 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.93
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Advantage |
$227.16
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: Priority Health SBD |
$204.44
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
IP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$291.10 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.34
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Advantage |
$323.44
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: Priority Health SBD |
$291.10
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
OP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$181.59 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: Aetna Medicare |
$231.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.34
|
| Rate for Payer: BCBS Complete |
$184.82
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Advantage |
$323.44
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: Priority Health SBD |
$291.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.34
|
| Rate for Payer: UHC Core |
$240.73
|
| Rate for Payer: UHC Exchange |
$181.59
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
OP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$263.96 |
| Max. Negotiated Rate |
$604.49 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: Aetna Medicare |
$335.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.57
|
| Rate for Payer: BCBS Complete |
$268.66
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Advantage |
$470.15
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$604.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$537.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: Priority Health SBD |
$423.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.57
|
| Rate for Payer: UHC Core |
$349.93
|
| Rate for Payer: UHC Exchange |
$263.96
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
IP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$423.14 |
| Max. Negotiated Rate |
$604.49 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.57
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Advantage |
$470.15
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$604.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: Priority Health SBD |
$423.14
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
IP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.65 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.53
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Advantage |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: Priority Health SBD |
$27.65
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
OP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: Aetna Medicare |
$21.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.53
|
| Rate for Payer: BCBS Complete |
$17.56
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Advantage |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: Priority Health SBD |
$27.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.53
|
| Rate for Payer: UHC Core |
$22.87
|
| Rate for Payer: UHC Exchange |
$17.25
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
IP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,127.08 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.86
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Advantage |
$1,252.31
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: Priority Health SBD |
$1,127.08
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
OP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Aetna Medicare |
$894.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.86
|
| Rate for Payer: BCBS Complete |
$715.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Advantage |
$1,252.31
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,431.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: Priority Health SBD |
$1,127.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,162.86
|
| Rate for Payer: UHC Core |
$932.07
|
| Rate for Payer: UHC Exchange |
$703.08
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
IP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,246.37 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.94
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Advantage |
$1,384.86
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: Priority Health SBD |
$1,246.37
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
OP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: Aetna Medicare |
$989.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.94
|
| Rate for Payer: BCBS Complete |
$791.35
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Advantage |
$1,384.86
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,582.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: Priority Health SBD |
$1,246.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.94
|
| Rate for Payer: UHC Core |
$1,030.73
|
| Rate for Payer: UHC Exchange |
$777.50
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
OP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: Aetna Medicare |
$143.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.89
|
| Rate for Payer: BCBS Complete |
$114.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Advantage |
$200.19
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: Priority Health SBD |
$180.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.89
|
| Rate for Payer: UHC Core |
$149.00
|
| Rate for Payer: UHC Exchange |
$112.39
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
IP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.17 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.89
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Advantage |
$200.19
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: Priority Health SBD |
$180.17
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
OP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,274.54 |
| Rate for Payer: Aetna Commercial |
$2,148.18
|
| Rate for Payer: Aetna Medicare |
$1,263.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,642.73
|
| Rate for Payer: BCBS Complete |
$1,010.91
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Advantage |
$1,769.09
|
| Rate for Payer: Cofinity Commercial |
$2,173.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Healthscope Commercial |
$2,274.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,021.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: PHP Commercial |
$2,148.18
|
| Rate for Payer: Priority Health SBD |
$1,592.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,642.73
|
| Rate for Payer: UHC Core |
$1,316.71
|
| Rate for Payer: UHC Exchange |
$993.22
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
IP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,592.18 |
| Max. Negotiated Rate |
$2,274.54 |
| Rate for Payer: Aetna Commercial |
$2,148.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,642.73
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Advantage |
$1,769.09
|
| Rate for Payer: Cofinity Commercial |
$2,173.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Healthscope Commercial |
$2,274.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: PHP Commercial |
$2,148.18
|
| Rate for Payer: Priority Health SBD |
$1,592.18
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.38
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Advantage |
$236.25
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: Priority Health SBD |
$212.62
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: Aetna Medicare |
$168.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.38
|
| Rate for Payer: BCBS Complete |
$135.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Advantage |
$236.25
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: Priority Health SBD |
$212.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.38
|
| Rate for Payer: UHC Core |
$175.84
|
| Rate for Payer: UHC Exchange |
$132.64
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
IP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,308.57 |
| Max. Negotiated Rate |
$3,297.96 |
| Rate for Payer: Aetna Commercial |
$3,114.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,381.86
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Advantage |
$2,565.08
|
| Rate for Payer: Cofinity Commercial |
$3,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Healthscope Commercial |
$3,297.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: PHP Commercial |
$3,114.74
|
| Rate for Payer: Priority Health SBD |
$2,308.57
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
OP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,297.96 |
| Rate for Payer: Aetna Commercial |
$3,114.74
|
| Rate for Payer: Aetna Medicare |
$1,832.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,381.86
|
| Rate for Payer: BCBS Complete |
$1,465.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Advantage |
$2,565.08
|
| Rate for Payer: Cofinity Commercial |
$3,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Healthscope Commercial |
$3,297.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,931.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: PHP Commercial |
$3,114.74
|
| Rate for Payer: Priority Health SBD |
$2,308.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,381.86
|
| Rate for Payer: UHC Core |
$1,909.15
|
| Rate for Payer: UHC Exchange |
$1,440.11
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
OP
|
$490.52
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$441.47 |
| Rate for Payer: Aetna Commercial |
$416.94
|
| Rate for Payer: Aetna Medicare |
$245.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.84
|
| Rate for Payer: BCBS Complete |
$196.21
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cofinity Advantage |
$343.36
|
| Rate for Payer: Cofinity Commercial |
$421.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.42
|
| Rate for Payer: Healthscope Commercial |
$441.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$392.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.89
|
| Rate for Payer: PHP Commercial |
$416.94
|
| Rate for Payer: Priority Health SBD |
$309.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.84
|
| Rate for Payer: UHC Core |
$255.56
|
| Rate for Payer: UHC Exchange |
$192.77
|
|
