|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$163.47 |
| Max. Negotiated Rate |
$408.67 |
| Rate for Payer: Aetna Commercial |
$367.80
|
| Rate for Payer: ASR ASR |
$396.41
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS Trust/PPO |
$316.84
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$384.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$408.67
|
| Rate for Payer: Healthscope Whirlpool |
$396.41
|
| Rate for Payer: Mclaren Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.89
|
| Rate for Payer: Priority Health Narrow Network |
$290.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.63
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$247.50
|
| Rate for Payer: ASR ASR |
$266.75
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS Trust/PPO |
$213.21
|
| Rate for Payer: BCN Commercial |
$213.21
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$258.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$266.75
|
| Rate for Payer: Mclaren Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.25
|
| Rate for Payer: Priority Health Narrow Network |
$195.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.00
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$192.50 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$247.50
|
| Rate for Payer: ASR ASR |
$266.75
|
| Rate for Payer: BCBS Trust/PPO |
$213.21
|
| Rate for Payer: BCN Commercial |
$213.21
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$258.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$266.75
|
| Rate for Payer: Mclaren Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.00
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.95 |
| Max. Negotiated Rate |
$124.22 |
| Rate for Payer: Aetna Commercial |
$111.80
|
| Rate for Payer: ASR ASR |
$120.49
|
| Rate for Payer: BCBS Trust/PPO |
$96.31
|
| Rate for Payer: BCN Commercial |
$96.31
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$116.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Healthscope Whirlpool |
$120.49
|
| Rate for Payer: Mclaren Commercial |
$111.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.31
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.69 |
| Max. Negotiated Rate |
$124.22 |
| Rate for Payer: Aetna Commercial |
$111.80
|
| Rate for Payer: ASR ASR |
$120.49
|
| Rate for Payer: BCBS Complete |
$49.69
|
| Rate for Payer: BCBS Trust/PPO |
$96.31
|
| Rate for Payer: BCN Commercial |
$96.31
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$116.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Healthscope Whirlpool |
$120.49
|
| Rate for Payer: Mclaren Commercial |
$111.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.04
|
| Rate for Payer: Priority Health Narrow Network |
$88.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.31
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,004.97 |
| Max. Negotiated Rate |
$11,844.24 |
| Rate for Payer: Aetna Commercial |
$10,659.82
|
| Rate for Payer: Aetna Medicare |
$9,149.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: ASR ASR |
$11,488.91
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$9,182.84
|
| Rate for Payer: BCN Commercial |
$9,182.84
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$11,133.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Healthscope Commercial |
$11,844.24
|
| Rate for Payer: Healthscope Whirlpool |
$11,488.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,149.86
|
| Rate for Payer: Mclaren Commercial |
$10,659.82
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Commercial |
$10,064.85
|
| Rate for Payer: PHP Medicaid |
$5,004.97
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,778.26
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$8,409.41
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,422.93
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,290.97 |
| Max. Negotiated Rate |
$11,844.24 |
| Rate for Payer: Aetna Commercial |
$10,659.82
|
| Rate for Payer: ASR ASR |
$11,488.91
|
| Rate for Payer: BCBS Trust/PPO |
$9,182.84
|
| Rate for Payer: BCN Commercial |
$9,182.84
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$11,133.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Healthscope Commercial |
$11,844.24
|
| Rate for Payer: Healthscope Whirlpool |
$11,488.91
|
| Rate for Payer: Mclaren Commercial |
$10,659.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,422.93
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,004.97 |
| Max. Negotiated Rate |
$11,437.32 |
| Rate for Payer: Aetna Commercial |
$9,290.97
|
| Rate for Payer: Aetna Medicare |
$9,149.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: ASR ASR |
$10,013.60
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$8,003.65
|
| Rate for Payer: BCN Commercial |
$8,003.65
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$9,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Healthscope Commercial |
$10,323.30
|
| Rate for Payer: Healthscope Whirlpool |
$10,013.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,149.86
|
| Rate for Payer: Mclaren Commercial |
$9,290.97
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Commercial |
$10,064.85
|
| Rate for Payer: PHP Medicaid |
$5,004.97
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,394.20
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,329.54
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,084.50
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,226.31 |
| Max. Negotiated Rate |
$10,323.30 |
| Rate for Payer: Aetna Commercial |
$9,290.97
|
| Rate for Payer: ASR ASR |
$10,013.60
|
| Rate for Payer: BCBS Trust/PPO |
$8,003.65
|
| Rate for Payer: BCN Commercial |
$8,003.65
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$9,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Healthscope Commercial |
$10,323.30
|
| Rate for Payer: Healthscope Whirlpool |
$10,013.60
|
| Rate for Payer: Mclaren Commercial |
$9,290.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,084.50
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$10,678.00
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,847.36 |
| Max. Negotiated Rate |
$10,678.00 |
| Rate for Payer: Aetna Commercial |
