|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
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 CANNABINOID URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.08 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: ASR ASR |
$98.61
|
| Rate for Payer: ASR Commercial |
$98.61
|
| Rate for Payer: BCBS Trust/PPO |
$82.84
|
| Rate for Payer: BCN Commercial |
$78.82
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$95.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Healthscope Whirlpool |
$98.61
|
| Rate for Payer: Mclaren Commercial |
$91.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.46
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$98.61
|
| Rate for Payer: ASR Commercial |
$98.61
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$83.25
|
| Rate for Payer: BCN Commercial |
$78.82
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$95.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Healthscope Whirlpool |
$98.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$91.49
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.07
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$71.26
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$353.74 |
| Max. Negotiated Rate |
$884.34 |
| Rate for Payer: Aetna Commercial |
$795.91
|
| Rate for Payer: Aetna Medicare |
$442.17
|
| Rate for Payer: ASR ASR |
$857.81
|
| Rate for Payer: ASR Commercial |
$857.81
|
| Rate for Payer: BCBS Complete |
$353.74
|
| Rate for Payer: BCBS Trust/PPO |
$724.19
|
| Rate for Payer: BCN Commercial |
$685.63
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Cofinity Commercial |
$831.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Healthscope Commercial |
$884.34
|
| Rate for Payer: Healthscope Whirlpool |
$857.81
|
| Rate for Payer: Mclaren Commercial |
$795.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: Nomi Health Commercial |
$725.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.86
|
| Rate for Payer: Priority Health Narrow Network |
$619.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.22
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$574.82 |
| Max. Negotiated Rate |
$884.34 |
| Rate for Payer: Aetna Commercial |
$795.91
|
| Rate for Payer: ASR ASR |
$857.81
|
| Rate for Payer: ASR Commercial |
$857.81
|
| Rate for Payer: BCBS Trust/PPO |
$720.65
|
| Rate for Payer: BCN Commercial |
$685.63
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Cofinity Commercial |
$831.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Healthscope Commercial |
$884.34
|
| Rate for Payer: Healthscope Whirlpool |
$857.81
|
| Rate for Payer: Mclaren Commercial |
$795.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: Nomi Health Commercial |
$725.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.22
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
OP
|
$302.94
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$121.18 |
| Max. Negotiated Rate |
$302.94 |
| Rate for Payer: Aetna Commercial |
$272.65
|
| Rate for Payer: Aetna Medicare |
$151.47
|
| Rate for Payer: ASR ASR |
$293.85
|
| Rate for Payer: ASR Commercial |
$293.85
|
| Rate for Payer: BCBS Complete |
$121.18
|
| Rate for Payer: BCBS Trust/PPO |
$248.08
|
| Rate for Payer: BCN Commercial |
$234.87
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$284.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Healthscope Commercial |
$302.94
|
| Rate for Payer: Healthscope Whirlpool |
$293.85
|
| Rate for Payer: Mclaren Commercial |
$272.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.44
|
| Rate for Payer: Priority Health Narrow Network |
$212.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.59
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
IP
|
$302.94
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$196.91 |
| Max. Negotiated Rate |
$302.94 |
| Rate for Payer: Aetna Commercial |
$272.65
|
| Rate for Payer: ASR ASR |
$293.85
|
| Rate for Payer: ASR Commercial |
$293.85
|
| Rate for Payer: BCBS Trust/PPO |
$246.87
|
| Rate for Payer: BCN Commercial |
$234.87
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$284.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Healthscope Commercial |
$302.94
|
| Rate for Payer: Healthscope Whirlpool |
$293.85
|
| Rate for Payer: Mclaren Commercial |
$272.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.59
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
IP
|
$116.28
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$75.58 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Aetna Commercial |
