|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$1,348.03
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$943.62 |
| Max. Negotiated Rate |
$1,348.03 |
| Rate for Payer: Aetna Commercial |
$1,213.23
|
| Rate for Payer: Aetna Commercial |
$1,912.86
|
| Rate for Payer: ASR ASR |
$1,307.59
|
| Rate for Payer: ASR ASR |
$2,061.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,045.13
|
| Rate for Payer: BCN Commercial |
$1,647.82
|
| Rate for Payer: BCN Commercial |
$1,045.13
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,267.15
|
| Rate for Payer: Cofinity Commercial |
$1,997.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.42
|
| Rate for Payer: Healthscope Commercial |
$2,125.40
|
| Rate for Payer: Healthscope Commercial |
$1,348.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,061.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,307.59
|
| Rate for Payer: Mclaren Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Commercial |
$1,213.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,145.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,870.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,186.27
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,125.40
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,125.40 |
| Rate for Payer: Aetna Commercial |
$1,912.86
|
| Rate for Payer: Aetna Commercial |
$1,213.23
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$1,307.59
|
| Rate for Payer: ASR ASR |
$2,061.64
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,045.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.82
|
| Rate for Payer: BCN Commercial |
$1,647.82
|
| Rate for Payer: BCN Commercial |
$1,045.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,997.88
|
| Rate for Payer: Cofinity Commercial |
$1,267.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,348.03
|
| Rate for Payer: Healthscope Commercial |
$2,125.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,061.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,307.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Commercial |
$1,213.23
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,145.83
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,934.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,226.71
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,509.03
|
| Rate for Payer: Priority Health Narrow Network |
$957.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,870.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,186.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,024.19
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,416.93 |
| Max. Negotiated Rate |
$2,024.19 |
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,569.35
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,024.19
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.78 |
| Max. Negotiated Rate |
$2,024.19 |
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,569.35
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.48
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$422.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,024.19
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,153.84 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,569.35
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,442.30
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,024.19
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,416.93 |
| Max. Negotiated Rate |
$2,024.19 |
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,569.35
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$164.44
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$115.11 |
| Max. Negotiated Rate |
$955.41 |
| Rate for Payer: Aetna Commercial |
$148.00
|
| Rate for Payer: Aetna Medicare |
$764.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$955.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$955.41
|
| Rate for Payer: ASR ASR |
$159.51
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$764.33
|
| Rate for Payer: BCBS Trust/PPO |
$127.49
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$764.33
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cofinity Commercial |
$154.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.33
|
| Rate for Payer: Healthscope Commercial |
$164.44
|
| Rate for Payer: Healthscope Whirlpool |
$159.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$764.33
|
| Rate for Payer: Mclaren Commercial |
$148.00
|
| Rate for Payer: Mclaren Medicaid |
$418.09
|
| Rate for Payer: Mclaren Medicare |
$764.33
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$802.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$878.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.77
|
| Rate for Payer: PACE Medicare |
$726.11
|
| Rate for Payer: PACE SWMI |
$764.33
|
| Rate for Payer: PHP Commercial |
$840.76
|
| Rate for Payer: PHP Medicaid |
$418.09
|
| Rate for Payer: PHP Medicare Advantage |
$764.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.64
|
| Rate for Payer: Priority Health Medicare |
$764.33
|
