|
HC ACB GARMENT MEASURE VISIT
|
Facility
|
OP
|
$372.74
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$372.74 |
| Rate for Payer: Aetna Commercial |
$335.47
|
| Rate for Payer: Aetna Medicare |
$186.37
|
| Rate for Payer: ASR ASR |
$361.56
|
| Rate for Payer: ASR Commercial |
$361.56
|
| Rate for Payer: BCBS Complete |
$149.10
|
| Rate for Payer: BCBS Trust/PPO |
$305.24
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$288.99
|
| Rate for Payer: Cash Price |
$298.19
|
| Rate for Payer: Cash Price |
$298.19
|
| Rate for Payer: Cofinity Commercial |
$350.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.19
|
| Rate for Payer: Healthscope Commercial |
$372.74
|
| Rate for Payer: Healthscope Whirlpool |
$361.56
|
| Rate for Payer: Mclaren Commercial |
$335.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.83
|
| Rate for Payer: Nomi Health Commercial |
$305.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.69
|
| Rate for Payer: Priority Health Narrow Network |
$95.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.01
|
|
|
HC ACB NEW PATIENT VISIT
|
Facility
|
OP
|
$165.16
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
51000100
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$165.16 |
| Rate for Payer: Aetna Commercial |
$148.64
|
| Rate for Payer: Aetna Medicare |
$82.58
|
| Rate for Payer: ASR ASR |
$160.21
|
| Rate for Payer: ASR Commercial |
$160.21
|
| Rate for Payer: BCBS Complete |
$66.06
|
| Rate for Payer: BCBS Trust/PPO |
$135.25
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$128.05
|
| Rate for Payer: Cash Price |
$132.13
|
| Rate for Payer: Cash Price |
$132.13
|
| Rate for Payer: Cofinity Commercial |
$155.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.13
|
| Rate for Payer: Healthscope Commercial |
$165.16
|
| Rate for Payer: Healthscope Whirlpool |
$160.21
|
| Rate for Payer: Mclaren Commercial |
$148.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.39
|
| Rate for Payer: Nomi Health Commercial |
$135.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.69
|
| Rate for Payer: Priority Health Narrow Network |
$95.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.34
|
|
|
HC ACB NEW PATIENT VISIT
|
Facility
|
IP
|
$165.16
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
51000100
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$165.16 |
| Rate for Payer: Aetna Commercial |
$148.64
|
| Rate for Payer: ASR ASR |
$160.21
|
| Rate for Payer: ASR Commercial |
$160.21
|
| Rate for Payer: BCBS Trust/PPO |
$134.59
|
| Rate for Payer: BCN Commercial |
$128.05
|
| Rate for Payer: Cash Price |
$132.13
|
| Rate for Payer: Cofinity Commercial |
$155.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.13
|
| Rate for Payer: Healthscope Commercial |
$165.16
|
| Rate for Payer: Healthscope Whirlpool |
$160.21
|
| Rate for Payer: Mclaren Commercial |
$148.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.39
|
| Rate for Payer: Nomi Health Commercial |
$135.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.34
|
|
|
HC ACB NEW PT LEVEL 2
|
Facility
|
IP
|
$494.43
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$321.38 |
| Max. Negotiated Rate |
$494.43 |
| Rate for Payer: Aetna Commercial |
$444.99
|
| Rate for Payer: ASR ASR |
$479.60
|
| Rate for Payer: ASR Commercial |
$479.60
|
| Rate for Payer: BCBS Trust/PPO |
$402.91
|
| Rate for Payer: BCN Commercial |
$383.33
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Commercial |
$464.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Healthscope Commercial |
$494.43
|
| Rate for Payer: Healthscope Whirlpool |
$479.60
|
| Rate for Payer: Mclaren Commercial |
$444.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Nomi Health Commercial |
$405.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.10
|
|
|
HC ACB NEW PT LEVEL 2
|
Facility
|
OP
|
$494.43
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.62 |
| Max. Negotiated Rate |
$494.43 |
| Rate for Payer: Aetna Commercial |
$444.99
|
| Rate for Payer: Aetna Medicare |
$247.22
|
| Rate for Payer: ASR ASR |
$479.60
|
| Rate for Payer: ASR Commercial |
$479.60
|
| Rate for Payer: BCBS Complete |
$197.77
|
| Rate for Payer: BCBS Trust/PPO |
$404.89
|
| Rate for Payer: BCCCP Commercial |
$68.62
|
