|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
IP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,279.16 |
| Max. Negotiated Rate |
$5,705.55 |
| Rate for Payer: Aetna Commercial |
$5,134.99
|
| Rate for Payer: ASR ASR |
$5,534.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,685.40
|
| Rate for Payer: BCN Commercial |
$4,685.40
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Commercial |
$5,363.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,534.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,705.55
|
| Rate for Payer: Mclaren Commercial |
$5,134.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Nomi Health Commercial |
$4,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,020.88
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
OP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,111.05 |
| Max. Negotiated Rate |
$5,705.55 |
| Rate for Payer: Aetna Commercial |
$5,134.99
|
| Rate for Payer: Aetna Medicare |
$2,111.05
|
| Rate for Payer: ASR ASR |
$5,534.38
|
| Rate for Payer: BCBS Complete |
$2,282.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,704.23
|
| Rate for Payer: BCN Commercial |
$4,704.23
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Commercial |
$5,363.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,534.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,705.55
|
| Rate for Payer: Mclaren Commercial |
$5,134.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,564.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Nomi Health Commercial |
$4,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,999.20
|
| Rate for Payer: Priority Health Narrow Network |
$3,999.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,020.88
|
|
|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
IP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8,374.78 |
| Max. Negotiated Rate |
$11,166.37 |
| Rate for Payer: Aetna Commercial |
$10,049.73
|
| Rate for Payer: ASR ASR |
$10,831.38
|
| Rate for Payer: BCBS Trust/PPO |
$9,169.82
|
| Rate for Payer: BCN Commercial |
$9,169.82
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Commercial |
$10,496.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Healthscope Commercial |
$10,831.38
|
| Rate for Payer: Healthscope Whirlpool |
$11,166.37
|
| Rate for Payer: Mclaren Commercial |
$10,049.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Nomi Health Commercial |
$9,156.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,826.41
|
|
|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
OP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,131.56 |
| Max. Negotiated Rate |
$11,166.37 |
| Rate for Payer: Aetna Commercial |
$10,049.73
|
| Rate for Payer: Aetna Medicare |
$4,131.56
|
| Rate for Payer: ASR ASR |
$10,831.38
|
| Rate for Payer: BCBS Complete |
$4,466.55
|
| Rate for Payer: BCBS Trust/PPO |
$9,206.67
|
| Rate for Payer: BCN Commercial |
$9,206.67
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Commercial |
$10,496.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Healthscope Commercial |
$10,831.38
|
| Rate for Payer: Healthscope Whirlpool |
$11,166.37
|
| Rate for Payer: Mclaren Commercial |
$10,049.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,933.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Nomi Health Commercial |
$9,156.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,783.97
|
| Rate for Payer: Priority Health Narrow Network |
$7,827.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,826.41
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
IP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,678.86 |
| Max. Negotiated Rate |
$3,571.82 |
| Rate for Payer: Aetna Commercial |
$3,214.64
|
| Rate for Payer: ASR ASR |
$3,464.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,933.18
|
| Rate for Payer: BCN Commercial |
$2,933.18
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Commercial |
$3,357.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Healthscope Commercial |
$3,464.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,571.82
|
| Rate for Payer: Mclaren Commercial |
$3,214.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Nomi Health Commercial |
$2,928.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,143.20
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
OP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,321.57 |
| Max. Negotiated Rate |
$3,571.82 |
| Rate for Payer: Aetna Commercial |
$3,214.64
|
| Rate for Payer: Aetna Medicare |
$1,321.57
|
| Rate for Payer: ASR ASR |
$3,464.67
|
| Rate for Payer: BCBS Complete |
$1,428.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,944.97
|
| Rate for Payer: BCN Commercial |
$2,944.97
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Commercial |
$3,357.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Healthscope Commercial |
$3,464.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,571.82
|
| Rate for Payer: Mclaren Commercial |
$3,214.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,857.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Nomi Health Commercial |
$2,928.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,129.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,503.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,143.20
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
IP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.35 |
| Max. Negotiated Rate |
$151.13 |
| Rate for Payer: Aetna Commercial |
$136.02
|
| Rate for Payer: ASR ASR |
$146.60
|
| Rate for Payer: BCBS Trust/PPO |
$124.11
|
| Rate for Payer: BCN Commercial |
$124.11
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$142.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$146.60
|
| Rate for Payer: Healthscope Whirlpool |
$151.13
|
| Rate for Payer: Mclaren Commercial |
$136.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.99
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
OP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.92 |
| Max. Negotiated Rate |
$151.13 |
| Rate for Payer: Aetna Commercial |
$136.02
|
| Rate for Payer: Aetna Medicare |
$55.92
|
| Rate for Payer: ASR ASR |
$146.60
|
| Rate for Payer: BCBS Complete |
$60.45
|
| Rate for Payer: BCBS Trust/PPO |
$124.61
|
| Rate for Payer: BCN Commercial |
$124.61
