|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.24 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$138.80
|
| Rate for Payer: ASR ASR |
$149.59
|
| Rate for Payer: ASR Commercial |
$149.59
|
| Rate for Payer: BCBS Trust/PPO |
$125.67
|
| Rate for Payer: BCN Commercial |
$119.57
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Healthscope Whirlpool |
$149.59
|
| Rate for Payer: Mclaren Commercial |
$138.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.71
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,323.03 |
| Max. Negotiated Rate |
$2,035.43 |
| Rate for Payer: Aetna Commercial |
$1,831.89
|
| Rate for Payer: ASR ASR |
$1,974.37
|
| Rate for Payer: ASR Commercial |
$1,974.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.67
|
| Rate for Payer: BCN Commercial |
$1,578.07
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,913.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$2,035.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.37
|
| Rate for Payer: Mclaren Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,791.18
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$814.17 |
| Max. Negotiated Rate |
$2,035.43 |
| Rate for Payer: Aetna Commercial |
$1,831.89
|
| Rate for Payer: Aetna Medicare |
$1,017.72
|
| Rate for Payer: ASR ASR |
$1,974.37
|
| Rate for Payer: ASR Commercial |
$1,974.37
|
| Rate for Payer: BCBS Complete |
$814.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,666.81
|
| Rate for Payer: BCN Commercial |
$1,578.07
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,913.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$2,035.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.37
|
| Rate for Payer: Mclaren Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,783.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,426.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,791.18
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.14 |
| Max. Negotiated Rate |
$2,167.91 |
| Rate for Payer: Aetna Commercial |
$1,951.12
|
| Rate for Payer: ASR ASR |
$2,102.87
|
| Rate for Payer: ASR Commercial |
$2,102.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,766.63
|
| Rate for Payer: BCN Commercial |
$1,680.78
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$2,037.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Healthscope Commercial |
$2,167.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,102.87
|
| Rate for Payer: Mclaren Commercial |
$1,951.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,907.76
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,951.12
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,102.87
|
| Rate for Payer: ASR Commercial |
$2,102.87
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.30
|
| Rate for Payer: BCN Commercial |
$1,680.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$2,037.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,167.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,102.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,951.12
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,899.52
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,519.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,907.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,342.04 |
| Max. Negotiated Rate |
$2,064.67 |
| Rate for Payer: Aetna Commercial |
$1,858.20
|
| Rate for Payer: ASR ASR |
$2,002.73
|
| Rate for Payer: ASR Commercial |
$2,002.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.50
|
| Rate for Payer: BCN Commercial |
$1,600.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,940.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.73
|
| Rate for Payer: Mclaren Commercial |
$1,858.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.91
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$452.38 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,858.20
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,002.73
|
| Rate for Payer: ASR Commercial |
$2,002.73
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.76
|
| Rate for Payer: BCN Commercial |
$1,600.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,940.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,858.20
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.47
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$452.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,578.87 |
| Max. Negotiated Rate |
$2,429.03 |
| Rate for Payer: Aetna Commercial |
$2,186.13
|
| Rate for Payer: ASR ASR |
$2,356.16
|
| Rate for Payer: ASR Commercial |
$2,356.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.42
|
| Rate for Payer: BCN Commercial |
$1,883.23
