|
HC BOSTON SCI PERIPHERAL STENT
|
Facility
|
IP
|
$2,626.53
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800004
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,838.57 |
| 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 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: UHC All Payor (Choice/PPO) + Core |
$2,311.35
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$13,947.49
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,579.00 |
| Max. Negotiated Rate |
$13,947.49 |
| Rate for Payer: Aetna Commercial |
$12,552.74
|
| Rate for Payer: ASR ASR |
$13,529.07
|
| Rate for Payer: BCBS Complete |
$5,579.00
|
| Rate for Payer: BCBS Trust/PPO |
$10,813.49
|
| Rate for Payer: BCN Commercial |
$10,813.49
|
| Rate for Payer: Cash Price |
$11,157.99
|
| Rate for Payer: Cofinity Commercial |
$13,110.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,157.99
|
| Rate for Payer: Healthscope Commercial |
$13,947.49
|
| Rate for Payer: Healthscope Whirlpool |
$13,529.07
|
| Rate for Payer: Mclaren Commercial |
$12,552.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,855.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,763.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,692.22
|
| Rate for Payer: Priority Health Narrow Network |
$9,902.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,273.79
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$13,947.49
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,763.24 |
| Max. Negotiated Rate |
$13,947.49 |
| Rate for Payer: Aetna Commercial |
$12,552.74
|
| Rate for Payer: ASR ASR |
$13,529.07
|
| Rate for Payer: BCBS Trust/PPO |
$10,813.49
|
| Rate for Payer: BCN Commercial |
$10,813.49
|
| Rate for Payer: Cash Price |
$11,157.99
|
| Rate for Payer: Cofinity Commercial |
$13,110.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,157.99
|
| Rate for Payer: Healthscope Commercial |
$13,947.49
|
| Rate for Payer: Healthscope Whirlpool |
$13,529.07
|
| Rate for Payer: Mclaren Commercial |
$12,552.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,855.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,763.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,273.79
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,600.98
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,440.39 |
| Max. Negotiated Rate |
$8,600.98 |
| Rate for Payer: Aetna Commercial |
$7,740.88
|
| Rate for Payer: ASR ASR |
$8,342.95
|
| Rate for Payer: BCBS Complete |
$3,440.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,668.34
|
| Rate for Payer: BCN Commercial |
$6,668.34
|
| Rate for Payer: Cash Price |
$6,880.78
|
| Rate for Payer: Cofinity Commercial |
$8,084.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,880.78
|
| Rate for Payer: Healthscope Commercial |
$8,600.98
|
| Rate for Payer: Healthscope Whirlpool |
$8,342.95
|
| Rate for Payer: Mclaren Commercial |
$7,740.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,310.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,020.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,826.89
|
| Rate for Payer: Priority Health Narrow Network |
$6,106.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,568.86
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,600.98
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,020.69 |
| Max. Negotiated Rate |
$8,600.98 |
| Rate for Payer: Aetna Commercial |
$7,740.88
|
| Rate for Payer: ASR ASR |
$8,342.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,668.34
|
| Rate for Payer: BCN Commercial |
$6,668.34
|
| Rate for Payer: Cash Price |
$6,880.78
|
| Rate for Payer: Cofinity Commercial |
$8,084.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,880.78
|
| Rate for Payer: Healthscope Commercial |
$8,600.98
|
| Rate for Payer: Healthscope Whirlpool |
$8,342.95
|
| Rate for Payer: Mclaren Commercial |
$7,740.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,310.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,020.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,568.86
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
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 BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
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 BOTTLE A/B CDI 500
|
Facility
|
IP
|
$198.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna Commercial |
$178.20
|
| Rate for Payer: ASR ASR |
$192.06
|
| Rate for Payer: BCBS Trust/PPO |
$153.51
|
| Rate for Payer: BCN Commercial |
$153.51
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$186.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Healthscope Whirlpool |
$192.06
|
| Rate for Payer: Mclaren Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.24
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
OP
|
$198.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna Commercial |
$178.20
|
| Rate for Payer: ASR ASR |
$192.06
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS Trust/PPO |
$153.51
|
| Rate for Payer: BCN Commercial |
$153.51
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$186.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Healthscope Whirlpool |
$192.06
|
| Rate for Payer: Mclaren Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.18
|
| Rate for Payer: Priority Health Narrow Network |
$140.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.24
|
|
|
HC BOWL
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$202.50
|