| Rate for Payer: BCN Commercial |
$383.33
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Commercial |
$464.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Healthscope Commercial |
$494.43
|
| Rate for Payer: Healthscope Whirlpool |
$479.60
|
| Rate for Payer: Mclaren Commercial |
$444.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Nomi Health Commercial |
$405.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.95
|
| Rate for Payer: Priority Health Narrow Network |
$151.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.10
|
|
|
HC ACB NEW PT LEVEL 3
|
Facility
|
OP
|
$688.85
|
|
|
Service Code
|
CPT 99203
|
| Hospital Charge Code |
51000102
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.06 |
| Max. Negotiated Rate |
$688.85 |
| Rate for Payer: Aetna Commercial |
$619.96
|
| Rate for Payer: Aetna Medicare |
$344.42
|
| Rate for Payer: ASR ASR |
$668.18
|
| Rate for Payer: ASR Commercial |
$668.18
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS Trust/PPO |
$564.10
|
| Rate for Payer: BCCCP Commercial |
$108.06
|
| Rate for Payer: BCN Commercial |
$534.07
|
| Rate for Payer: Cash Price |
$551.08
|
| Rate for Payer: Cash Price |
$551.08
|
| Rate for Payer: Cofinity Commercial |
$647.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.08
|
| Rate for Payer: Healthscope Commercial |
$688.85
|
| Rate for Payer: Healthscope Whirlpool |
$668.18
|
| Rate for Payer: Mclaren Commercial |
$619.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.52
|
| Rate for Payer: Nomi Health Commercial |
$564.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.50
|
| Rate for Payer: Priority Health Narrow Network |
$174.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$606.19
|
|
|
HC ACB NEW PT LEVEL 3
|
Facility
|
IP
|
$688.85
|
|
|
Service Code
|
CPT 99203
|
| Hospital Charge Code |
51000102
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$447.75 |
| Max. Negotiated Rate |
$688.85 |
| Rate for Payer: Aetna Commercial |
$619.96
|
| Rate for Payer: ASR ASR |
$668.18
|
| Rate for Payer: ASR Commercial |
$668.18
|
| Rate for Payer: BCBS Trust/PPO |
$561.34
|
| Rate for Payer: BCN Commercial |
$534.07
|
| Rate for Payer: Cash Price |
$551.08
|
| Rate for Payer: Cofinity Commercial |
$647.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.08
|
| Rate for Payer: Healthscope Commercial |
$688.85
|
| Rate for Payer: Healthscope Whirlpool |
$668.18
|
| Rate for Payer: Mclaren Commercial |
$619.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.52
|
| Rate for Payer: Nomi Health Commercial |
$564.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$606.19
|
|
|
HC ACB NEW PT LEVEL 4
|
Facility
|
IP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$568.44 |
| Max. Negotiated Rate |
$874.52 |
| Rate for Payer: Aetna Commercial |
$787.07
|
| Rate for Payer: ASR ASR |
$848.28
|
| Rate for Payer: ASR Commercial |
$848.28
|
| Rate for Payer: BCBS Trust/PPO |
$712.65
|
| Rate for Payer: BCN Commercial |
$678.02
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$822.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Healthscope Commercial |
$874.52
|
| Rate for Payer: Healthscope Whirlpool |
$848.28
|
| Rate for Payer: Mclaren Commercial |
$787.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.34
|
| Rate for Payer: Nomi Health Commercial |
$717.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.58
|
|
|
HC ACB NEW PT LEVEL 4
|
Facility
|
OP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$874.52 |
| Rate for Payer: Aetna Commercial |
$787.07
|
| Rate for Payer: Aetna Medicare |
$437.26
|
| Rate for Payer: ASR ASR |
$848.28
|
| Rate for Payer: ASR Commercial |
$848.28
|
| Rate for Payer: BCBS Complete |
$349.81
|
| Rate for Payer: BCBS Trust/PPO |
$716.14
|
| Rate for Payer: BCCCP Commercial |
$115.00
|
| Rate for Payer: BCN Commercial |
$678.02
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$822.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Healthscope Commercial |
$874.52
|
| Rate for Payer: Healthscope Whirlpool |
$848.28
|
| Rate for Payer: Mclaren Commercial |
$787.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.34
|
| Rate for Payer: Nomi Health Commercial |
$717.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$766.25