$104.65
|
| Rate for Payer: ASR ASR |
$112.79
|
| Rate for Payer: ASR Commercial |
$112.79
|
| Rate for Payer: BCBS Trust/PPO |
$94.76
|
| Rate for Payer: BCN Commercial |
$90.15
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$116.28
|
| Rate for Payer: Healthscope Whirlpool |
$112.79
|
| Rate for Payer: Mclaren Commercial |
$104.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.84
|
| Rate for Payer: Nomi Health Commercial |
$95.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.33
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
OP
|
$116.28
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.51 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Aetna Commercial |
$104.65
|
| Rate for Payer: Aetna Medicare |
$58.14
|
| Rate for Payer: ASR ASR |
$112.79
|
| Rate for Payer: ASR Commercial |
$112.79
|
| Rate for Payer: BCBS Complete |
$46.51
|
| Rate for Payer: BCBS Trust/PPO |
$95.22
|
| Rate for Payer: BCN Commercial |
$90.15
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$116.28
|
| Rate for Payer: Healthscope Whirlpool |
$112.79
|
| Rate for Payer: Mclaren Commercial |
$104.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.84
|
| Rate for Payer: Nomi Health Commercial |
$95.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.88
|
| Rate for Payer: Priority Health Narrow Network |
$81.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.33
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: Aetna Medicare |
$12.24
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.45
|
| Rate for Payer: Priority Health Narrow Network |
$17.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.95
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC CANNULA BIOMEDICUS
|
Facility
|
OP
|
$1,473.47
|
|
| Hospital Charge Code |
27006715
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$589.39 |
| Max. Negotiated Rate |
$1,473.47 |
| Rate for Payer: Aetna Commercial |
$1,326.12
|
| Rate for Payer: Aetna Medicare |
$736.74
|
| Rate for Payer: ASR ASR |
$1,429.27
|
| Rate for Payer: ASR Commercial |
$1,429.27
|
| Rate for Payer: BCBS Complete |
$589.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.62
|
| Rate for Payer: BCN Commercial |
$1,142.38
|
| Rate for Payer: Cash Price |
$1,178.78
|
| Rate for Payer: Cofinity Commercial |
$1,385.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,178.78
|
| Rate for Payer: Healthscope Commercial |
$1,473.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,429.27
|
| Rate for Payer: Mclaren Commercial |
$1,326.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.45
|
| Rate for Payer: Nomi Health Commercial |
$1,208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$957.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,032.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,296.65
|
|
|
HC CANNULA BIOMEDICUS
|
Facility
|
IP
|
$1,473.47
|
|
| Hospital Charge Code |
27006715
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$957.76 |
| Max. Negotiated Rate |
$1,473.47 |
| Rate for Payer: Aetna Commercial |
$1,326.12
|
| Rate for Payer: ASR ASR |
$1,429.27
|
| Rate for Payer: ASR Commercial |
$1,429.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.73
|
| Rate for Payer: BCN Commercial |
$1,142.38
|
| Rate for Payer: Cash Price |
$1,178.78
|
| Rate for Payer: Cofinity Commercial |
$1,385.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,178.78
|
| Rate for Payer: Healthscope Commercial |
$1,473.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,429.27
|
| Rate for Payer: Mclaren Commercial |
$1,326.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.45
|
| Rate for Payer: Nomi Health Commercial |
$1,208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$957.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,296.65
|
|
|
HC CANNULA CARDIOPLEGIA
|
Facility
|
OP
|
$47.43
|
|
| Hospital Charge Code |
27000092
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.97 |
| Max. Negotiated Rate |
$47.43 |
| Rate for Payer: Aetna Commercial |
$42.69
|
| Rate for Payer: Aetna Medicare |
$23.72
|
| Rate for Payer: ASR ASR |
$46.01
|
| Rate for Payer: ASR Commercial |
$46.01
|
| Rate for Payer: BCBS Complete |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$38.84
|
| Rate for Payer: BCN Commercial |
$36.77
|
| Rate for Payer: Cash Price |
$37.94
|
| Rate for Payer: Cofinity Commercial |
$44.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.94
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$46.01
|
| Rate for Payer: Mclaren Commercial |
