|
HC BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
76100463
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,189.00
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,609.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
OP
|
$1,644.96
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,151.47 |
| Max. Negotiated Rate |
$6,105.86 |
| Rate for Payer: Aetna Commercial |
$1,480.46
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$1,595.61
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.34
|
| Rate for Payer: BCN Commercial |
$1,275.34
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$1,315.97
|
| Rate for Payer: Cash Price |
$1,315.97
|
| Rate for Payer: Cofinity Commercial |
$1,546.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,315.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$1,644.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,595.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$1,480.46
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,398.22
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,151.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,496.91
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,167.92
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,447.56
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
IP
|
$1,644.96
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,151.47 |
| Max. Negotiated Rate |
$1,644.96 |
| Rate for Payer: Aetna Commercial |
$1,480.46
|
| Rate for Payer: ASR ASR |
$1,595.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.34
|
| Rate for Payer: BCN Commercial |
$1,275.34
|
| Rate for Payer: Cash Price |
$1,315.97
|
| Rate for Payer: Cofinity Commercial |
$1,546.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,315.97
|
| Rate for Payer: Healthscope Commercial |
$1,644.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,595.61
|
| Rate for Payer: Mclaren Commercial |
$1,480.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,398.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,151.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,447.56
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,215.00
|
| Rate for Payer: Aetna Medicare |
$489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: ASR ASR |
$1,309.50
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.66
|
| Rate for Payer: BCN Commercial |
$1,046.66
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,269.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,309.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$489.06
|
| Rate for Payer: Mclaren Commercial |
$1,215.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$537.97
|
| Rate for Payer: PHP Medicaid |
$267.52
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.83
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$402.26
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,188.00
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$945.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,215.00
|
| Rate for Payer: ASR ASR |
$1,309.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.66
|
| Rate for Payer: BCN Commercial |
$1,046.66
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,269.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,309.50
|
| Rate for Payer: Mclaren Commercial |
$1,215.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,188.00
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
IP
|
$853.80
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$597.66 |
| Max. Negotiated Rate |
$853.80 |
| Rate for Payer: Aetna Commercial |
$768.42
|
| Rate for Payer: ASR ASR |
$828.19
|
| Rate for Payer: BCBS Trust/PPO |
$661.95
|
| Rate for Payer: BCN Commercial |
$661.95
|
| Rate for Payer: Cash Price |
$683.04
|
| Rate for Payer: Cofinity Commercial |
$802.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$683.04
|
| Rate for Payer: Healthscope Commercial |
$853.80
|
| Rate for Payer: Healthscope Whirlpool |
$828.19
|
| Rate for Payer: Mclaren Commercial |
$768.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.34
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
OP
|
$853.80
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.88 |
| Max. Negotiated Rate |
$893.22 |
| Rate for Payer: Aetna Commercial |
$768.42
|
| Rate for Payer: Aetna Medicare |
$714.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.22
|
| Rate for Payer: ASR ASR |
$828.19
|
| Rate for Payer: BCBS Complete |
$410.45
|
| Rate for Payer: BCBS MAPPO |
$714.58
|
| Rate for Payer: BCBS Trust/PPO |
$661.95
|
| Rate for Payer: BCN Commercial |
$661.95
|
| Rate for Payer: BCN Medicare Advantage |
$714.58
|
| Rate for Payer: Cash Price |
$683.04
|
| Rate for Payer: Cash Price |
$683.04
|
| Rate for Payer: Cofinity Commercial |
$802.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$683.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.58
|
| Rate for Payer: Healthscope Commercial |
$853.80
|
| Rate for Payer: Healthscope Whirlpool |
$828.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$714.58
|
| Rate for Payer: Mclaren Commercial |
$768.42
|
| Rate for Payer: Mclaren Medicaid |
$390.88
|
| Rate for Payer: Mclaren Medicare |
$714.58
|
| Rate for Payer: Meridian Medicaid |
$410.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.73
|
| Rate for Payer: PACE Medicare |
$678.85
|
| Rate for Payer: PACE SWMI |
$714.58
|
| Rate for Payer: PHP Commercial |
$786.04
|
| Rate for Payer: PHP Medicaid |
$390.88
|
| Rate for Payer: PHP Medicare Advantage |
$714.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.59
|
| Rate for Payer: Priority Health Medicare |
$714.58
|
| Rate for Payer: Priority Health Narrow Network |
$530.87
|
| Rate for Payer: Railroad Medicare Medicare |
$714.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.34
|
| Rate for Payer: UHC Medicare Advantage |
$736.02
|
| Rate for Payer: VA VA |
$714.58
|
|
|
HC BIOSENSE 8MM ABLATION CATHETER
|
Facility
|
OP
|
$4,590.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,836.00 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Aetna Commercial |
$4,131.00
|
| Rate for Payer: ASR ASR |
$4,452.30
|
| Rate for Payer: BCBS Complete |
$1,836.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,558.63
|
| Rate for Payer: BCN Commercial |
$3,558.63
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$4,314.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,672.00