$9,610.20
|
| Rate for Payer: Aetna Medicare |
$5,205.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,506.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,506.78
|
| Rate for Payer: ASR ASR |
$10,357.66
|
| Rate for Payer: BCBS Complete |
$2,989.99
|
| Rate for Payer: BCBS MAPPO |
$5,205.42
|
| Rate for Payer: BCBS Trust/PPO |
$8,278.65
|
| Rate for Payer: BCN Commercial |
$8,278.65
|
| Rate for Payer: BCN Medicare Advantage |
$5,205.42
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cofinity Commercial |
$10,037.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,542.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,205.42
|
| Rate for Payer: Healthscope Commercial |
$10,678.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,357.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,205.42
|
| Rate for Payer: Mclaren Commercial |
$9,610.20
|
| Rate for Payer: Mclaren Medicaid |
$2,847.36
|
| Rate for Payer: Mclaren Medicare |
$5,205.42
|
| Rate for Payer: Meridian Medicaid |
$2,989.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,465.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,986.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,076.30
|
| Rate for Payer: PACE Medicare |
$4,945.15
|
| Rate for Payer: PACE SWMI |
$5,205.42
|
| Rate for Payer: PHP Commercial |
$5,725.96
|
| Rate for Payer: PHP Medicaid |
$2,847.36
|
| Rate for Payer: PHP Medicare Advantage |
$5,205.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,847.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,474.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,716.98
|
| Rate for Payer: Priority Health Medicare |
$5,205.42
|
| Rate for Payer: Priority Health Narrow Network |
$7,581.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5,205.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,396.64
|
| Rate for Payer: UHC Medicare Advantage |
$5,361.58
|
| Rate for Payer: VA VA |
$5,205.42
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,678.00
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,474.60 |
| Max. Negotiated Rate |
$10,678.00 |
| Rate for Payer: Aetna Commercial |
$9,610.20
|
| Rate for Payer: ASR ASR |
$10,357.66
|
| Rate for Payer: BCBS Trust/PPO |
$8,278.65
|
| Rate for Payer: BCN Commercial |
$8,278.65
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cofinity Commercial |
$10,037.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,542.40
|
| Rate for Payer: Healthscope Commercial |
$10,678.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,357.66
|
| Rate for Payer: Mclaren Commercial |
$9,610.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,076.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,474.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,396.64
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,457.80
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,383.12 |
| Max. Negotiated Rate |
$3,457.80 |
| Rate for Payer: Aetna Commercial |
$3,112.02
|
| Rate for Payer: ASR ASR |
$3,354.07
|
| Rate for Payer: BCBS Complete |
$1,383.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,680.83
|
| Rate for Payer: BCN Commercial |
$2,680.83
|
| Rate for Payer: Cash Price |
$2,766.24
|
| Rate for Payer: Cofinity Commercial |
$3,250.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.24
|
| Rate for Payer: Healthscope Commercial |
$3,457.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,354.07
|
| Rate for Payer: Mclaren Commercial |
$3,112.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,939.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,420.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,146.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,455.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.86
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,457.80
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,420.46 |
| Max. Negotiated Rate |
$3,457.80 |
| Rate for Payer: Aetna Commercial |
$3,112.02
|
| Rate for Payer: ASR ASR |
$3,354.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,680.83
|
| Rate for Payer: BCN Commercial |
$2,680.83
|
| Rate for Payer: Cash Price |
$2,766.24
|
| Rate for Payer: Cofinity Commercial |
$3,250.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.24
|
| Rate for Payer: Healthscope Commercial |
$3,457.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,354.07
|
| Rate for Payer: Mclaren Commercial |
$3,112.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,939.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,420.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.86
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,019.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,613.89 |
| Max. Negotiated Rate |
$8,019.84 |
| Rate for Payer: Aetna Commercial |
$7,217.86
|
| Rate for Payer: ASR ASR |
$7,779.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,217.78
|
| Rate for Payer: BCN Commercial |
$6,217.78
|
| Rate for Payer: Cash Price |
$6,415.87
|
| Rate for Payer: Cofinity Commercial |
$7,538.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,415.87
|
| Rate for Payer: Healthscope Commercial |
$8,019.84
|
| Rate for Payer: Healthscope Whirlpool |
$7,779.24
|
| Rate for Payer: Mclaren Commercial |
$7,217.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,816.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,613.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,057.46
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,019.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,207.94 |
| Max. Negotiated Rate |
$8,019.84 |
| Rate for Payer: Aetna Commercial |
$7,217.86
|
| Rate for Payer: ASR ASR |
$7,779.24
|
| Rate for Payer: BCBS Complete |
$3,207.94
|
| Rate for Payer: BCBS Trust/PPO |
$6,217.78
|
| Rate for Payer: BCN Commercial |
$6,217.78
|
| Rate for Payer: Cash Price |
$6,415.87
|
| Rate for Payer: Cofinity Commercial |
$7,538.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,415.87
|
| Rate for Payer: Healthscope Commercial |
$8,019.84
|
| Rate for Payer: Healthscope Whirlpool |
$7,779.24
|
| Rate for Payer: Mclaren Commercial |
