|
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
|
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 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 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
|
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 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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| 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 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
|
|
|
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 BOWL
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: Aetna Medicare |
$114.75
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$187.94
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.09
|
| Rate for Payer: Priority Health Narrow Network |
$160.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
HC BOWL
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$149.18 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$164.76 |
| Max. Negotiated Rate |
$253.47 |
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: ASR ASR |
$245.87
|
| Rate for Payer: ASR Commercial |
$245.87
|
| Rate for Payer: BCBS Trust/PPO |
$206.55
|
| Rate for Payer: BCN Commercial |
$196.52
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$238.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$253.47
|
| Rate for Payer: Healthscope Whirlpool |
$245.87
|
| Rate for Payer: Mclaren Commercial |
$228.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: Nomi Health Commercial |
$207.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.05
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.39 |
| Max. Negotiated Rate |
$253.47 |
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: Aetna Medicare |
$126.74
|
| Rate for Payer: ASR ASR |
$245.87
|
| Rate for Payer: ASR Commercial |
$245.87
|
| Rate for Payer: BCBS Complete |
$101.39
|
| Rate for Payer: BCBS Trust/PPO |
$207.57
|
| Rate for Payer: BCN Commercial |
$196.52
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$238.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$253.47
|
| Rate for Payer: Healthscope Whirlpool |
$245.87
|
| Rate for Payer: Mclaren Commercial |
$228.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: Nomi Health Commercial |
$207.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.09
|
| Rate for Payer: Priority Health Narrow Network |
$177.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.05
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
OP
|
$52.44
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.20
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.87
|
| Rate for Payer: ASR Commercial |
$50.87
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.94
|
| Rate for Payer: BCN Commercial |
$40.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cofinity Commercial |
$49.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.44
|
| Rate for Payer: Healthscope Whirlpool |
$50.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.20
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.57
|
| Rate for Payer: Nomi Health Commercial |
$43.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.95
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.76
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
IP
|
$52.44
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.09 |
| Max. Negotiated Rate |
$52.44 |
| Rate for Payer: Aetna Commercial |
$47.20
|
| Rate for Payer: ASR ASR |
$50.87
|
| Rate for Payer: ASR Commercial |
$50.87
|
| Rate for Payer: BCBS Trust/PPO |
$42.73
|
| Rate for Payer: BCN Commercial |
$40.66
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cofinity Commercial |
$49.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.95
|
| Rate for Payer: Healthscope Commercial |
$52.44
|
| Rate for Payer: Healthscope Whirlpool |
$50.87
|
| Rate for Payer: Mclaren Commercial |
$47.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.57
|
| Rate for Payer: Nomi Health Commercial |
$43.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.15
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$57.40 |
| Rate for Payer: Aetna Commercial |
$51.66
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$55.68
|
| Rate for Payer: ASR Commercial |
$55.68
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$47.00
|
| Rate for Payer: BCN Commercial |
$44.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$53.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$57.40
|
| Rate for Payer: Healthscope Whirlpool |
$55.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$51.66
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.29
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$40.24
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$57.40 |
| Rate for Payer: Aetna Commercial |
$51.66
|
| Rate for Payer: ASR ASR |
$55.68
|
| Rate for Payer: ASR Commercial |
$55.68
|
| Rate for Payer: BCBS Trust/PPO |
$46.78
|
| Rate for Payer: BCN Commercial |
$44.50
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$53.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$57.40
|
| Rate for Payer: Healthscope Whirlpool |
$55.68
|
| Rate for Payer: Mclaren Commercial |
$51.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.51
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
OP
|
$972.10
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$388.84 |
| Max. Negotiated Rate |
$972.10 |
| Rate for Payer: Aetna Commercial |
$874.89
|
| Rate for Payer: Aetna Medicare |
$486.05
|
| Rate for Payer: ASR ASR |
$942.94
|
| Rate for Payer: ASR Commercial |
$942.94
|
| Rate for Payer: BCBS Complete |
$388.84
|
| Rate for Payer: BCBS Trust/PPO |
$796.05
|
| Rate for Payer: BCN Commercial |
$753.67
|
| Rate for Payer: Cash Price |
$777.68
|
| Rate for Payer: Cofinity Commercial |
$913.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.68
|
