|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$842.06
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$842.06 |
| Rate for Payer: Aetna Commercial |
$757.85
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$816.80
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$694.28
|
| Rate for Payer: BCN Commercial |
$694.28
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cofinity Commercial |
$791.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$816.80
|
| Rate for Payer: Healthscope Whirlpool |
$842.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$757.85
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.75
|
| Rate for Payer: Nomi Health Commercial |
$690.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.54
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$602.26
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$481.81
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$741.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
IP
|
$842.06
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$631.54 |
| Max. Negotiated Rate |
$842.06 |
| Rate for Payer: Aetna Commercial |
$757.85
|
| Rate for Payer: ASR ASR |
$816.80
|
| Rate for Payer: BCBS Trust/PPO |
$691.50
|
| Rate for Payer: BCN Commercial |
$691.50
|
| Rate for Payer: Cash Price |
$673.65
|
| Rate for Payer: Cofinity Commercial |
$791.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.65
|
| Rate for Payer: Healthscope Commercial |
$816.80
|
| Rate for Payer: Healthscope Whirlpool |
$842.06
|
| Rate for Payer: Mclaren Commercial |
$757.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.75
|
| Rate for Payer: Nomi Health Commercial |
$690.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$741.01
|
|
|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$13.69 |
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: ASR ASR |
$13.28
|
| Rate for Payer: BCBS Trust/PPO |
$11.24
|
| Rate for Payer: BCN Commercial |
$11.24
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$12.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$13.28
|
| Rate for Payer: Healthscope Whirlpool |
$13.69
|
| Rate for Payer: Mclaren Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.05
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$13.69 |
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: Aetna Medicare |
$5.07
|
| Rate for Payer: ASR ASR |
$13.28
|
| Rate for Payer: BCBS Complete |
$5.48
|
| Rate for Payer: BCBS Trust/PPO |
$11.29
|
| Rate for Payer: BCN Commercial |
$11.29
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$12.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$13.28
|
| Rate for Payer: Healthscope Whirlpool |
$13.69
|
| Rate for Payer: Mclaren Commercial |
$12.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$9.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.05
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$19.37 |
| Max. Negotiated Rate |
$682.57 |
| Rate for Payer: Aetna Commercial |
$614.31
|
| Rate for Payer: Aetna Medicare |
$252.55
|
| Rate for Payer: ASR ASR |
$662.09
|
| Rate for Payer: BCBS Complete |
$273.03
|
| Rate for Payer: BCBS Trust/PPO |
$562.78
|
| Rate for Payer: BCN Commercial |
$562.78
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Commercial |
$641.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$662.09
|
| Rate for Payer: Healthscope Whirlpool |
$682.57
|
| Rate for Payer: Mclaren Commercial |
$614.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$546.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Nomi Health Commercial |
$559.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.21
|
| Rate for Payer: Priority Health Narrow Network |
$19.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$600.66
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$511.93 |
| Max. Negotiated Rate |
$682.57 |
| Rate for Payer: Aetna Commercial |
$614.31
|
| Rate for Payer: ASR ASR |
$662.09
|
| Rate for Payer: BCBS Trust/PPO |
$560.53
|
| Rate for Payer: BCN Commercial |
$560.53
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Commercial |
$641.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$662.09
|
| Rate for Payer: Healthscope Whirlpool |
$682.57
|
| Rate for Payer: Mclaren Commercial |
$614.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Nomi Health Commercial |
$559.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$600.66
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$100.72 |
| Max. Negotiated Rate |
$650.63 |
| Rate for Payer: Aetna Commercial |
$585.57
|
| Rate for Payer: Aetna Medicare |
$240.73
|
| Rate for Payer: ASR ASR |
$631.11
|
| Rate for Payer: BCBS Complete |
$260.25
|
| Rate for Payer: BCBS Trust/PPO |
$536.44
|
| Rate for Payer: BCN Commercial |
$536.44
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Commercial |
$611.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Healthscope Whirlpool |
$650.63
|
| Rate for Payer: Mclaren Commercial |
$585.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$520.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Nomi Health Commercial |
$533.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$125.89
|
| Rate for Payer: Priority Health Narrow Network |
$100.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.55
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$487.97 |
| Max. Negotiated Rate |
$650.63 |
| Rate for Payer: Aetna Commercial |
$585.57
|
| Rate for Payer: ASR ASR |
$631.11
|
| Rate for Payer: BCBS Trust/PPO |
$534.30
|
| Rate for Payer: BCN Commercial |
$534.30
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Commercial |
