|
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 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 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 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 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 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 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 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 |
$3,443.41
|
| 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 |
$5,572.39 |
| 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 |
$7,286.97
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.39
|
| 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 |
$7,286.97
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.39
|
| 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
|
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 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 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
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$903.10 |
| Max. Negotiated Rate |
$2,257.76 |
| Rate for Payer: Aetna Commercial |
$2,031.98
|
| Rate for Payer: Aetna Medicare |
$1,128.88
|
| Rate for Payer: ASR ASR |
$2,190.03
|
| Rate for Payer: ASR Commercial |
$2,190.03
|
| Rate for Payer: BCBS Complete |
$903.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,848.88
|
| Rate for Payer: BCN Commercial |
$1,750.44
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$2,122.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Healthscope Commercial |
$2,257.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,190.03
|
| Rate for Payer: Mclaren Commercial |
$2,031.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: Nomi Health Commercial |
$1,851.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,978.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,582.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,986.83
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,467.54 |
| Max. Negotiated Rate |
$2,257.76 |
| Rate for Payer: Aetna Commercial |
$2,031.98
|
| Rate for Payer: ASR ASR |
$2,190.03
|
| Rate for Payer: ASR Commercial |
$2,190.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,839.85
|
| Rate for Payer: BCN Commercial |
$1,750.44
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$2,122.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Healthscope Commercial |
$2,257.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,190.03
|
| Rate for Payer: Mclaren Commercial |
$2,031.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: Nomi Health Commercial |
$1,851.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,986.83
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,247.19 |
| Max. Negotiated Rate |
$14,226.44 |
| Rate for Payer: Aetna Commercial |
$12,803.80
|
| Rate for Payer: ASR ASR |
$13,799.65
|
| Rate for Payer: ASR Commercial |
$13,799.65
|
| Rate for Payer: BCBS Trust/PPO |
$11,593.13
|
| Rate for Payer: BCN Commercial |
$11,029.76
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$13,372.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Healthscope Commercial |
$14,226.44
|
| Rate for Payer: Healthscope Whirlpool |
$13,799.65
|
| Rate for Payer: Mclaren Commercial |
$12,803.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: Nomi Health Commercial |
$11,665.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,519.27
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,690.58 |
| Max. Negotiated Rate |
$14,226.44 |
| Rate for Payer: Aetna Commercial |
$12,803.80
|
| Rate for Payer: Aetna Medicare |
$7,113.22
|
| Rate for Payer: ASR ASR |
$13,799.65
|
| Rate for Payer: ASR Commercial |
$13,799.65
|
| Rate for Payer: BCBS Complete |
$5,690.58
|
| Rate for Payer: BCBS Trust/PPO |
$11,650.03
|
| Rate for Payer: BCN Commercial |
$11,029.76
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$13,372.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Healthscope Commercial |
$14,226.44
|
| Rate for Payer: Healthscope Whirlpool |
$13,799.65
|
| Rate for Payer: Mclaren Commercial |
$12,803.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: Nomi Health Commercial |
$11,665.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,465.21
|
| Rate for Payer: Priority Health Narrow Network |
$9,972.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,519.27
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,509.20 |
| Max. Negotiated Rate |
$8,773.00 |
| Rate for Payer: Aetna Commercial |
$7,895.70
|
| Rate for Payer: Aetna Medicare |
$4,386.50
|
| Rate for Payer: ASR ASR |
$8,509.81
|
| Rate for Payer: ASR Commercial |
$8,509.81
|
| Rate for Payer: BCBS Complete |
$3,509.20
|
| Rate for Payer: BCBS Trust/PPO |
$7,184.21
|
| Rate for Payer: BCN Commercial |
$6,801.71
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$8,246.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Healthscope Commercial |
$8,773.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,509.81
|
| Rate for Payer: Mclaren Commercial |
$7,895.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: Nomi Health Commercial |
$7,193.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,686.90
|
| Rate for Payer: Priority Health Narrow Network |
$6,149.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,720.24
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,702.45 |
| Max. Negotiated Rate |
$8,773.00 |
| Rate for Payer: Aetna Commercial |
$7,895.70
|
| Rate for Payer: ASR ASR |
$8,509.81
|
| Rate for Payer: ASR Commercial |
$8,509.81
|
| Rate for Payer: BCBS Trust/PPO |
$7,149.12
|
| Rate for Payer: BCN Commercial |
$6,801.71
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$8,246.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Healthscope Commercial |
$8,773.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,509.81
|
| Rate for Payer: Mclaren Commercial |
$7,895.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: Nomi Health Commercial |
$7,193.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,720.24
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
IP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$131.27 |
| Max. Negotiated Rate |
$201.96 |
| Rate for Payer: Aetna Commercial |
$181.76
|
| Rate for Payer: ASR ASR |
$195.90
|
| Rate for Payer: ASR Commercial |
$195.90
|
| Rate for Payer: BCBS Trust/PPO |
$164.58
|
| Rate for Payer: BCN Commercial |
$156.58
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$189.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$201.96
|
| Rate for Payer: Healthscope Whirlpool |
$195.90
|
| Rate for Payer: Mclaren Commercial |
$181.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: Nomi Health Commercial |
$165.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.72
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
OP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$80.78 |
| Max. Negotiated Rate |
$201.96 |
| Rate for Payer: Aetna Commercial |
$181.76
|
| Rate for Payer: Aetna Medicare |
$100.98
|
| Rate for Payer: ASR ASR |
$195.90
|
| Rate for Payer: ASR Commercial |
$195.90
|
| Rate for Payer: BCBS Complete |
$80.78
|
| Rate for Payer: BCBS Trust/PPO |
$165.39
|
| Rate for Payer: BCN Commercial |
$156.58
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$189.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$201.96
|
| Rate for Payer: Healthscope Whirlpool |
$195.90
|
| Rate for Payer: Mclaren Commercial |
$181.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: Nomi Health Commercial |
$165.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.96
|
| Rate for Payer: Priority Health Narrow Network |
$141.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.72
|
|