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,283.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,429.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,356.16
|
| Rate for Payer: Mclaren Commercial |
$2,186.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,137.55
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,234.61 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$2,186.13
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$2,356.16
|
| Rate for Payer: ASR Commercial |
$2,356.16
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.13
|
| Rate for Payer: BCN Commercial |
$1,883.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,283.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,429.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,356.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$2,186.13
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.26
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,137.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.02 |
| Max. Negotiated Rate |
$167.73 |
| Rate for Payer: Aetna Commercial |
$150.96
|
| Rate for Payer: ASR ASR |
$162.70
|
| Rate for Payer: ASR Commercial |
$162.70
|
| Rate for Payer: BCBS Trust/PPO |
$136.68
|
| Rate for Payer: BCN Commercial |
$130.04
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$157.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Healthscope Commercial |
$167.73
|
| Rate for Payer: Healthscope Whirlpool |
$162.70
|
| Rate for Payer: Mclaren Commercial |
$150.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.60
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.02 |
| Max. Negotiated Rate |
$1,240.59 |
| Rate for Payer: Aetna Commercial |
$150.96
|
| Rate for Payer: Aetna Medicare |
$800.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.48
|
| Rate for Payer: ASR ASR |
$162.70
|
| Rate for Payer: ASR Commercial |
$162.70
|
| Rate for Payer: BCBS Complete |
$450.45
|
| Rate for Payer: BCBS MAPPO |
$800.38
|
| Rate for Payer: BCBS Trust/PPO |
$137.35
|
| Rate for Payer: BCN Commercial |
$130.04
|
| Rate for Payer: BCN Medicare Advantage |
$800.38
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$157.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.38
|
| Rate for Payer: Healthscope Commercial |
$167.73
|
| Rate for Payer: Healthscope Whirlpool |
$162.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$800.38
|
| Rate for Payer: Mclaren Commercial |
$150.96
|
| Rate for Payer: Mclaren Medicaid |
$429.00
|
| Rate for Payer: Mclaren Medicare |
$800.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.40
|
| Rate for Payer: Meridian Medicaid |
$450.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE Medicare |
$760.36
|
| Rate for Payer: PACE SWMI |
$800.38
|
| Rate for Payer: PHP Commercial |
$880.42
|
| Rate for Payer: PHP Medicaid |
$429.00
|
| Rate for Payer: PHP Medicare Advantage |
$800.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.97
|
| Rate for Payer: Priority Health Medicare |
$800.38
|
| Rate for Payer: Priority Health Narrow Network |
$117.58
|
| Rate for Payer: Railroad Medicare Medicare |
$800.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.38
|
| Rate for Payer: UHC Exchange |
$1,240.59
|
| Rate for Payer: UHC Medicare Advantage |
$800.38
|
| Rate for Payer: UHCCP DNSP |
$800.38
|
| Rate for Payer: UHCCP Medicaid |
$429.00
|
| Rate for Payer: VA VA |
$800.38
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$148.17 |
| Rate for Payer: Aetna Commercial |
$133.35
|
| Rate for Payer: ASR ASR |
$143.72
|
| Rate for Payer: ASR Commercial |
$143.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.74
|
| Rate for Payer: BCN Commercial |
$114.88
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$139.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$148.17
|
| Rate for Payer: Healthscope Whirlpool |
$143.72
|
| Rate for Payer: Mclaren Commercial |
$133.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.39
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.27 |
| Max. Negotiated Rate |
$148.17 |
| Rate for Payer: Aetna Commercial |
$133.35
|
| Rate for Payer: Aetna Medicare |
$74.08
|
| Rate for Payer: ASR ASR |
$143.72
|
| Rate for Payer: ASR Commercial |
$143.72
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS Trust/PPO |
$121.34
|
| Rate for Payer: BCN Commercial |
$114.88
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$139.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$148.17
|
| Rate for Payer: Healthscope Whirlpool |
$143.72
|
| Rate for Payer: Mclaren Commercial |
$133.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.83
|
| Rate for Payer: Priority Health Narrow Network |
$103.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.39
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$48.80 |
