|
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 |
$748.12 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna Medicare |
$819.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$984.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$984.38
|
| Rate for Payer: BCBS Complete |
$1,260.00
|
| Rate for Payer: BCBS MAPPO |
$787.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,589.62
|
| Rate for Payer: BCN Commercial |
$2,449.12
|
| Rate for Payer: BCN Medicare Advantage |
$787.50
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.50
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$905.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: PACE Senior Care Partners |
$748.12
|
| Rate for Payer: PACE SWMI |
$787.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: PHP Medicare Advantage |
$787.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Medicare |
$795.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,110.50
|
| Rate for Payer: Railroad Medicare Medicare |
$787.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.50
|
| Rate for Payer: UHC Exchange |
$787.50
|
| Rate for Payer: UHC Medicare Advantage |
$787.50
|
| Rate for Payer: VA VA |
$787.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
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 |
$2,592.20 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,255.40
|
| Rate for Payer: BCN Commercial |
$3,081.93
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,671.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
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 |
$947.15 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna Medicare |
$1,036.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.25
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: BCBS MAPPO |
$997.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,278.53
|
| Rate for Payer: BCN Commercial |
$3,100.67
|
| Rate for Payer: BCN Medicare Advantage |
$997.00
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.00
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: PACE Senior Care Partners |
$947.15
|
| Rate for Payer: PACE SWMI |
$997.00
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: PHP Medicare Advantage |
$997.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Medicare |
$1,006.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,671.96
|
| Rate for Payer: Railroad Medicare Medicare |
$997.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$997.00
|
| Rate for Payer: UHC Exchange |
$997.00
|
| Rate for Payer: UHC Medicare Advantage |
$997.00
|
| Rate for Payer: VA VA |
$997.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
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 |
$3,003.00 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,771.31
|
| Rate for Payer: BCN Commercial |
$3,570.34
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,019.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,095.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,065.60
|
| Rate for Payer: UHC Core |
$3,857.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
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 |
$1,097.25 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna Medicare |
$1,201.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,443.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,443.75
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: BCBS MAPPO |
$1,155.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,798.10
|
| Rate for Payer: BCN Commercial |
$3,592.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,212.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,097.25
|
| Rate for Payer: PACE SWMI |
$1,155.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,019.40
|
| Rate for Payer: Priority Health Medicare |
$1,166.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,095.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,065.60
|
| Rate for Payer: UHC Core |
$3,857.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.00
|
| Rate for Payer: UHC Exchange |
$1,155.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.00
|
| Rate for Payer: VA VA |
$1,155.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
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 |
$3,112.20 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,908.44
|
| Rate for Payer: BCN Commercial |
$3,700.17
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health HMO/PPO |
$4,165.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,207.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,213.44
|
| Rate for Payer: UHC Core |
$3,997.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
|
|
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 |
$1,137.15 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna Medicare |
$1,244.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,496.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,496.25
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: BCBS MAPPO |
$1,197.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,936.21
|
| Rate for Payer: BCN Commercial |
$3,722.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,197.00
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,197.00
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,256.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,376.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,137.15
|
| Rate for Payer: PACE SWMI |
$1,197.00
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,197.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health HMO/PPO |
$4,165.56
|
| Rate for Payer: Priority Health Medicare |
$1,208.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,207.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,197.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,213.44
|
| Rate for Payer: UHC Core |
$3,997.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,197.00
|
| Rate for Payer: UHC Exchange |
$1,197.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,197.00
|