| Rate for Payer: ASR ASR |
$218.25
|
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: BCBS Trust/PPO |
$174.44
|
| Rate for Payer: BCN Commercial |
$174.44
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$211.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$225.00
|
| Rate for Payer: Healthscope Whirlpool |
$218.25
|
| Rate for Payer: Mclaren Commercial |
$202.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.75
|
| Rate for Payer: Priority Health Narrow Network |
$159.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.00
|
|
|
HC BOWL
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$202.50
|
| Rate for Payer: ASR ASR |
$218.25
|
| Rate for Payer: BCBS Trust/PPO |
$174.44
|
| Rate for Payer: BCN Commercial |
$174.44
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$211.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$225.00
|
| Rate for Payer: Healthscope Whirlpool |
$218.25
|
| Rate for Payer: Mclaren Commercial |
$202.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.00
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$248.50
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.95 |
| Max. Negotiated Rate |
$248.50 |
| Rate for Payer: Aetna Commercial |
$223.65
|
| Rate for Payer: ASR ASR |
$241.04
|
| Rate for Payer: BCBS Trust/PPO |
$192.66
|
| Rate for Payer: BCN Commercial |
$192.66
|
| Rate for Payer: Cash Price |
$198.80
|
| Rate for Payer: Cofinity Commercial |
$233.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.80
|
| Rate for Payer: Healthscope Commercial |
$248.50
|
| Rate for Payer: Healthscope Whirlpool |
$241.04
|
| Rate for Payer: Mclaren Commercial |
$223.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.68
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$248.50
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.40 |
| Max. Negotiated Rate |
$248.50 |
| Rate for Payer: Aetna Commercial |
$223.65
|
| Rate for Payer: ASR ASR |
$241.04
|
| Rate for Payer: BCBS Complete |
$99.40
|
| Rate for Payer: BCBS Trust/PPO |
$192.66
|
| Rate for Payer: BCN Commercial |
$192.66
|
| Rate for Payer: Cash Price |
$198.80
|
| Rate for Payer: Cofinity Commercial |
$233.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.80
|
| Rate for Payer: Healthscope Commercial |
$248.50
|
| Rate for Payer: Healthscope Whirlpool |
$241.04
|
| Rate for Payer: Mclaren Commercial |
$223.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.14
|
| Rate for Payer: Priority Health Narrow Network |
$176.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.68
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
IP
|
$51.41
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.99 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna Commercial |
$46.27
|
| Rate for Payer: ASR ASR |
$49.87
|
| Rate for Payer: BCBS Trust/PPO |
$39.86
|
| Rate for Payer: BCN Commercial |
$39.86
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.13
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Healthscope Whirlpool |
$49.87
|
| Rate for Payer: Mclaren Commercial |
$46.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.24
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
OP
|
$51.41
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna Commercial |
$46.27
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$49.87
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.86
|
| Rate for Payer: BCN Commercial |
$39.86
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Healthscope Whirlpool |
$49.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.27
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.70
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.78
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.50
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.24
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
OP
|
$51.41
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna Commercial |
$46.27
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$49.87
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.86
|
| Rate for Payer: BCN Commercial |
$39.86
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Healthscope Whirlpool |
$49.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.27
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.70
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.78
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.50
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.24
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
IP
|
$51.41
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.99 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna Commercial |
$46.27
|
| Rate for Payer: ASR ASR |
$49.87
|
| Rate for Payer: BCBS Trust/PPO |
$39.86
|
| Rate for Payer: BCN Commercial |
$39.86
|
| Rate for Payer: Cash Price |
$41.13
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.13
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Healthscope Whirlpool |
$49.87
|
| Rate for Payer: Mclaren Commercial |
$46.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.24
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
OP
|
$953.04
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$381.22 |
| Max. Negotiated Rate |
$953.04 |
| Rate for Payer: Aetna Commercial |
$857.74
|
| Rate for Payer: ASR ASR |
$924.45
|
| Rate for Payer: BCBS Complete |
$381.22
|
| Rate for Payer: BCBS Trust/PPO |
$738.89
|
| Rate for Payer: BCN Commercial |
$738.89
|