$611.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Healthscope Whirlpool |
$650.63
|
| Rate for Payer: Mclaren Commercial |
$585.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Nomi Health Commercial |
$533.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.55
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: ASR ASR |
$24.25
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS Trust/PPO |
$20.61
|
| Rate for Payer: BCN Commercial |
$20.61
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$23.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Healthscope Whirlpool |
$25.00
|
| Rate for Payer: Mclaren Commercial |
$22.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.91
|
| Rate for Payer: Priority Health Narrow Network |
$17.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.00
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: ASR ASR |
$24.25
|
| Rate for Payer: BCBS Trust/PPO |
$20.53
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$23.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Healthscope Whirlpool |
$25.00
|
| Rate for Payer: Mclaren Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.00
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.17 |
| Max. Negotiated Rate |
$1,149.10 |
| Rate for Payer: Aetna Commercial |
$1,034.19
|
| Rate for Payer: Aetna Medicare |
$425.17
|
| Rate for Payer: ASR ASR |
$1,114.63
|
| Rate for Payer: BCBS Complete |
$459.64
|
| Rate for Payer: BCBS Trust/PPO |
$947.43
|
| Rate for Payer: BCN Commercial |
$947.43
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$1,080.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,114.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.10
|
| Rate for Payer: Mclaren Commercial |
$1,034.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$919.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Nomi Health Commercial |
$942.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,006.84
|
| Rate for Payer: Priority Health Narrow Network |
$805.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,011.21
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$861.83 |
| Max. Negotiated Rate |
$1,149.10 |
| Rate for Payer: Aetna Commercial |
$1,034.19
|
| Rate for Payer: ASR ASR |
$1,114.63
|
| Rate for Payer: BCBS Trust/PPO |
$943.64
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$1,080.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,114.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.10
|
| Rate for Payer: Mclaren Commercial |
$1,034.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Nomi Health Commercial |
$942.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,011.21
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.44 |
| Max. Negotiated Rate |
$995.79 |
| Rate for Payer: Aetna Commercial |
$896.21
|
| Rate for Payer: Aetna Medicare |
$368.44
|
| Rate for Payer: ASR ASR |
$965.92
|
| Rate for Payer: BCBS Complete |
$398.32
|
| Rate for Payer: BCBS Trust/PPO |
$821.03
|
| Rate for Payer: BCN Commercial |
$821.03
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Commercial |
$936.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Healthscope Commercial |
$965.92
|
| Rate for Payer: Healthscope Whirlpool |
$995.79
|
| Rate for Payer: Mclaren Commercial |
$896.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Nomi Health Commercial |
$816.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$872.51
|
| Rate for Payer: Priority Health Narrow Network |
$698.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$876.30
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$746.84 |
| Max. Negotiated Rate |
$995.79 |
| Rate for Payer: Aetna Commercial |
$896.21
|
| Rate for Payer: ASR ASR |
$965.92
|
| Rate for Payer: BCBS Trust/PPO |
$817.74
|
| Rate for Payer: BCN Commercial |
$817.74
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Commercial |
$936.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Healthscope Commercial |
$965.92
|
| Rate for Payer: Healthscope Whirlpool |
$995.79
|
| Rate for Payer: Mclaren Commercial |
$896.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Nomi Health Commercial |
$816.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$876.30
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$940.18 |
| Max. Negotiated Rate |
$1,253.58 |
| Rate for Payer: Aetna Commercial |
$1,128.22
|
| Rate for Payer: ASR ASR |
$1,215.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,029.44
|
| Rate for Payer: BCN Commercial |
$1,029.44
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,178.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,215.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,253.58
|
| Rate for Payer: Mclaren Commercial |
$1,128.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.15
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$463.82 |
| Max. Negotiated Rate |
$1,253.58 |
| Rate for Payer: Aetna Commercial |
$1,128.22
|
| Rate for Payer: Aetna Medicare |
$463.82
|
| Rate for Payer: ASR ASR |
$1,215.97
|
| Rate for Payer: BCBS Complete |
$501.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.58
|
| Rate for Payer: BCN Commercial |
$1,033.58
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,178.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,215.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,253.58
|
| Rate for Payer: Mclaren Commercial |
$1,128.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,002.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,098.39
|
| Rate for Payer: Priority Health Narrow Network |