| Rate for Payer: VA VA |
$1,197.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
|
|
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 |
$727.35 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: BCBS Trust/PPO |
$913.44
|
| Rate for Payer: BCN Commercial |
$864.76
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO |
$973.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.72
|
| Rate for Payer: UHC Core |
$934.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
|
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 |
$265.76 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna Medicare |
$290.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.69
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS MAPPO |
$279.75
|
| Rate for Payer: BCBS Trust/PPO |
$919.93
|
| Rate for Payer: BCN Commercial |
$870.02
|
| Rate for Payer: BCN Medicare Advantage |
$279.75
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.75
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: PACE Senior Care Partners |
$265.76
|
| Rate for Payer: PACE SWMI |
$279.75
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: PHP Medicare Advantage |
$279.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO |
$973.53
|
| Rate for Payer: Priority Health Medicare |
$282.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.73
|
| Rate for Payer: Railroad Medicare Medicare |
$279.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.72
|
| Rate for Payer: UHC Core |
$934.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.75
|
| Rate for Payer: UHC Exchange |
$279.75
|
| Rate for Payer: UHC Medicare Advantage |
$279.75
|
| Rate for Payer: VA VA |
$279.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
|
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 |
$318.84 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: Aetna Medicare |
$349.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$419.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$419.53
|
| Rate for Payer: BCBS Complete |
$537.00
|
| Rate for Payer: BCBS MAPPO |
$335.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.67
|
| Rate for Payer: BCN Commercial |
$1,043.79
|
| Rate for Payer: BCN Medicare Advantage |
$335.62
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.62
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: Nomi Health Commercial |
$1,100.85
|
| Rate for Payer: PACE Senior Care Partners |
$318.84
|
| Rate for Payer: PACE SWMI |
$335.62
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: PHP Medicare Advantage |
$335.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health HMO/PPO |
$1,167.98
|
| Rate for Payer: Priority Health Medicare |
$338.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.48
|
| Rate for Payer: Railroad Medicare Medicare |
$335.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.40
|
| Rate for Payer: UHC Core |
$1,120.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.62
|
| Rate for Payer: UHC Exchange |
$335.62
|
| Rate for Payer: UHC Medicare Advantage |
$335.62
|
| Rate for Payer: VA VA |
$335.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.88
|
|
|
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 |
$872.62 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.88
|
| Rate for Payer: BCN Commercial |
$1,037.48
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: Nomi Health Commercial |
$1,100.85
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health HMO/PPO |
$1,167.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.40
|
| Rate for Payer: UHC Core |
$1,120.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.88
|
|
|
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 |
$999.38 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,255.06
|
| Rate for Payer: BCN Commercial |
$1,188.18
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: Nomi Health Commercial |
$1,260.75
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,030.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.00
|
| Rate for Payer: UHC Core |
$1,283.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.12
|
|
|
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 |
$365.16 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: Aetna Medicare |
$399.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.47
|
| Rate for Payer: BCBS Complete |
$615.00
|
| Rate for Payer: BCBS MAPPO |
$384.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.98
|
| Rate for Payer: BCN Commercial |
$1,195.41
|
| Rate for Payer: BCN Medicare Advantage |
$384.38
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.38
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$442.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: Nomi Health Commercial |
$1,260.75
|
| Rate for Payer: PACE Senior Care Partners |
$365.16
|
| Rate for Payer: PACE SWMI |
$384.38
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: PHP Medicare Advantage |
$384.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.62
|
| Rate for Payer: Priority Health Medicare |
$388.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,030.12
|
| Rate for Payer: Railroad Medicare Medicare |
$384.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.00
|
| Rate for Payer: UHC Core |
$1,283.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.38
|
| Rate for Payer: UHC Exchange |
$384.38
|
| Rate for Payer: UHC Medicare Advantage |
$384.38
|
| Rate for Payer: VA VA |
$384.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.12
|
|
|
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 |
$2,437.50 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,061.12
|
| Rate for Payer: BCN Commercial |
$2,898.00
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Nomi Health Commercial |
$3,075.00
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,262.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,512.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,300.00
|
| Rate for Payer: UHC Core |
$3,131.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
|
|