|
| Rate for Payer: Priority Health Narrow Network |
$613.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.58
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
OP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$1,042.88 |
| Rate for Payer: Aetna Commercial |
$938.59
|
| Rate for Payer: Aetna Medicare |
$521.44
|
| Rate for Payer: ASR ASR |
$1,011.59
|
| Rate for Payer: ASR Commercial |
$1,011.59
|
| Rate for Payer: BCBS Complete |
$417.15
|
| Rate for Payer: BCBS Trust/PPO |
$854.01
|
| Rate for Payer: BCCCP Commercial |
$115.00
|
| Rate for Payer: BCN Commercial |
$808.54
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$980.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Healthscope Commercial |
$1,042.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,011.59
|
| Rate for Payer: Mclaren Commercial |
$938.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.45
|
| Rate for Payer: Nomi Health Commercial |
$855.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.77
|
| Rate for Payer: Priority Health Narrow Network |
$731.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$917.73
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
IP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$677.87 |
| Max. Negotiated Rate |
$1,042.88 |
| Rate for Payer: Aetna Commercial |
$938.59
|
| Rate for Payer: ASR ASR |
$1,011.59
|
| Rate for Payer: ASR Commercial |
$1,011.59
|
| Rate for Payer: BCBS Trust/PPO |
$849.84
|
| Rate for Payer: BCN Commercial |
$808.54
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$980.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Healthscope Commercial |
$1,042.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,011.59
|
| Rate for Payer: Mclaren Commercial |
$938.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.45
|
| Rate for Payer: Nomi Health Commercial |
$855.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$917.73
|
|
|
HC ACCESS AORTA
|
Facility
|
IP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,548.20 |
| Max. Negotiated Rate |
$3,920.31 |
| Rate for Payer: Aetna Commercial |
$3,528.28
|
| Rate for Payer: ASR ASR |
$3,802.70
|
| Rate for Payer: ASR Commercial |
$3,802.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,194.66
|
| Rate for Payer: BCN Commercial |
$3,039.42
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$3,685.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Healthscope Commercial |
$3,920.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,802.70
|
| Rate for Payer: Mclaren Commercial |
$3,528.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: Nomi Health Commercial |
$3,214.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,449.87
|
|
|
HC ACCESS AORTA
|
Facility
|
OP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,568.12 |
| Max. Negotiated Rate |
$3,920.31 |
| Rate for Payer: Aetna Commercial |
$3,528.28
|
| Rate for Payer: Aetna Medicare |
$1,960.16
|
| Rate for Payer: ASR ASR |
$3,802.70
|
| Rate for Payer: ASR Commercial |
$3,802.70
|
| Rate for Payer: BCBS Complete |
$1,568.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,210.34
|
| Rate for Payer: BCN Commercial |
$3,039.42
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$3,685.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Healthscope Commercial |
$3,920.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,802.70
|
| Rate for Payer: Mclaren Commercial |
$3,528.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: Nomi Health Commercial |
$3,214.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,434.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,748.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,449.87
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
OP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.37 |
| Max. Negotiated Rate |
$500.92 |
| Rate for Payer: Aetna Commercial |
$450.83
|
| Rate for Payer: Aetna Medicare |
$250.46
|
| Rate for Payer: ASR ASR |
$485.89
|
| Rate for Payer: ASR Commercial |
$485.89
|
| Rate for Payer: BCBS Complete |
$200.37
|
| Rate for Payer: BCBS Trust/PPO |
$410.20
|
| Rate for Payer: BCN Commercial |
$388.36
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$470.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$500.92