| Rate for Payer: Healthscope Commercial |
$972.10
|
| Rate for Payer: Healthscope Whirlpool |
$942.94
|
| Rate for Payer: Mclaren Commercial |
$874.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.28
|
| Rate for Payer: Nomi Health Commercial |
$797.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.75
|
| Rate for Payer: Priority Health Narrow Network |
$681.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.45
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
IP
|
$972.10
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$631.86 |
| Max. Negotiated Rate |
$972.10 |
| Rate for Payer: Aetna Commercial |
$874.89
|
| Rate for Payer: ASR ASR |
$942.94
|
| Rate for Payer: ASR Commercial |
$942.94
|
| Rate for Payer: BCBS Trust/PPO |
$792.16
|
| Rate for Payer: BCN Commercial |
$753.67
|
| Rate for Payer: Cash Price |
$777.68
|
| Rate for Payer: Cofinity Commercial |
$913.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.68
|
| Rate for Payer: Healthscope Commercial |
$972.10
|
| Rate for Payer: Healthscope Whirlpool |
$942.94
|
| Rate for Payer: Mclaren Commercial |
$874.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.28
|
| Rate for Payer: Nomi Health Commercial |
$797.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.45
|
|
|
HC BRACE AFO
|
Facility
|
OP
|
$596.14
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$238.46 |
| Max. Negotiated Rate |
$596.14 |
| Rate for Payer: Aetna Commercial |
$536.53
|
| Rate for Payer: Aetna Medicare |
$298.07
|
| Rate for Payer: ASR ASR |
$578.26
|
| Rate for Payer: ASR Commercial |
$578.26
|
| Rate for Payer: BCBS Complete |
$238.46
|
| Rate for Payer: BCBS Trust/PPO |
$488.18
|
| Rate for Payer: BCN Commercial |
$462.19
|
| Rate for Payer: Cash Price |
$476.91
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.91
|
| Rate for Payer: Healthscope Commercial |
$596.14
|
| Rate for Payer: Healthscope Whirlpool |
$578.26
|
| Rate for Payer: Mclaren Commercial |
$536.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.72
|
| Rate for Payer: Nomi Health Commercial |
$488.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.34
|
| Rate for Payer: Priority Health Narrow Network |
$417.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.60
|
|
|
HC BRACE AFO
|
Facility
|
IP
|
$596.14
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$387.49 |
| Max. Negotiated Rate |
$596.14 |
| Rate for Payer: Aetna Commercial |
$536.53
|
| Rate for Payer: ASR ASR |
$578.26
|
| Rate for Payer: ASR Commercial |
$578.26
|
| Rate for Payer: BCBS Trust/PPO |
$485.79
|
| Rate for Payer: BCN Commercial |
$462.19
|
| Rate for Payer: Cash Price |
$476.91
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.91
|
| Rate for Payer: Healthscope Commercial |
$596.14
|
| Rate for Payer: Healthscope Whirlpool |
$578.26
|
| Rate for Payer: Mclaren Commercial |
$536.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.72
|
| Rate for Payer: Nomi Health Commercial |
$488.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.60
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
OP
|
$1,466.73
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$586.69 |
| Max. Negotiated Rate |
$1,466.73 |
| Rate for Payer: Aetna Commercial |
$1,320.06
|
| Rate for Payer: Aetna Medicare |
$733.36
|
| Rate for Payer: ASR ASR |
$1,422.73
|
| Rate for Payer: ASR Commercial |
$1,422.73
|
| Rate for Payer: BCBS Complete |
$586.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.11
|
| Rate for Payer: BCN Commercial |
$1,137.16
|
| Rate for Payer: Cash Price |
$1,173.38
|
| Rate for Payer: Cofinity Commercial |
$1,378.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.38
|
| Rate for Payer: Healthscope Commercial |
$1,466.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,422.73
|
| Rate for Payer: Mclaren Commercial |
$1,320.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,246.72
|
| Rate for Payer: Nomi Health Commercial |
$1,202.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,285.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,028.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,290.72
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
IP
|
$1,466.73
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$953.37 |
| Max. Negotiated Rate |
$1,466.73 |
| Rate for Payer: Aetna Commercial |
$1,320.06
|
| Rate for Payer: ASR ASR |
$1,422.73
|
| Rate for Payer: ASR Commercial |
$1,422.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.24
|
| Rate for Payer: BCN Commercial |
$1,137.16
|
| Rate for Payer: Cash Price |
$1,173.38
|
| Rate for Payer: Cofinity Commercial |
$1,378.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.38
|
| Rate for Payer: Healthscope Commercial |
$1,466.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,422.73
|
| Rate for Payer: Mclaren Commercial |
$1,320.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,246.72
|
| Rate for Payer: Nomi Health Commercial |
$1,202.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,290.72
|
|
|
HC BRACE AK PELVIC CONTROL BELT LIGHT
|
Facility
|
IP
|
$329.81
|
|
|
Service Code
|
HCPCS L5692
|
| Hospital Charge Code |
27400038
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$214.38 |
| Max. Negotiated Rate |
$329.81 |
| Rate for Payer: Aetna Commercial |
$296.83
|
| Rate for Payer: ASR ASR |
$319.92
|
| Rate for Payer: ASR Commercial |
$319.92
|
| Rate for Payer: BCBS Trust/PPO |
$268.76
|
| Rate for Payer: BCN Commercial |
$255.70
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cofinity Commercial |
$310.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.85
|
| Rate for Payer: Healthscope Commercial |
$329.81
|
| Rate for Payer: Healthscope Whirlpool |
$319.92
|
| Rate for Payer: Mclaren Commercial |
$296.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.34
|
| Rate for Payer: Nomi Health Commercial |
$270.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.23
|
|