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 |
$890.62 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna Medicare |
$975.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,171.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,171.88
|
| Rate for Payer: BCBS Complete |
$1,500.00
|
| Rate for Payer: BCBS MAPPO |
$937.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,082.88
|
| Rate for Payer: BCN Commercial |
$2,915.62
|
| Rate for Payer: BCN Medicare Advantage |
$937.50
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.50
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,078.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Nomi Health Commercial |
$3,075.00
|
| Rate for Payer: PACE Senior Care Partners |
$890.62
|
| Rate for Payer: PACE SWMI |
$937.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: PHP Medicare Advantage |
$937.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,262.50
|
| Rate for Payer: Priority Health Medicare |
$946.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,512.50
|
| Rate for Payer: Railroad Medicare Medicare |
$937.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,300.00
|
| Rate for Payer: UHC Core |
$3,131.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.50
|
| Rate for Payer: UHC Exchange |
$937.50
|
| Rate for Payer: UHC Medicare Advantage |
$937.50
|
| Rate for Payer: VA VA |
$937.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
|
|
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 |
$285.09 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: BCBS Trust/PPO |
$358.03
|
| Rate for Payer: BCN Commercial |
$338.95
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO |
$381.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.97
|
| Rate for Payer: UHC Core |
$366.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
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 |
$104.17 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna Medicare |
$114.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.06
|
| Rate for Payer: BCBS Complete |
$175.44
|
| Rate for Payer: BCBS MAPPO |
$109.65
|
| Rate for Payer: BCBS Trust/PPO |
$360.57
|
| Rate for Payer: BCN Commercial |
$341.01
|
| Rate for Payer: BCN Medicare Advantage |
$109.65
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.65
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PACE Senior Care Partners |
$104.17
|
| Rate for Payer: PACE SWMI |
$109.65
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: PHP Medicare Advantage |
$109.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO |
$381.58
|
| Rate for Payer: Priority Health Medicare |
$110.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.86
|
| Rate for Payer: Railroad Medicare Medicare |
$109.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.97
|
| Rate for Payer: UHC Core |
$366.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.65
|
| Rate for Payer: UHC Exchange |
$109.65
|
| Rate for Payer: UHC Medicare Advantage |
$109.65
|
| Rate for Payer: VA VA |
$109.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$593.75 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$2,125.00
|
| Rate for Payer: Aetna Medicare |
$650.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.25
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: BCBS MAPPO |
$625.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,055.25
|
| Rate for Payer: BCN Commercial |
$1,943.75
|
| Rate for Payer: BCN Medicare Advantage |
$625.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,150.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.00
|
| Rate for Payer: Healthscope Commercial |
$2,250.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,875.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: Nomi Health Commercial |
$2,050.00
|
| Rate for Payer: PACE Senior Care Partners |
$593.75
|
| Rate for Payer: PACE SWMI |
$625.00
|
| Rate for Payer: PHP Commercial |
$2,125.00
|
| Rate for Payer: PHP Medicare Advantage |
$625.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,175.00
|
| Rate for Payer: Priority Health Medicare |
$631.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,675.00
|
| Rate for Payer: Railroad Medicare Medicare |
$625.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,200.00
|
| Rate for Payer: UHC Core |
$2,087.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.00
|
| Rate for Payer: UHC Exchange |
$625.00
|
| Rate for Payer: UHC Medicare Advantage |
$625.00
|
| Rate for Payer: VA VA |
$625.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,875.00
|
|
|
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 |
$1,625.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$2,125.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,040.75
|
| Rate for Payer: BCN Commercial |
$1,932.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,150.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Healthscope Commercial |
$2,250.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,875.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: Nomi Health Commercial |
$2,050.00
|
| Rate for Payer: PHP Commercial |
$2,125.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,175.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,675.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,200.00
|
| Rate for Payer: UHC Core |
$2,087.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,875.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 32
|
Facility
|
OP
|
$3,242.50
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.09 |
| Max. Negotiated Rate |
$2,918.25 |
| Rate for Payer: Aetna Commercial |
$2,756.12
|
| Rate for Payer: Aetna Medicare |
$843.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,013.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,013.28
|
| Rate for Payer: BCBS Complete |
$1,297.00
|
| Rate for Payer: BCBS MAPPO |
$810.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,665.66
|
| Rate for Payer: BCN Commercial |
$2,521.04
|
| Rate for Payer: BCN Medicare Advantage |
$810.62
|