$42.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.32
|
| Rate for Payer: Nomi Health Commercial |
$38.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.56
|
| Rate for Payer: Priority Health Narrow Network |
$33.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.74
|
|
|
HC CANNULA CARDIOPLEGIA
|
Facility
|
IP
|
$47.43
|
|
| Hospital Charge Code |
27000092
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.83 |
| Max. Negotiated Rate |
$47.43 |
| Rate for Payer: Aetna Commercial |
$42.69
|
| Rate for Payer: ASR ASR |
$46.01
|
| Rate for Payer: ASR Commercial |
$46.01
|
| Rate for Payer: BCBS Trust/PPO |
$38.65
|
| Rate for Payer: BCN Commercial |
$36.77
|
| Rate for Payer: Cash Price |
$37.94
|
| Rate for Payer: Cofinity Commercial |
$44.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.94
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$46.01
|
| Rate for Payer: Mclaren Commercial |
$42.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.32
|
| Rate for Payer: Nomi Health Commercial |
$38.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.74
|
|
|
HC CANNULA COR ART 7MM ST
|
Facility
|
OP
|
$323.06
|
|
| Hospital Charge Code |
27006707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.22 |
| Max. Negotiated Rate |
$323.06 |
| Rate for Payer: Aetna Commercial |
$290.75
|
| Rate for Payer: Aetna Medicare |
$161.53
|
| Rate for Payer: ASR ASR |
$313.37
|
| Rate for Payer: ASR Commercial |
$313.37
|
| Rate for Payer: BCBS Complete |
$129.22
|
| Rate for Payer: BCBS Trust/PPO |
$264.55
|
| Rate for Payer: BCN Commercial |
$250.47
|
| Rate for Payer: Cash Price |
$258.45
|
| Rate for Payer: Cofinity Commercial |
$303.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.45
|
| Rate for Payer: Healthscope Commercial |
$323.06
|
| Rate for Payer: Healthscope Whirlpool |
$313.37
|
| Rate for Payer: Mclaren Commercial |
$290.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.60
|
| Rate for Payer: Nomi Health Commercial |
$264.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.07
|
| Rate for Payer: Priority Health Narrow Network |
$226.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.29
|
|
|
HC CANNULA COR ART 7MM ST
|
Facility
|
IP
|
$323.06
|
|
| Hospital Charge Code |
27006707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$209.99 |
| Max. Negotiated Rate |
$323.06 |
| Rate for Payer: Aetna Commercial |
$290.75
|
| Rate for Payer: ASR ASR |
$313.37
|
| Rate for Payer: ASR Commercial |
$313.37
|
| Rate for Payer: BCBS Trust/PPO |
$263.26
|
| Rate for Payer: BCN Commercial |
$250.47
|
| Rate for Payer: Cash Price |
$258.45
|
| Rate for Payer: Cofinity Commercial |
$303.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.45
|
| Rate for Payer: Healthscope Commercial |
$323.06
|
| Rate for Payer: Healthscope Whirlpool |
$313.37
|
| Rate for Payer: Mclaren Commercial |
$290.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.60
|
| Rate for Payer: Nomi Health Commercial |
$264.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.29
|
|
|
HC CANNULA COR ART 8 MM ST
|
Facility
|
IP
|
$313.65
|
|
| Hospital Charge Code |
27006708
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.87 |
| Max. Negotiated Rate |
$313.65 |
| Rate for Payer: Aetna Commercial |
$282.28
|
| Rate for Payer: ASR ASR |
$304.24
|
| Rate for Payer: ASR Commercial |
$304.24
|
| Rate for Payer: BCBS Trust/PPO |
$255.59
|
| Rate for Payer: BCN Commercial |
$243.17
|
| Rate for Payer: Cash Price |
$250.92
|
| Rate for Payer: Cofinity Commercial |
$294.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.92
|
| Rate for Payer: Healthscope Commercial |
$313.65
|
| Rate for Payer: Healthscope Whirlpool |
$304.24
|
| Rate for Payer: Mclaren Commercial |
$282.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.60
|
| Rate for Payer: Nomi Health Commercial |
$257.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.01
|
|
|
HC CANNULA COR ART 8 MM ST
|
Facility
|
OP
|
$313.65
|
|
| Hospital Charge Code |
27006708
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$125.46 |
| Max. Negotiated Rate |
$313.65 |
| Rate for Payer: Aetna Commercial |
$282.28
|
| Rate for Payer: Aetna Medicare |
$156.82
|
| Rate for Payer: ASR ASR |
$304.24
|
| Rate for Payer: ASR Commercial |
$304.24
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS Trust/PPO |
$256.85
|
| Rate for Payer: BCN Commercial |
$243.17
|
| Rate for Payer: Cash Price |
$250.92
|
| Rate for Payer: Cofinity Commercial |
$294.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.92
|
| Rate for Payer: Healthscope Commercial |
$313.65