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,452.30
|
| Rate for Payer: Mclaren Commercial |
$4,131.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,901.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,213.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,176.90
|
| Rate for Payer: Priority Health Narrow Network |
$3,258.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,039.20
|
|
|
HC BIOSENSE 8MM ABLATION CATHETER
|
Facility
|
IP
|
$4,590.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,213.00 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Aetna Commercial |
$4,131.00
|
| Rate for Payer: ASR ASR |
$4,452.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,558.63
|
| Rate for Payer: BCN Commercial |
$3,558.63
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$4,314.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,672.00
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,452.30
|
| Rate for Payer: Mclaren Commercial |
$4,131.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,901.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,213.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,039.20
|
|
|
HC BIOSENSE ABLATION CATHETER
|
Facility
|
IP
|
$4,002.32
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,801.62 |
| Max. Negotiated Rate |
$4,002.32 |
| Rate for Payer: Aetna Commercial |
$3,602.09
|
| Rate for Payer: ASR ASR |
$3,882.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,103.00
|
| Rate for Payer: BCN Commercial |
$3,103.00
|
| Rate for Payer: Cash Price |
$3,201.86
|
| Rate for Payer: Cofinity Commercial |
$3,762.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,201.86
|
| Rate for Payer: Healthscope Commercial |
$4,002.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,882.25
|
| Rate for Payer: Mclaren Commercial |
$3,602.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,401.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,801.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,522.04
|
|
|
HC BIOSENSE ABLATION CATHETER
|
Facility
|
OP
|
$4,002.32
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,600.93 |
| Max. Negotiated Rate |
$4,002.32 |
| Rate for Payer: Aetna Commercial |
$3,602.09
|
| Rate for Payer: ASR ASR |
$3,882.25
|
| Rate for Payer: BCBS Complete |
$1,600.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,103.00
|
| Rate for Payer: BCN Commercial |
$3,103.00
|
| Rate for Payer: Cash Price |
$3,201.86
|
| Rate for Payer: Cofinity Commercial |
$3,762.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,201.86
|
| Rate for Payer: Healthscope Commercial |
$4,002.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,882.25
|
| Rate for Payer: Mclaren Commercial |
$3,602.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,401.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,801.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,642.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,841.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,522.04
|
|
|
HC BIOSENSE THERMOCOOL CATHETER
|
Facility
|
OP
|
$6,249.11
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,499.64 |
| Max. Negotiated Rate |
$6,249.11 |
| Rate for Payer: Aetna Commercial |
$5,624.20
|
| Rate for Payer: ASR ASR |
$6,061.64
|
| Rate for Payer: BCBS Complete |
$2,499.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,844.93
|
| Rate for Payer: BCN Commercial |
$4,844.93
|
| Rate for Payer: Cash Price |
$4,999.29
|
| Rate for Payer: Cofinity Commercial |
$5,874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,999.29
|
| Rate for Payer: Healthscope Commercial |
$6,249.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,061.64
|
| Rate for Payer: Mclaren Commercial |
$5,624.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,311.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,374.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,686.69
|
| Rate for Payer: Priority Health Narrow Network |
$4,436.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,499.22
|
|
|
HC BIOSENSE THERMOCOOL CATHETER
|
Facility
|
IP
|
$6,249.11
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,374.38 |
| Max. Negotiated Rate |
$6,249.11 |
| Rate for Payer: Aetna Commercial |
$5,624.20
|
| Rate for Payer: ASR ASR |
$6,061.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,844.93
|
| Rate for Payer: BCN Commercial |
$4,844.93
|
| Rate for Payer: Cash Price |
$4,999.29
|
| Rate for Payer: Cofinity Commercial |
$5,874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,999.29
|
| Rate for Payer: Healthscope Commercial |
$6,249.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,061.64
|
| Rate for Payer: Mclaren Commercial |
$5,624.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,311.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,374.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,499.22
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$64.99
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Commercial |
$51.95
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$60.30
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.23
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.97
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$47.57
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.96
|
| Rate for Payer: UHC Medicare Advantage |
$17.38
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC BIOTINIDASE
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: ASR ASR |
$64.99
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Commercial |
$51.95
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.99
|
| Rate for Payer: Mclaren Commercial |
$60.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.96
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,442.85
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,777.14 |
| Max. Negotiated Rate |
$9,442.85 |
| Rate for Payer: Aetna Commercial |
$8,498.56
|
| Rate for Payer: ASR ASR |
$9,159.56
|
| Rate for Payer: BCBS Complete |
$3,777.14
|
| Rate for Payer: BCBS Trust/PPO |
$7,321.04
|
| Rate for Payer: BCN Commercial |
$7,321.04
|
| Rate for Payer: Cash Price |
$7,554.28
|
| Rate for Payer: Cofinity Commercial |
$8,876.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,554.28
|
| Rate for Payer: Healthscope Commercial |
$9,442.85
|
| Rate for Payer: Healthscope Whirlpool |
$9,159.56
|