$7,217.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,816.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,613.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,298.05
|
| Rate for Payer: Priority Health Narrow Network |
$5,694.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,057.46
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,031.54
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8,422.08 |
| Max. Negotiated Rate |
$12,031.54 |
| Rate for Payer: Aetna Commercial |
$10,828.39
|
| Rate for Payer: ASR ASR |
$11,670.59
|
| Rate for Payer: BCBS Trust/PPO |
$9,328.05
|
| Rate for Payer: BCN Commercial |
$9,328.05
|
| Rate for Payer: Cash Price |
$9,625.23
|
| Rate for Payer: Cofinity Commercial |
$11,309.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,625.23
|
| Rate for Payer: Healthscope Commercial |
$12,031.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,670.59
|
| Rate for Payer: Mclaren Commercial |
$10,828.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,226.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,422.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,587.76
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,031.54
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,812.62 |
| Max. Negotiated Rate |
$12,031.54 |
| Rate for Payer: Aetna Commercial |
$10,828.39
|
| Rate for Payer: ASR ASR |
$11,670.59
|
| Rate for Payer: BCBS Complete |
$4,812.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,328.05
|
| Rate for Payer: BCN Commercial |
$9,328.05
|
| Rate for Payer: Cash Price |
$9,625.23
|
| Rate for Payer: Cofinity Commercial |
$11,309.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,625.23
|
| Rate for Payer: Healthscope Commercial |
$12,031.54
|
| Rate for Payer: Healthscope Whirlpool |
$11,670.59
|
| Rate for Payer: Mclaren Commercial |
$10,828.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,226.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,422.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,948.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,542.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,587.76
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$19.38 |
| Rate for Payer: Aetna Commercial |
$17.44
|
| Rate for Payer: ASR ASR |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$15.03
|
| Rate for Payer: BCN Commercial |
$15.03
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$18.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$19.38
|
| Rate for Payer: Healthscope Whirlpool |
$18.80
|
| Rate for Payer: Mclaren Commercial |
$17.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.05
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$81.06 |
| Rate for Payer: Aetna Commercial |
$17.44
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$18.80
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$15.03
|
| Rate for Payer: BCN Commercial |
$15.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$18.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$19.38
|
| Rate for Payer: Healthscope Whirlpool |
$18.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$17.44
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.06
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$64.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.05
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.73 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Complete |
$8.12
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.14
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Mclaren Medicaid |
$7.73
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Medicaid |
$8.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$15.55
|
| Rate for Payer: PHP Medicaid |
$7.73
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.42
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$14.56
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$43.00 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: ASR ASR |
$41.71
|
| Rate for Payer: BCBS Trust/PPO |
$33.34
|
| Rate for Payer: BCN Commercial |
$33.34
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$43.00
|
| Rate for Payer: Healthscope Whirlpool |
$41.71
|
| Rate for Payer: Mclaren Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.84
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$81.06 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$41.71
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$33.34
|
| Rate for Payer: BCN Commercial |
$33.34
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$43.00
|
| Rate for Payer: Healthscope Whirlpool |
$41.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$38.70
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.06
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$64.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.84
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$140.35
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$126.32
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$136.14
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$108.81
|
| Rate for Payer: BCN Commercial |
$108.81
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$112.28
|
| Rate for Payer: Cash Price |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$131.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$140.35
|
| Rate for Payer: Healthscope Whirlpool |
$136.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$126.32
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.30
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.51
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$140.35
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$98.24 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$126.32
|
| Rate for Payer: ASR ASR |
$136.14
|
| Rate for Payer: BCBS Trust/PPO |
$108.81
|
| Rate for Payer: BCN Commercial |
$108.81
|
| Rate for Payer: Cash Price |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$131.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.28
|
| Rate for Payer: Healthscope Commercial |
$140.35
|
| Rate for Payer: Healthscope Whirlpool |
$136.14
|
| Rate for Payer: Mclaren Commercial |
$126.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.51
|
|