| Rate for Payer: Priority Health Narrow Network |
$116.75
|
| Rate for Payer: Railroad Medicare Medicare |
$764.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.71
|
| Rate for Payer: UHC Medicare Advantage |
$787.26
|
| Rate for Payer: VA VA |
$764.33
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$164.44
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$115.11 |
| Max. Negotiated Rate |
$164.44 |
| Rate for Payer: Aetna Commercial |
$148.00
|
| Rate for Payer: ASR ASR |
$159.51
|
| Rate for Payer: BCBS Trust/PPO |
$127.49
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cofinity Commercial |
$154.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.55
|
| Rate for Payer: Healthscope Commercial |
$164.44
|
| Rate for Payer: Healthscope Whirlpool |
$159.51
|
| Rate for Payer: Mclaren Commercial |
$148.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.71
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$145.26
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.68 |
| Max. Negotiated Rate |
$145.26 |
| Rate for Payer: Aetna Commercial |
$130.73
|
| Rate for Payer: ASR ASR |
$140.90
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$136.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Healthscope Commercial |
$145.26
|
| Rate for Payer: Healthscope Whirlpool |
$140.90
|
| Rate for Payer: Mclaren Commercial |
$130.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.83
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$145.26
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$145.26 |
| Rate for Payer: Aetna Commercial |
$130.73
|
| Rate for Payer: ASR ASR |
$140.90
|
| Rate for Payer: BCBS Complete |
$58.10
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$136.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Healthscope Commercial |
$145.26
|
| Rate for Payer: Healthscope Whirlpool |
$140.90
|
| Rate for Payer: Mclaren Commercial |
$130.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.19
|
| Rate for Payer: Priority Health Narrow Network |
$103.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.83
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$47.84
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.14 |
| Max. Negotiated Rate |
$47.84 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: ASR ASR |
$46.40
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Trust/PPO |
$37.09
|
| Rate for Payer: BCN Commercial |
$37.09
|
| Rate for Payer: Cash Price |
$38.27
|
| Rate for Payer: Cofinity Commercial |
$44.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.27
|
| Rate for Payer: Healthscope Commercial |
$47.84
|
| Rate for Payer: Healthscope Whirlpool |
$46.40
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.53
|
| Rate for Payer: Priority Health Narrow Network |
$33.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.10
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$47.84
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.49 |
| Max. Negotiated Rate |
$47.84 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: ASR ASR |
$46.40
|
| Rate for Payer: BCBS Trust/PPO |
$37.09
|
| Rate for Payer: BCN Commercial |
$37.09
|
| Rate for Payer: Cash Price |
$38.27
|
| Rate for Payer: Cofinity Commercial |
$44.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.27
|
| Rate for Payer: Healthscope Commercial |
$47.84
|
| Rate for Payer: Healthscope Whirlpool |
$46.40
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.10
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$25,806.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,322.40 |
| Max. Negotiated Rate |
$25,806.00 |
| Rate for Payer: Aetna Commercial |
$23,225.40
|
| Rate for Payer: ASR ASR |
$25,031.82
|
| Rate for Payer: BCBS Complete |
$10,322.40
|
| Rate for Payer: BCBS Trust/PPO |
$20,007.39
|
| Rate for Payer: BCN Commercial |
$20,007.39
|
| Rate for Payer: Cash Price |
$20,644.80
|
| Rate for Payer: Cofinity Commercial |
$24,257.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,644.80
|
| Rate for Payer: Healthscope Commercial |
$25,806.00
|
| Rate for Payer: Healthscope Whirlpool |
$25,031.82
|
| Rate for Payer: Mclaren Commercial |
$23,225.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,935.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,064.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,483.46
|
| Rate for Payer: Priority Health Narrow Network |
$18,322.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,709.28
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$25,806.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,064.20 |
| Max. Negotiated Rate |
$25,806.00 |
| Rate for Payer: Aetna Commercial |
$23,225.40
|
| Rate for Payer: ASR ASR |
$25,031.82
|
| Rate for Payer: BCBS Trust/PPO |
$20,007.39
|
| Rate for Payer: BCN Commercial |
$20,007.39
|
| Rate for Payer: Cash Price |
$20,644.80
|
| Rate for Payer: Cofinity Commercial |
$24,257.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,644.80
|
| Rate for Payer: Healthscope Commercial |
$25,806.00
|
| Rate for Payer: Healthscope Whirlpool |
$25,031.82