| Rate for Payer: Mclaren Commercial |
$8,498.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,026.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,610.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,592.99
|
| Rate for Payer: Priority Health Narrow Network |
$6,704.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,309.71
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,442.85
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,610.00 |
| Max. Negotiated Rate |
$9,442.85 |
| Rate for Payer: Aetna Commercial |
$8,498.56
|
| Rate for Payer: ASR ASR |
$9,159.56
|
| Rate for Payer: BCBS Trust/PPO |
$7,321.04
|
| Rate for Payer: BCN Commercial |
$7,321.04
|
| Rate for Payer: Cash Price |
$7,554.28
|
| Rate for Payer: Cofinity Commercial |
$8,876.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,554.28
|
| Rate for Payer: Healthscope Commercial |
$9,442.85
|
| Rate for Payer: Healthscope Whirlpool |
$9,159.56
|
| Rate for Payer: Mclaren Commercial |
$8,498.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,026.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,610.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,309.71
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,722.47
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$688.99 |
| Max. Negotiated Rate |
$1,722.47 |
| Rate for Payer: Aetna Commercial |
$1,550.22
|
| Rate for Payer: ASR ASR |
$1,670.80
|
| Rate for Payer: BCBS Complete |
$688.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.43
|
| Rate for Payer: BCN Commercial |
$1,335.43
|
| Rate for Payer: Cash Price |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,619.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.98
|
| Rate for Payer: Healthscope Commercial |
$1,722.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,670.80
|
| Rate for Payer: Mclaren Commercial |
$1,550.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,567.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,222.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,515.77
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,722.47
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,205.73 |
| Max. Negotiated Rate |
$1,722.47 |
| Rate for Payer: Aetna Commercial |
$1,550.22
|
| Rate for Payer: ASR ASR |
$1,670.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.43
|
| Rate for Payer: BCN Commercial |
$1,335.43
|
| Rate for Payer: Cash Price |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,619.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.98
|
| Rate for Payer: Healthscope Commercial |
$1,722.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,670.80
|
| Rate for Payer: Mclaren Commercial |
$1,550.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,515.77
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$857.95
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$600.56 |
| Max. Negotiated Rate |
$857.95 |
| Rate for Payer: Aetna Commercial |
$772.16
|
| Rate for Payer: ASR ASR |
$832.21
|
| Rate for Payer: BCBS Trust/PPO |
$665.17
|
| Rate for Payer: BCN Commercial |
$665.17
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cofinity Commercial |
$806.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.36
|
| Rate for Payer: Healthscope Commercial |
$857.95
|
| Rate for Payer: Healthscope Whirlpool |
$832.21
|
| Rate for Payer: Mclaren Commercial |
$772.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.00
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$857.95
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$103.71 |
| Max. Negotiated Rate |
$1,755.80 |
| Rate for Payer: Aetna Commercial |
$772.16
|
| Rate for Payer: Aetna Medicare |
$189.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: ASR ASR |
$832.21
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$665.17
|
| Rate for Payer: BCN Commercial |
$665.17
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cash Price |
$686.36
|
| Rate for Payer: Cofinity Commercial |
$806.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$857.95
|
| Rate for Payer: Healthscope Whirlpool |
$832.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.59
|
| Rate for Payer: Mclaren Commercial |
$772.16
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.26
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$208.55
|
| Rate for Payer: PHP Medicaid |
$103.71
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,755.80
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.64
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.00
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: VA VA |
$189.59
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC BIRCH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$1,998.72
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$799.49 |
| Max. Negotiated Rate |
$1,998.72 |
| Rate for Payer: Aetna Commercial |
$1,798.85
|
| Rate for Payer: ASR ASR |
$1,938.76
|
| Rate for Payer: BCBS Complete |
$799.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,549.61
|
| Rate for Payer: BCN Commercial |
$1,549.61
|
| Rate for Payer: Cash Price |
$1,598.98
|
| Rate for Payer: Cofinity Commercial |
$1,878.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.98
|
| Rate for Payer: Healthscope Commercial |
$1,998.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.76
|
| Rate for Payer: Mclaren Commercial |
$1,798.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,698.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,818.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,419.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,758.87
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$1,998.72
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,399.10 |
| Max. Negotiated Rate |
$1,998.72 |
| Rate for Payer: Aetna Commercial |
$1,798.85
|
| Rate for Payer: ASR ASR |
$1,938.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,549.61
|
| Rate for Payer: BCN Commercial |
$1,549.61
|
| Rate for Payer: Cash Price |
$1,598.98
|
| Rate for Payer: Cofinity Commercial |
$1,878.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.98
|
| Rate for Payer: Healthscope Commercial |
$1,998.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,938.76
|
| Rate for Payer: Mclaren Commercial |
$1,798.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,698.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,758.87
|
|