| Rate for Payer: Aetna Commercial |
$43.92
|
| Rate for Payer: Aetna Medicare |
$24.40
|
| Rate for Payer: ASR ASR |
$47.34
|
| Rate for Payer: ASR Commercial |
$47.34
|
| Rate for Payer: BCBS Complete |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$39.96
|
| Rate for Payer: BCN Commercial |
$37.83
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$45.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$48.80
|
| Rate for Payer: Healthscope Whirlpool |
$47.34
|
| Rate for Payer: Mclaren Commercial |
$43.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.76
|
| Rate for Payer: Priority Health Narrow Network |
$34.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.94
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$48.80 |
| Rate for Payer: Aetna Commercial |
$43.92
|
| Rate for Payer: ASR ASR |
$47.34
|
| Rate for Payer: ASR Commercial |
$47.34
|
| Rate for Payer: BCBS Trust/PPO |
$39.77
|
| Rate for Payer: BCN Commercial |
$37.83
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$45.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$48.80
|
| Rate for Payer: Healthscope Whirlpool |
$47.34
|
| Rate for Payer: Mclaren Commercial |
$43.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.94
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,528.85 |
| Max. Negotiated Rate |
$26,322.12 |
| Rate for Payer: Aetna Commercial |
$23,689.91
|
| Rate for Payer: Aetna Medicare |
$13,161.06
|
| Rate for Payer: ASR ASR |
$25,532.46
|
| Rate for Payer: ASR Commercial |
$25,532.46
|
| Rate for Payer: BCBS Complete |
$10,528.85
|
| Rate for Payer: BCBS Trust/PPO |
$21,555.18
|
| Rate for Payer: BCN Commercial |
$20,407.54
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$24,742.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Healthscope Commercial |
$26,322.12
|
| Rate for Payer: Healthscope Whirlpool |
$25,532.46
|
| Rate for Payer: Mclaren Commercial |
$23,689.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: Nomi Health Commercial |
$21,584.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,063.44
|
| Rate for Payer: Priority Health Narrow Network |
$18,451.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,163.47
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$17,109.38 |
| Max. Negotiated Rate |
$26,322.12 |
| Rate for Payer: Aetna Commercial |
$23,689.91
|
| Rate for Payer: ASR ASR |
$25,532.46
|
| Rate for Payer: ASR Commercial |
$25,532.46
|
| Rate for Payer: BCBS Trust/PPO |
$21,449.90
|
| Rate for Payer: BCN Commercial |
$20,407.54
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$24,742.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Healthscope Commercial |
$26,322.12
|
| Rate for Payer: Healthscope Whirlpool |
$25,532.46
|
| Rate for Payer: Mclaren Commercial |
$23,689.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: Nomi Health Commercial |
$21,584.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,163.47
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,754.72 |
| Max. Negotiated Rate |
$6,886.81 |
| Rate for Payer: Aetna Commercial |
$6,198.13
|
| Rate for Payer: Aetna Medicare |
$3,443.40
|
| Rate for Payer: ASR ASR |
$6,680.21
|
| Rate for Payer: ASR Commercial |
$6,680.21
|
| Rate for Payer: BCBS Complete |
$2,754.72
|
| Rate for Payer: BCBS Trust/PPO |
$5,639.61
|
| Rate for Payer: BCN Commercial |
$5,339.34
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$6,473.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Healthscope Commercial |
$6,886.81
|
| Rate for Payer: Healthscope Whirlpool |
$6,680.21
|
| Rate for Payer: Mclaren Commercial |
$6,198.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: Nomi Health Commercial |
$5,647.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,034.22
|
| Rate for Payer: Priority Health Narrow Network |
$4,827.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,060.39
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,476.43 |
| Max. Negotiated Rate |
$6,886.81 |
| Rate for Payer: Aetna Commercial |
$6,198.13
|
| Rate for Payer: ASR ASR |
$6,680.21
|
| Rate for Payer: ASR Commercial |
$6,680.21
|
| Rate for Payer: BCBS Trust/PPO |
$5,612.06
|
| Rate for Payer: BCN Commercial |
$5,339.34
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$6,473.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Healthscope Commercial |
$6,886.81
|
| Rate for Payer: Healthscope Whirlpool |
$6,680.21
|
| Rate for Payer: Mclaren Commercial |
$6,198.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: Nomi Health Commercial |
$5,647.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,060.39
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,572.38 |
| Max. Negotiated Rate |
$8,572.90 |
| Rate for Payer: Aetna Commercial |