|
| Rate for Payer: Healthscope Whirlpool |
$485.89
|
| Rate for Payer: Mclaren Commercial |
$450.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$438.91
|
| Rate for Payer: Priority Health Narrow Network |
$351.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.81
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
IP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.60 |
| Max. Negotiated Rate |
$500.92 |
| Rate for Payer: Aetna Commercial |
$450.83
|
| Rate for Payer: ASR ASR |
$485.89
|
| Rate for Payer: ASR Commercial |
$485.89
|
| Rate for Payer: BCBS Trust/PPO |
$408.20
|
| Rate for Payer: BCN Commercial |
$388.36
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$470.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$500.92
|
| Rate for Payer: Healthscope Whirlpool |
$485.89
|
| Rate for Payer: Mclaren Commercial |
$450.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.81
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
IP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$277.93 |
| Max. Negotiated Rate |
$427.58 |
| Rate for Payer: Aetna Commercial |
$384.82
|
| Rate for Payer: ASR ASR |
$414.75
|
| Rate for Payer: ASR Commercial |
$414.75
|
| Rate for Payer: BCBS Trust/PPO |
$348.43
|
| Rate for Payer: BCN Commercial |
$331.50
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$401.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Healthscope Commercial |
$427.58
|
| Rate for Payer: Healthscope Whirlpool |
$414.75
|
| Rate for Payer: Mclaren Commercial |
$384.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: Nomi Health Commercial |
$350.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$376.27
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
OP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$427.58 |
| Rate for Payer: Aetna Commercial |
$384.82
|
| Rate for Payer: Aetna Medicare |
$213.79
|
| Rate for Payer: ASR ASR |
$414.75
|
| Rate for Payer: ASR Commercial |
$414.75
|
| Rate for Payer: BCBS Complete |
$171.03
|
| Rate for Payer: BCBS Trust/PPO |
$350.15
|
| Rate for Payer: BCN Commercial |
$331.50
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$401.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Healthscope Commercial |
$427.58
|
| Rate for Payer: Healthscope Whirlpool |
$414.75
|
| Rate for Payer: Mclaren Commercial |
$384.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: Nomi Health Commercial |
$350.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.65
|
| Rate for Payer: Priority Health Narrow Network |
$299.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$376.27
|
|
|
HC ACCESS VEIN
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.48 |
| Max. Negotiated Rate |
$388.71 |
| Rate for Payer: Aetna Commercial |
$349.84
|
| Rate for Payer: Aetna Medicare |
$194.36
|
| Rate for Payer: ASR ASR |
$377.05
|
| Rate for Payer: ASR Commercial |
$377.05
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS Trust/PPO |
$318.31
|
| Rate for Payer: BCN Commercial |
$301.37
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$365.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$388.71
|
| Rate for Payer: Healthscope Whirlpool |
$377.05
|
| Rate for Payer: Mclaren Commercial |
$349.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.59
|
| Rate for Payer: Priority Health Narrow Network |
$272.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.06
|
|
|
HC ACCESS VEIN
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$388.71 |
| Rate for Payer: Aetna Commercial |
$349.84
|
| Rate for Payer: ASR ASR |
$377.05
|
| Rate for Payer: ASR Commercial |
$377.05
|
| Rate for Payer: BCBS Trust/PPO |
$316.76
|
| Rate for Payer: BCN Commercial |
$301.37
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$365.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$388.71
|
| Rate for Payer: Healthscope Whirlpool |
$377.05
|
| Rate for Payer: Mclaren Commercial |
$349.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.06
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$1,069.35 |
| Rate for Payer: Aetna Commercial |
$962.42
|
| Rate for Payer: Aetna Medicare |
$534.68
|
| Rate for Payer: ASR ASR |
$1,037.27
|
| Rate for Payer: ASR Commercial |
$1,037.27
|
| Rate for Payer: BCBS Complete |