| Rate for Payer: Cash Price |
$762.43
|
| Rate for Payer: Cofinity Commercial |
$895.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$762.43
|
| Rate for Payer: Healthscope Commercial |
$953.04
|
| Rate for Payer: Healthscope Whirlpool |
$924.45
|
| Rate for Payer: Mclaren Commercial |
$857.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$810.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$667.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.27
|
| Rate for Payer: Priority Health Narrow Network |
$676.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.68
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
IP
|
$953.04
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$667.13 |
| Max. Negotiated Rate |
$953.04 |
| Rate for Payer: Aetna Commercial |
$857.74
|
| Rate for Payer: ASR ASR |
$924.45
|
| Rate for Payer: BCBS Trust/PPO |
$738.89
|
| Rate for Payer: BCN Commercial |
$738.89
|
| Rate for Payer: Cash Price |
$762.43
|
| Rate for Payer: Cofinity Commercial |
$895.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$762.43
|
| Rate for Payer: Healthscope Commercial |
$953.04
|
| Rate for Payer: Healthscope Whirlpool |
$924.45
|
| Rate for Payer: Mclaren Commercial |
$857.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$810.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$667.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.68
|
|
|
HC BRACE AFO
|
Facility
|
OP
|
$584.45
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$233.78 |
| Max. Negotiated Rate |
$584.45 |
| Rate for Payer: Aetna Commercial |
$526.00
|
| Rate for Payer: ASR ASR |
$566.92
|
| Rate for Payer: BCBS Complete |
$233.78
|
| Rate for Payer: BCBS Trust/PPO |
$453.12
|
| Rate for Payer: BCN Commercial |
$453.12
|
| Rate for Payer: Cash Price |
$467.56
|
| Rate for Payer: Cofinity Commercial |
$549.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.56
|
| Rate for Payer: Healthscope Commercial |
$584.45
|
| Rate for Payer: Healthscope Whirlpool |
$566.92
|
| Rate for Payer: Mclaren Commercial |
$526.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$496.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.85
|
| Rate for Payer: Priority Health Narrow Network |
$414.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.32
|
|
|
HC BRACE AFO
|
Facility
|
IP
|
$584.45
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$409.12 |
| Max. Negotiated Rate |
$584.45 |
| Rate for Payer: Aetna Commercial |
$526.00
|
| Rate for Payer: ASR ASR |
$566.92
|
| Rate for Payer: BCBS Trust/PPO |
$453.12
|
| Rate for Payer: BCN Commercial |
$453.12
|
| Rate for Payer: Cash Price |
$467.56
|
| Rate for Payer: Cofinity Commercial |
$549.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.56
|
| Rate for Payer: Healthscope Commercial |
$584.45
|
| Rate for Payer: Healthscope Whirlpool |
$566.92
|
| Rate for Payer: Mclaren Commercial |
$526.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$496.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.32
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
OP
|
$1,437.97
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$575.19 |
| Max. Negotiated Rate |
$1,437.97 |
| Rate for Payer: Aetna Commercial |
$1,294.17
|
| Rate for Payer: ASR ASR |
$1,394.83
|
| Rate for Payer: BCBS Complete |
$575.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,114.86
|
| Rate for Payer: BCN Commercial |
$1,114.86
|
| Rate for Payer: Cash Price |
$1,150.38
|
| Rate for Payer: Cofinity Commercial |
$1,351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,150.38
|
| Rate for Payer: Healthscope Commercial |
$1,437.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,394.83
|
| Rate for Payer: Mclaren Commercial |
$1,294.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,222.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,265.41
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
IP
|
$1,437.97
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,006.58 |
| Max. Negotiated Rate |
$1,437.97 |
| Rate for Payer: Aetna Commercial |
$1,294.17
|
| Rate for Payer: ASR ASR |
$1,394.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,114.86
|
| Rate for Payer: BCN Commercial |
$1,114.86
|
| Rate for Payer: Cash Price |
$1,150.38
|
| Rate for Payer: Cofinity Commercial |
$1,351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,150.38
|
| Rate for Payer: Healthscope Commercial |
$1,437.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,394.83
|
| Rate for Payer: Mclaren Commercial |
$1,294.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,222.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,265.41
|
|
|
HC BRACE AK PELVIC CONTROL BELT LIGHT
|
Facility
|
IP
|
$323.34
|
|
|
Service Code
|
HCPCS L5692
|
| Hospital Charge Code |
27400038
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$226.34 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: BCBS Trust/PPO |
$250.69
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
|
HC BRACE AK PELVIC CONTROL BELT LIGHT
|
Facility
|
OP
|
$323.34
|
|
|
Service Code
|
HCPCS L5692
|
| Hospital Charge Code |
27400038
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$129.34 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: BCBS Complete |
$129.34
|
| Rate for Payer: BCBS Trust/PPO |
$250.69
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.24
|
| Rate for Payer: Priority Health Narrow Network |
$229.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