|
| Rate for Payer: Mclaren Commercial |
$23,225.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,935.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,064.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22,709.28
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$6,751.77
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,700.71 |
| Max. Negotiated Rate |
$6,751.77 |
| Rate for Payer: Aetna Commercial |
$6,076.59
|
| Rate for Payer: ASR ASR |
$6,549.22
|
| Rate for Payer: BCBS Complete |
$2,700.71
|
| Rate for Payer: BCBS Trust/PPO |
$5,234.65
|
| Rate for Payer: BCN Commercial |
$5,234.65
|
| Rate for Payer: Cash Price |
$5,401.42
|
| Rate for Payer: Cofinity Commercial |
$6,346.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,401.42
|
| Rate for Payer: Healthscope Commercial |
$6,751.77
|
| Rate for Payer: Healthscope Whirlpool |
$6,549.22
|
| Rate for Payer: Mclaren Commercial |
$6,076.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,739.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,726.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,144.11
|
| Rate for Payer: Priority Health Narrow Network |
$4,793.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,941.56
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$6,751.77
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,726.24 |
| Max. Negotiated Rate |
$6,751.77 |
| Rate for Payer: Aetna Commercial |
$6,076.59
|
| Rate for Payer: ASR ASR |
$6,549.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,234.65
|
| Rate for Payer: BCN Commercial |
$5,234.65
|
| Rate for Payer: Cash Price |
$5,401.42
|
| Rate for Payer: Cofinity Commercial |
$6,346.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,401.42
|
| Rate for Payer: Healthscope Commercial |
$6,751.77
|
| Rate for Payer: Healthscope Whirlpool |
$6,549.22
|
| Rate for Payer: Mclaren Commercial |
$6,076.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,739.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,726.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,941.56
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,404.80
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,361.92 |
| Max. Negotiated Rate |
$8,404.80 |
| Rate for Payer: Aetna Commercial |
$7,564.32
|
| Rate for Payer: ASR ASR |
$8,152.66
|
| Rate for Payer: BCBS Complete |
$3,361.92
|
| Rate for Payer: BCBS Trust/PPO |
$6,516.24
|
| Rate for Payer: BCN Commercial |
$6,516.24
|
| Rate for Payer: Cash Price |
$6,723.84
|
| Rate for Payer: Cofinity Commercial |
$7,900.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,723.84
|
| Rate for Payer: Healthscope Commercial |
$8,404.80
|
| Rate for Payer: Healthscope Whirlpool |
$8,152.66
|
| Rate for Payer: Mclaren Commercial |
$7,564.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,883.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,648.37
|
| Rate for Payer: Priority Health Narrow Network |
$5,967.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,396.22
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,404.80
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,883.36 |
| Max. Negotiated Rate |
$8,404.80 |
| Rate for Payer: Aetna Commercial |
$7,564.32
|
| Rate for Payer: ASR ASR |
$8,152.66
|
| Rate for Payer: BCBS Trust/PPO |
$6,516.24
|
| Rate for Payer: BCN Commercial |
$6,516.24
|
| Rate for Payer: Cash Price |
$6,723.84
|
| Rate for Payer: Cofinity Commercial |
$7,900.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,723.84
|
| Rate for Payer: Healthscope Commercial |
$8,404.80
|
| Rate for Payer: Healthscope Whirlpool |
$8,152.66
|
| Rate for Payer: Mclaren Commercial |
$7,564.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,883.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,396.22
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,156.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,709.20 |
| Max. Negotiated Rate |
$18,156.00 |
| Rate for Payer: Aetna Commercial |
$16,340.40
|
| Rate for Payer: ASR ASR |
$17,611.32
|
| Rate for Payer: BCBS Trust/PPO |
$14,076.35
|
| Rate for Payer: BCN Commercial |
$14,076.35
|
| Rate for Payer: Cash Price |
$14,524.80
|
| Rate for Payer: Cofinity Commercial |
$17,066.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,524.80
|
| Rate for Payer: Healthscope Commercial |
$18,156.00
|
| Rate for Payer: Healthscope Whirlpool |
$17,611.32
|
| Rate for Payer: Mclaren Commercial |
$16,340.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,709.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,977.28
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,156.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,262.40 |
| Max. Negotiated Rate |
$18,156.00 |
| Rate for Payer: Aetna Commercial |
$16,340.40
|
| Rate for Payer: ASR ASR |
$17,611.32
|
| Rate for Payer: BCBS Complete |
$7,262.40
|
| Rate for Payer: BCBS Trust/PPO |
$14,076.35
|
| Rate for Payer: BCN Commercial |
$14,076.35
|
| Rate for Payer: Cash Price |
$14,524.80
|
| Rate for Payer: Cofinity Commercial |
$17,066.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,524.80