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$142.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$146.60
|
| Rate for Payer: Healthscope Whirlpool |
$151.13
|
| Rate for Payer: Mclaren Commercial |
$136.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.42
|
| Rate for Payer: Priority Health Narrow Network |
$105.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.99
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$293.34 |
| Max. Negotiated Rate |
$792.81 |
| Rate for Payer: Aetna Commercial |
$713.53
|
| Rate for Payer: Aetna Medicare |
$293.34
|
| Rate for Payer: ASR ASR |
$769.03
|
| Rate for Payer: BCBS Complete |
$317.12
|
| Rate for Payer: BCBS Trust/PPO |
$653.67
|
| Rate for Payer: BCN Commercial |
$653.67
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$745.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$769.03
|
| Rate for Payer: Healthscope Whirlpool |
$792.81
|
| Rate for Payer: Mclaren Commercial |
$713.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$694.66
|
| Rate for Payer: Priority Health Narrow Network |
$555.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$697.67
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
IP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$594.61 |
| Max. Negotiated Rate |
$792.81 |
| Rate for Payer: Aetna Commercial |
$713.53
|
| Rate for Payer: ASR ASR |
$769.03
|
| Rate for Payer: BCBS Trust/PPO |
$651.06
|
| Rate for Payer: BCN Commercial |
$651.06
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$745.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$769.03
|
| Rate for Payer: Healthscope Whirlpool |
$792.81
|
| Rate for Payer: Mclaren Commercial |
$713.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$697.67
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
OP
|
$1,562.73
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$578.21 |
| Max. Negotiated Rate |
$1,562.73 |
| Rate for Payer: Aetna Commercial |
$1,406.46
|
| Rate for Payer: Aetna Medicare |
$578.21
|
| Rate for Payer: ASR ASR |
$1,515.85
|
| Rate for Payer: BCBS Complete |
$625.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.47
|
| Rate for Payer: BCN Commercial |
$1,288.47
|
| Rate for Payer: Cash Price |
$1,250.18
|
| Rate for Payer: Cofinity Commercial |
$1,468.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,250.18
|
| Rate for Payer: Healthscope Commercial |
$1,515.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,562.73
|
| Rate for Payer: Mclaren Commercial |
$1,406.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,250.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,328.32
|
| Rate for Payer: Nomi Health Commercial |
$1,281.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,369.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,095.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,375.20
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
IP
|
$1,562.73
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,172.05 |
| Max. Negotiated Rate |
$1,562.73 |
| Rate for Payer: Aetna Commercial |
$1,406.46
|
| Rate for Payer: ASR ASR |
$1,515.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.31
|
| Rate for Payer: BCN Commercial |
$1,283.31
|
| Rate for Payer: Cash Price |
$1,250.18
|
| Rate for Payer: Cofinity Commercial |
$1,468.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,250.18
|
| Rate for Payer: Healthscope Commercial |
$1,515.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,562.73
|
| Rate for Payer: Mclaren Commercial |
$1,406.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,328.32
|
| Rate for Payer: Nomi Health Commercial |
$1,281.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,375.20
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$30.77 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: ASR ASR |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$25.27
|
| Rate for Payer: BCN Commercial |
$25.27
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$28.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$29.85
|
| Rate for Payer: Healthscope Whirlpool |
$30.77
|
| Rate for Payer: Mclaren Commercial |
$27.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.08
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$30.77 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare |
$9.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: ASR ASR |
$29.85
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS Trust/PPO |
$25.37
|
| Rate for Payer: BCN Commercial |
$25.37
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$28.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$29.85
|
| Rate for Payer: Healthscope Whirlpool |
$30.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.34
|
| Rate for Payer: Mclaren Commercial |
$27.69
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$10.27
|
| Rate for Payer: PHP Medicaid |
$5.01
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.46
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health Narrow Network |
$6.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$14.48
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP DNSP |
$9.34
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: VA VA |
$9.34
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$50.49 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$55.28
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$65.30
|
| Rate for Payer: Healthscope Whirlpool |
$67.32
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.91 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS Trust/PPO |
$55.51
|
| Rate for Payer: BCN Commercial |
$55.51
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$65.30
|
| Rate for Payer: Healthscope Whirlpool |
$67.32
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.99
|
| Rate for Payer: Priority Health Narrow Network |
$47.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$267.75 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: BCBS Trust/PPO |
$293.17
|
| Rate for Payer: BCN Commercial |
$293.17
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$346.29
|
| Rate for Payer: Healthscope Whirlpool |
$357.00
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.09 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: Aetna Medicare |
$132.09
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$294.35
|
| Rate for Payer: BCN Commercial |
$294.35
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$346.29