|
| Rate for Payer: Healthscope Whirlpool |
$304.24
|
| Rate for Payer: Mclaren Commercial |
$282.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.60
|
| Rate for Payer: Nomi Health Commercial |
$257.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.82
|
| Rate for Payer: Priority Health Narrow Network |
$219.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.01
|
|
|
HC CANNULA COR OSTIA CONCAVE
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000265
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CANNULA COR OSTIA CONCAVE
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000265
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CANNULA COR OSTIA LPG 4MM
|
Facility
|
IP
|
$341.19
|
|
| Hospital Charge Code |
27006704
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$221.77 |
| Max. Negotiated Rate |
$341.19 |
| Rate for Payer: Aetna Commercial |
$307.07
|
| Rate for Payer: ASR ASR |
$330.95
|
| Rate for Payer: ASR Commercial |
$330.95
|
| Rate for Payer: BCBS Trust/PPO |
$278.04
|
| Rate for Payer: BCN Commercial |
$264.52
|
| Rate for Payer: Cash Price |
$272.95
|
| Rate for Payer: Cofinity Commercial |
$320.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.95
|
| Rate for Payer: Healthscope Commercial |
$341.19
|
| Rate for Payer: Healthscope Whirlpool |
$330.95
|
| Rate for Payer: Mclaren Commercial |
$307.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.01
|
| Rate for Payer: Nomi Health Commercial |
$279.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.25
|
|
|
HC CANNULA COR OSTIA LPG 4MM
|
Facility
|
OP
|
$341.19
|
|
| Hospital Charge Code |
27006704
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.48 |
| Max. Negotiated Rate |
$341.19 |
| Rate for Payer: Aetna Commercial |
$307.07
|
| Rate for Payer: Aetna Medicare |
$170.60
|
| Rate for Payer: ASR ASR |
$330.95
|
| Rate for Payer: ASR Commercial |
$330.95
|
| Rate for Payer: BCBS Complete |
$136.48
|
| Rate for Payer: BCBS Trust/PPO |
$279.40
|
| Rate for Payer: BCN Commercial |
$264.52
|
| Rate for Payer: Cash Price |
$272.95
|
| Rate for Payer: Cofinity Commercial |
$320.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.95
|
| Rate for Payer: Healthscope Commercial |
$341.19
|
| Rate for Payer: Healthscope Whirlpool |
$330.95
|
| Rate for Payer: Mclaren Commercial |
$307.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.01
|
| Rate for Payer: Nomi Health Commercial |
$279.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.95
|
| Rate for Payer: Priority Health Narrow Network |
$239.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.25
|
|
|
HC CANNULA COR OSTIA LPG 5MM
|
Facility
|
IP
|
$341.19
|
|
| Hospital Charge Code |
27006705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$221.77 |
| Max. Negotiated Rate |
$341.19 |
| Rate for Payer: Aetna Commercial |
$307.07
|
| Rate for Payer: ASR ASR |
$330.95
|
| Rate for Payer: ASR Commercial |
$330.95
|
| Rate for Payer: BCBS Trust/PPO |
$278.04
|
| Rate for Payer: BCN Commercial |
$264.52
|
| Rate for Payer: Cash Price |
$272.95
|
| Rate for Payer: Cofinity Commercial |
$320.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.95
|
| Rate for Payer: Healthscope Commercial |
$341.19
|
| Rate for Payer: Healthscope Whirlpool |
$330.95
|
| Rate for Payer: Mclaren Commercial |
$307.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.01
|
| Rate for Payer: Nomi Health Commercial |
$279.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.25
|
|
|
HC CANNULA COR OSTIA LPG 5MM
|
Facility
|
OP
|
$341.19
|
|
| Hospital Charge Code |
27006705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.48 |
| Max. Negotiated Rate |
$341.19 |
| Rate for Payer: Aetna Commercial |
$307.07
|
| Rate for Payer: Aetna Medicare |
$170.60
|
| Rate for Payer: ASR ASR |
$330.95
|
| Rate for Payer: ASR Commercial |
$330.95
|
| Rate for Payer: BCBS Complete |
$136.48
|
| Rate for Payer: BCBS Trust/PPO |
$279.40
|
| Rate for Payer: BCN Commercial |
$264.52
|
| Rate for Payer: Cash Price |
$272.95
|
| Rate for Payer: Cofinity Commercial |
$320.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.95
|
| Rate for Payer: Healthscope Commercial |
$341.19
|
| Rate for Payer: Healthscope Whirlpool |
$330.95
|
| Rate for Payer: Mclaren Commercial |
$307.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.01
|
| Rate for Payer: Nomi Health Commercial |
$279.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.95
|
| Rate for Payer: Priority Health Narrow Network |
$239.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.25
|
|