$427.74
|
| Rate for Payer: BCBS Trust/PPO |
$875.69
|
| Rate for Payer: BCN Commercial |
$829.07
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$1,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$1,069.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.27
|
| Rate for Payer: Mclaren Commercial |
$962.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.96
|
| Rate for Payer: Priority Health Narrow Network |
$749.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$941.03
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$695.08 |
| Max. Negotiated Rate |
$1,069.35 |
| Rate for Payer: Aetna Commercial |
$962.42
|
| Rate for Payer: ASR ASR |
$1,037.27
|
| Rate for Payer: ASR Commercial |
$1,037.27
|
| Rate for Payer: BCBS Trust/PPO |
$871.41
|
| Rate for Payer: BCN Commercial |
$829.07
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$1,005.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$1,069.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,037.27
|
| Rate for Payer: Mclaren Commercial |
$962.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$941.03
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
OP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,251.43 |
| Max. Negotiated Rate |
$3,128.58 |
| Rate for Payer: Aetna Commercial |
$2,815.72
|
| Rate for Payer: Aetna Medicare |
$1,564.29
|
| Rate for Payer: ASR ASR |
$3,034.72
|
| Rate for Payer: ASR Commercial |
$3,034.72
|
| Rate for Payer: BCBS Complete |
$1,251.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.99
|
| Rate for Payer: BCN Commercial |
$2,425.59
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,940.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Healthscope Commercial |
$3,128.58
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.72
|
| Rate for Payer: Mclaren Commercial |
$2,815.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: Nomi Health Commercial |
$2,565.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,741.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,193.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,753.15
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
IP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.58 |
| Max. Negotiated Rate |
$3,128.58 |
| Rate for Payer: Aetna Commercial |
$2,815.72
|
| Rate for Payer: ASR ASR |
$3,034.72
|
| Rate for Payer: ASR Commercial |
$3,034.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.48
|
| Rate for Payer: BCN Commercial |
$2,425.59
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,940.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Healthscope Commercial |
$3,128.58
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.72
|
| Rate for Payer: Mclaren Commercial |
$2,815.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: Nomi Health Commercial |
$2,565.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,753.15
|
|
|
HC ACCESS WINDOW
|
Facility
|
OP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$38.93 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: Aetna Medicare |
$19.46
|
| Rate for Payer: ASR ASR |
$37.76
|
| Rate for Payer: ASR Commercial |
$37.76
|
| Rate for Payer: BCBS Complete |
$15.57
|
| Rate for Payer: BCBS Trust/PPO |
$31.88
|
| Rate for Payer: BCN Commercial |
$30.18
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$38.93
|
| Rate for Payer: Healthscope Whirlpool |
$37.76
|
| Rate for Payer: Mclaren Commercial |
$35.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: Nomi Health Commercial |
$31.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.11
|
| Rate for Payer: Priority Health Narrow Network |
$27.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.26
|
|
|
HC ACCESS WINDOW
|
Facility
|
IP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$38.93 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: ASR ASR |
$37.76
|
| Rate for Payer: ASR Commercial |
$37.76
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$30.18
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$38.93
|
| Rate for Payer: Healthscope Whirlpool |
$37.76
|
| Rate for Payer: Mclaren Commercial |
$35.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: Nomi Health Commercial |
$31.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.26
|
|