|
| Rate for Payer: Healthscope Commercial |
$18,156.00
|
| Rate for Payer: Healthscope Whirlpool |
$17,611.32
|
| Rate for Payer: Mclaren Commercial |
$16,340.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,709.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,521.96
|
| Rate for Payer: Priority Health Narrow Network |
$12,890.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,977.28
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$21,624.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,136.80 |
| Max. Negotiated Rate |
$21,624.00 |
| Rate for Payer: Aetna Commercial |
$19,461.60
|
| Rate for Payer: ASR ASR |
$20,975.28
|
| Rate for Payer: BCBS Trust/PPO |
$16,765.09
|
| Rate for Payer: BCN Commercial |
$16,765.09
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$20,326.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Healthscope Commercial |
$21,624.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,975.28
|
| Rate for Payer: Mclaren Commercial |
$19,461.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,380.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,136.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,029.12
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$21,624.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,649.60 |
| Max. Negotiated Rate |
$21,624.00 |
| Rate for Payer: Aetna Commercial |
$19,461.60
|
| Rate for Payer: ASR ASR |
$20,975.28
|
| Rate for Payer: BCBS Complete |
$8,649.60
|
| Rate for Payer: BCBS Trust/PPO |
$16,765.09
|
| Rate for Payer: BCN Commercial |
$16,765.09
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$20,326.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Healthscope Commercial |
$21,624.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,975.28
|
| Rate for Payer: Mclaren Commercial |
$19,461.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18,380.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,136.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,677.84
|
| Rate for Payer: Priority Health Narrow Network |
$15,353.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,029.12
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,213.49
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$885.40 |
| Max. Negotiated Rate |
$2,213.49 |
| Rate for Payer: Aetna Commercial |
$1,992.14
|
| Rate for Payer: ASR ASR |
$2,147.09
|
| Rate for Payer: BCBS Complete |
$885.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.12
|
| Rate for Payer: BCN Commercial |
$1,716.12
|
| Rate for Payer: Cash Price |
$1,770.79
|
| Rate for Payer: Cofinity Commercial |
$2,080.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,770.79
|
| Rate for Payer: Healthscope Commercial |
$2,213.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,147.09
|
| Rate for Payer: Mclaren Commercial |
$1,992.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,881.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,549.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,014.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,571.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,947.87
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,213.49
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,549.44 |
| Max. Negotiated Rate |
$2,213.49 |
| Rate for Payer: Aetna Commercial |
$1,992.14
|
| Rate for Payer: ASR ASR |
$2,147.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.12
|
| Rate for Payer: BCN Commercial |
$1,716.12
|
| Rate for Payer: Cash Price |
$1,770.79
|
| Rate for Payer: Cofinity Commercial |
$2,080.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,770.79
|
| Rate for Payer: Healthscope Commercial |
$2,213.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,147.09
|
| Rate for Payer: Mclaren Commercial |
$1,992.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,881.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,549.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,947.87
|
|
|
HC BOSTON SCI PERIPHERAL STENT
|
Facility
|
OP
|
$2,626.53
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800004
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.61 |
| Max. Negotiated Rate |
$2,626.53 |
| Rate for Payer: Aetna Commercial |
$2,363.88
|
| Rate for Payer: ASR ASR |
$2,547.73
|
| Rate for Payer: BCBS Complete |
$1,050.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.35
|
| Rate for Payer: BCN Commercial |
$2,036.35
|
| Rate for Payer: Cash Price |
$2,101.22
|
| Rate for Payer: Cofinity Commercial |
$2,468.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,101.22
|
| Rate for Payer: Healthscope Commercial |
$2,626.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,547.73
|
| Rate for Payer: Mclaren Commercial |
$2,363.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,232.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,838.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,390.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,864.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,311.35
|
|