| Rate for Payer: Cash Price |
$2,594.00
|
| Rate for Payer: Cofinity Commercial |
$2,788.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,594.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.62
|
| Rate for Payer: Healthscope Commercial |
$2,918.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$851.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$932.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,756.12
|
| Rate for Payer: Nomi Health Commercial |
$2,658.85
|
| Rate for Payer: PACE Senior Care Partners |
$770.09
|
| Rate for Payer: PACE SWMI |
$810.62
|
| Rate for Payer: PHP Commercial |
$2,756.12
|
| Rate for Payer: PHP Medicare Advantage |
$810.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,107.62
|
| Rate for Payer: Priority Health HMO/PPO |
$2,820.98
|
| Rate for Payer: Priority Health Medicare |
$818.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,172.48
|
| Rate for Payer: Railroad Medicare Medicare |
$810.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,853.40
|
| Rate for Payer: UHC Core |
$2,707.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.62
|
| Rate for Payer: UHC Exchange |
$810.62
|
| Rate for Payer: UHC Medicare Advantage |
$810.62
|
| Rate for Payer: VA VA |
$810.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 32
|
Facility
|
IP
|
$3,242.50
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,107.62 |
| Max. Negotiated Rate |
$2,918.25 |
| Rate for Payer: Aetna Commercial |
$2,756.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,646.85
|
| Rate for Payer: BCN Commercial |
$2,505.80
|
| Rate for Payer: Cash Price |
$2,594.00
|
| Rate for Payer: Cofinity Commercial |
$2,788.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,594.00
|
| Rate for Payer: Healthscope Commercial |
$2,918.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,756.12
|
| Rate for Payer: Nomi Health Commercial |
$2,658.85
|
| Rate for Payer: PHP Commercial |
$2,756.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,107.62
|
| Rate for Payer: Priority Health HMO/PPO |
$2,820.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,172.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,853.40
|
| Rate for Payer: UHC Core |
$2,707.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 8
|
Facility
|
OP
|
$825.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.94 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: Aetna Medicare |
$214.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$257.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$257.81
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS MAPPO |
$206.25
|
| Rate for Payer: BCBS Trust/PPO |
$678.23
|
| Rate for Payer: BCN Commercial |
$641.44
|
| Rate for Payer: BCN Medicare Advantage |
$206.25
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.25
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.25
|
| Rate for Payer: Nomi Health Commercial |
$676.50
|
| Rate for Payer: PACE Senior Care Partners |
$195.94
|
| Rate for Payer: PACE SWMI |
$206.25
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: PHP Medicare Advantage |
$206.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO |
$717.75
|
| Rate for Payer: Priority Health Medicare |
$208.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.75
|
| Rate for Payer: Railroad Medicare Medicare |
$206.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.00
|
| Rate for Payer: UHC Core |
$688.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.25
|
| Rate for Payer: UHC Exchange |
$206.25
|
| Rate for Payer: UHC Medicare Advantage |
$206.25
|
| Rate for Payer: VA VA |
$206.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 8
|
Facility
|
IP
|
$825.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$536.25 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: BCBS Trust/PPO |
$673.45
|
| Rate for Payer: BCN Commercial |
$637.56
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.25
|
| Rate for Payer: Nomi Health Commercial |
$676.50
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO |
$717.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.00
|
| Rate for Payer: UHC Core |
$688.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 9
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
27200366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.75 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna Medicare |
$234.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.25
|
| Rate for Payer: BCBS Complete |
$360.00
|
| Rate for Payer: BCBS MAPPO |
$225.00
|
| Rate for Payer: BCBS Trust/PPO |
$739.89
|
| Rate for Payer: BCN Commercial |
$699.75
|
| Rate for Payer: BCN Medicare Advantage |
$225.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: Nomi Health Commercial |
$738.00
|
| Rate for Payer: PACE Senior Care Partners |
$213.75
|
| Rate for Payer: PACE SWMI |
$225.00
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: PHP Medicare Advantage |
$225.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO |
$783.00
|
| Rate for Payer: Priority Health Medicare |
$227.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$603.00
|
| Rate for Payer: Railroad Medicare Medicare |
$225.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.00
|
| Rate for Payer: UHC Core |
$751.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.00
|
| Rate for Payer: UHC Exchange |
$225.00
|
| Rate for Payer: UHC Medicare Advantage |
$225.00
|
| Rate for Payer: VA VA |
$225.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 9
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
27200366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: BCBS Trust/PPO |
$734.67
|
| Rate for Payer: BCN Commercial |
$695.52
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: Nomi Health Commercial |
$738.00
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO |
$783.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$603.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.00
|
| Rate for Payer: UHC Core |
$751.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.00
|
|