$7,715.61
|
| Rate for Payer: ASR ASR |
$8,315.71
|
| Rate for Payer: ASR Commercial |
$8,315.71
|
| Rate for Payer: BCBS Trust/PPO |
$6,986.06
|
| Rate for Payer: BCN Commercial |
$6,646.57
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$8,058.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Healthscope Commercial |
$8,572.90
|
| Rate for Payer: Healthscope Whirlpool |
$8,315.71
|
| Rate for Payer: Mclaren Commercial |
$7,715.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,544.15
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,429.16 |
| Max. Negotiated Rate |
$8,572.90 |
| Rate for Payer: Aetna Commercial |
$7,715.61
|
| Rate for Payer: Aetna Medicare |
$4,286.45
|
| Rate for Payer: ASR ASR |
$8,315.71
|
| Rate for Payer: ASR Commercial |
$8,315.71
|
| Rate for Payer: BCBS Complete |
$3,429.16
|
| Rate for Payer: BCBS Trust/PPO |
$7,020.35
|
| Rate for Payer: BCN Commercial |
$6,646.57
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$8,058.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Healthscope Commercial |
$8,572.90
|
| Rate for Payer: Healthscope Whirlpool |
$8,315.71
|
| Rate for Payer: Mclaren Commercial |
$7,715.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,511.57
|
| Rate for Payer: Priority Health Narrow Network |
$6,009.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,544.15
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,037.43 |
| Max. Negotiated Rate |
$18,519.12 |
| Rate for Payer: Aetna Commercial |
$16,667.21
|
| Rate for Payer: ASR ASR |
$17,963.55
|
| Rate for Payer: ASR Commercial |
$17,963.55
|
| Rate for Payer: BCBS Trust/PPO |
$15,091.23
|
| Rate for Payer: BCN Commercial |
$14,357.87
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$17,407.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Healthscope Commercial |
$18,519.12
|
| Rate for Payer: Healthscope Whirlpool |
$17,963.55
|
| Rate for Payer: Mclaren Commercial |
$16,667.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: Nomi Health Commercial |
$15,185.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,296.83
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,407.65 |
| Max. Negotiated Rate |
$18,519.12 |
| Rate for Payer: Aetna Commercial |
$16,667.21
|
| Rate for Payer: Aetna Medicare |
$9,259.56
|
| Rate for Payer: ASR ASR |
$17,963.55
|
| Rate for Payer: ASR Commercial |
$17,963.55
|
| Rate for Payer: BCBS Complete |
$7,407.65
|
| Rate for Payer: BCBS Trust/PPO |
$15,165.31
|
| Rate for Payer: BCN Commercial |
$14,357.87
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$17,407.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Healthscope Commercial |
$18,519.12
|
| Rate for Payer: Healthscope Whirlpool |
$17,963.55
|
| Rate for Payer: Mclaren Commercial |
$16,667.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: Nomi Health Commercial |
$15,185.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,226.45
|
| Rate for Payer: Priority Health Narrow Network |
$12,981.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,296.83
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14,336.71 |
| Max. Negotiated Rate |
$22,056.48 |
| Rate for Payer: Aetna Commercial |
$19,850.83
|
| Rate for Payer: ASR ASR |
$21,394.79
|
| Rate for Payer: ASR Commercial |
$21,394.79
|
| Rate for Payer: BCBS Trust/PPO |
$17,973.83
|
| Rate for Payer: BCN Commercial |
$17,100.39
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$20,733.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Healthscope Commercial |
$22,056.48
|
| Rate for Payer: Healthscope Whirlpool |
$21,394.79
|
| Rate for Payer: Mclaren Commercial |
$19,850.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: Nomi Health Commercial |
$18,086.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,409.70
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,822.59 |
| Max. Negotiated Rate |
$22,056.48 |
| Rate for Payer: Aetna Commercial |
$19,850.83
|
| Rate for Payer: Aetna Medicare |
$11,028.24
|
| Rate for Payer: ASR ASR |
$21,394.79
|
| Rate for Payer: ASR Commercial |
$21,394.79
|
| Rate for Payer: BCBS Complete |
$8,822.59
|
| Rate for Payer: BCBS Trust/PPO |
$18,062.05
|
| Rate for Payer: BCN Commercial |
$17,100.39
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$20,733.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Healthscope Commercial |
$22,056.48
|
| Rate for Payer: Healthscope Whirlpool |
$21,394.79
|
| Rate for Payer: Mclaren Commercial |
$19,850.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: Nomi Health Commercial |
$18,086.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,325.89
|
| Rate for Payer: Priority Health Narrow Network |
$15,461.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,409.70
|
|