$878.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.15
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$814.73 |
| Max. Negotiated Rate |
$1,086.31 |
| Rate for Payer: Aetna Commercial |
$977.68
|
| Rate for Payer: ASR ASR |
$1,053.72
|
| Rate for Payer: BCBS Trust/PPO |
$892.08
|
| Rate for Payer: BCN Commercial |
$892.08
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$1,021.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$1,053.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.31
|
| Rate for Payer: Mclaren Commercial |
$977.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.95
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$1,086.31 |
| Rate for Payer: Aetna Commercial |
$977.68
|
| Rate for Payer: Aetna Medicare |
$401.93
|
| Rate for Payer: ASR ASR |
$1,053.72
|
| Rate for Payer: BCBS Complete |
$434.52
|
| Rate for Payer: BCBS Trust/PPO |
$895.66
|
| Rate for Payer: BCN Commercial |
$895.66
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$1,021.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$1,053.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.31
|
| Rate for Payer: Mclaren Commercial |
$977.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$869.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$951.82
|
| Rate for Payer: Priority Health Narrow Network |
$761.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.95
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$940.18 |
| Max. Negotiated Rate |
$1,253.58 |
| Rate for Payer: Aetna Commercial |
$1,128.22
|
| Rate for Payer: ASR ASR |
$1,215.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,029.44
|
| Rate for Payer: BCN Commercial |
$1,029.44
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,178.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,215.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,253.58
|
| Rate for Payer: Mclaren Commercial |
$1,128.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.15
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$463.82 |
| Max. Negotiated Rate |
$1,253.58 |
| Rate for Payer: Aetna Commercial |
$1,128.22
|
| Rate for Payer: Aetna Medicare |
$463.82
|
| Rate for Payer: ASR ASR |
$1,215.97
|
| Rate for Payer: BCBS Complete |
$501.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.58
|
| Rate for Payer: BCN Commercial |
$1,033.58
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,178.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,215.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,253.58
|
| Rate for Payer: Mclaren Commercial |
$1,128.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,002.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,098.39
|
| Rate for Payer: Priority Health Narrow Network |
$878.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.15
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$1,086.31 |
| Rate for Payer: Aetna Commercial |
$977.68
|
| Rate for Payer: Aetna Medicare |
$401.93
|
| Rate for Payer: ASR ASR |
$1,053.72
|
| Rate for Payer: BCBS Complete |
$434.52
|
| Rate for Payer: BCBS Trust/PPO |
$895.66
|
| Rate for Payer: BCN Commercial |
$895.66
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$1,021.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$1,053.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.31
|
| Rate for Payer: Mclaren Commercial |
$977.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$869.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$951.82
|
| Rate for Payer: Priority Health Narrow Network |
$761.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.95
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$814.73 |
| Max. Negotiated Rate |
$1,086.31 |
| Rate for Payer: Aetna Commercial |
$977.68
|
| Rate for Payer: ASR ASR |
$1,053.72
|
| Rate for Payer: BCBS Trust/PPO |
$892.08
|
| Rate for Payer: BCN Commercial |
$892.08
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$1,021.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$1,053.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,086.31
|
| Rate for Payer: Mclaren Commercial |
$977.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.95
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.94 |
| Max. Negotiated Rate |
$75.52 |
| Rate for Payer: Aetna Commercial |
$67.97
|
| Rate for Payer: Aetna Medicare |
$27.94
|
| Rate for Payer: ASR ASR |
$73.25
|
| Rate for Payer: BCBS Complete |
$30.21
|
| Rate for Payer: BCBS Trust/PPO |
$62.27
|
| Rate for Payer: BCN Commercial |
$62.27
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$70.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$73.25
|
| Rate for Payer: Healthscope Whirlpool |
$75.52
|
| Rate for Payer: Mclaren Commercial |
$67.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.17
|
| Rate for Payer: Priority Health Narrow Network |
$52.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.46
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.64 |
| Max. Negotiated Rate |
$75.52 |
| Rate for Payer: Aetna Commercial |
$67.97
|
| Rate for Payer: ASR ASR |
$73.25
|
| Rate for Payer: BCBS Trust/PPO |
$62.02
|
| Rate for Payer: BCN Commercial |
$62.02
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$70.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$73.25
|
| Rate for Payer: Healthscope Whirlpool |
$75.52
|
| Rate for Payer: Mclaren Commercial |
$67.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.46
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Trust/PPO |
$40.96
|
| Rate for Payer: BCN Commercial |
$40.96
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
|