|
| Rate for Payer: Healthscope Whirlpool |
$357.00
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$312.80
|
| Rate for Payer: Priority Health Narrow Network |
$250.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
OP
|
$12,094.65
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,475.02 |
| Max. Negotiated Rate |
$12,094.65 |
| Rate for Payer: Aetna Commercial |
$10,885.18
|
| Rate for Payer: Aetna Medicare |
$4,475.02
|
| Rate for Payer: ASR ASR |
$11,731.81
|
| Rate for Payer: BCBS Complete |
$4,837.86
|
| Rate for Payer: BCBS Trust/PPO |
$9,972.04
|
| Rate for Payer: BCN Commercial |
$9,972.04
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$11,368.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$11,731.81
|
| Rate for Payer: Healthscope Whirlpool |
$12,094.65
|
| Rate for Payer: Mclaren Commercial |
$10,885.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,675.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,597.33
|
| Rate for Payer: Priority Health Narrow Network |
$8,478.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,643.29
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
IP
|
$12,094.65
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,070.99 |
| Max. Negotiated Rate |
$12,094.65 |
| Rate for Payer: Aetna Commercial |
$10,885.18
|
| Rate for Payer: ASR ASR |
$11,731.81
|
| Rate for Payer: BCBS Trust/PPO |
$9,932.13
|
| Rate for Payer: BCN Commercial |
$9,932.13
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$11,368.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$11,731.81
|
| Rate for Payer: Healthscope Whirlpool |
$12,094.65
|
| Rate for Payer: Mclaren Commercial |
$10,885.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,643.29
|
|
|
HC CATHETER SINGLE
|
Facility
|
IP
|
$194.37
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.78 |
| Max. Negotiated Rate |
$194.37 |
| Rate for Payer: Aetna Commercial |
$174.93
|
| Rate for Payer: ASR ASR |
$188.54
|
| Rate for Payer: BCBS Trust/PPO |
$159.62
|
| Rate for Payer: BCN Commercial |
$159.62
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Commercial |
$182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$188.54
|
| Rate for Payer: Healthscope Whirlpool |
$194.37
|
| Rate for Payer: Mclaren Commercial |
$174.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Nomi Health Commercial |
$159.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.05
|
|
|
HC CATHETER SINGLE
|
Facility
|
OP
|
$194.37
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.92 |
| Max. Negotiated Rate |
$194.37 |
| Rate for Payer: Aetna Commercial |
$174.93
|
| Rate for Payer: Aetna Medicare |
$71.92
|
| Rate for Payer: ASR ASR |
$188.54
|
| Rate for Payer: BCBS Complete |
$77.75
|
| Rate for Payer: BCBS Trust/PPO |
$160.26
|
| Rate for Payer: BCN Commercial |
$160.26
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Commercial |
$182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$188.54
|
| Rate for Payer: Healthscope Whirlpool |
$194.37
|
| Rate for Payer: Mclaren Commercial |
$174.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Nomi Health Commercial |
$159.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$170.31
|
| Rate for Payer: Priority Health Narrow Network |
$136.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.05
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
OP
|
$1,671.40
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$618.42 |
| Max. Negotiated Rate |
$1,671.40 |
| Rate for Payer: Aetna Commercial |
$1,504.26
|
| Rate for Payer: Aetna Medicare |
$618.42
|
| Rate for Payer: ASR ASR |
$1,621.26
|
| Rate for Payer: BCBS Complete |
$668.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,378.07
|
| Rate for Payer: BCN Commercial |
$1,378.07
|
| Rate for Payer: Cash Price |
$1,337.12
|
| Rate for Payer: Cofinity Commercial |
$1,571.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,337.12
|
| Rate for Payer: Healthscope Commercial |
$1,621.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,671.40
|
| Rate for Payer: Mclaren Commercial |
$1,504.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,337.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,420.69
|
| Rate for Payer: Nomi Health Commercial |
$1,370.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,253.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,464.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,171.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,470.83
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
IP
|
$1,671.40
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,253.55 |
| Max. Negotiated Rate |
$1,671.40 |
| Rate for Payer: Aetna Commercial |
$1,504.26
|
| Rate for Payer: ASR ASR |
$1,621.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,372.55
|
| Rate for Payer: BCN Commercial |
$1,372.55
|
| Rate for Payer: Cash Price |
$1,337.12
|
| Rate for Payer: Cofinity Commercial |
$1,571.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,337.12
|
| Rate for Payer: Healthscope Commercial |
$1,621.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,671.40
|
| Rate for Payer: Mclaren Commercial |
$1,504.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,420.69
|
| Rate for Payer: Nomi Health Commercial |
$1,370.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,253.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,470.83
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
OP
|
$7,849.99
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,904.50 |
| Max. Negotiated Rate |
$7,849.99 |
| Rate for Payer: Aetna Commercial |
$7,064.99
|
| Rate for Payer: Aetna Medicare |
$2,904.50
|
| Rate for Payer: ASR ASR |
$7,614.49
|
| Rate for Payer: BCBS Complete |
$3,140.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,472.32
|
| Rate for Payer: BCN Commercial |
$6,472.32
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Commercial |
$7,378.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,614.49
|
| Rate for Payer: Healthscope Whirlpool |
$7,849.99
|
| Rate for Payer: Mclaren Commercial |
$7,064.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Nomi Health Commercial |
$6,436.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,878.16
|
| Rate for Payer: Priority Health Narrow Network |
$5,502.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,907.99
|
|
