|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
IP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,708.61 |
| Max. Negotiated Rate |
$5,705.55 |
| Rate for Payer: Aetna Commercial |
$5,135.00
|
| Rate for Payer: ASR ASR |
$5,534.38
|
| Rate for Payer: ASR Commercial |
$5,534.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,649.45
|
| Rate for Payer: BCN Commercial |
$4,423.51
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Commercial |
$5,363.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,705.55
|
| Rate for Payer: Healthscope Whirlpool |
$5,534.38
|
| Rate for Payer: Mclaren Commercial |
$5,135.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Nomi Health Commercial |
$4,678.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,708.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,020.88
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
OP
|
$3,501.78
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,400.71 |
| Max. Negotiated Rate |
$3,501.78 |
| Rate for Payer: Aetna Commercial |
$3,151.60
|
| Rate for Payer: Aetna Medicare |
$1,750.89
|
| Rate for Payer: ASR ASR |
$3,396.73
|
| Rate for Payer: ASR Commercial |
$3,396.73
|
| Rate for Payer: BCBS Complete |
$1,400.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,867.61
|
| Rate for Payer: BCN Commercial |
$2,714.93
|
| Rate for Payer: Cash Price |
$2,801.42
|
| Rate for Payer: Cofinity Commercial |
$3,291.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,801.42
|
| Rate for Payer: Healthscope Commercial |
$3,501.78
|
| Rate for Payer: Healthscope Whirlpool |
$3,396.73
|
| Rate for Payer: Mclaren Commercial |
$3,151.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,976.51
|
| Rate for Payer: Nomi Health Commercial |
$2,871.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,068.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,454.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,081.57
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
IP
|
$3,501.78
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,276.16 |
| Max. Negotiated Rate |
$3,501.78 |
| Rate for Payer: Aetna Commercial |
$3,151.60
|
| Rate for Payer: ASR ASR |
$3,396.73
|
| Rate for Payer: ASR Commercial |
$3,396.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,853.60
|
| Rate for Payer: BCN Commercial |
$2,714.93
|
| Rate for Payer: Cash Price |
$2,801.42
|
| Rate for Payer: Cofinity Commercial |
$3,291.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,801.42
|
| Rate for Payer: Healthscope Commercial |
$3,501.78
|
| Rate for Payer: Healthscope Whirlpool |
$3,396.73
|
| Rate for Payer: Mclaren Commercial |
$3,151.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,976.51
|
| Rate for Payer: Nomi Health Commercial |
$2,871.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,081.57
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
OP
|
$148.17
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| 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 CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
IP
|
$148.17
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| 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 CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$317.12 |
| Max. Negotiated Rate |
$792.81 |
| Rate for Payer: Aetna Commercial |
$713.53
|
| Rate for Payer: Aetna Medicare |
$396.40
|
| Rate for Payer: ASR ASR |
$769.03
|
| Rate for Payer: ASR Commercial |
$769.03
|
| Rate for Payer: BCBS Complete |
$317.12
|
| Rate for Payer: BCBS Trust/PPO |
$649.23
|
| Rate for Payer: BCN Commercial |
$614.67
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$745.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$792.81
|
| Rate for Payer: Healthscope Whirlpool |
$769.03
|
| Rate for Payer: Mclaren Commercial |
$713.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.66
|
| Rate for Payer: Priority Health Narrow Network |
$555.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$697.67
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
IP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$515.33 |
| Max. Negotiated Rate |
$792.81 |
| Rate for Payer: Aetna Commercial |
$713.53
|
| Rate for Payer: ASR ASR |
$769.03
|
| Rate for Payer: ASR Commercial |
$769.03
|
| Rate for Payer: BCBS Trust/PPO |
$646.06
|
| Rate for Payer: BCN Commercial |
$614.67
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$745.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$792.81
|
| Rate for Payer: Healthscope Whirlpool |
$769.03
|
| Rate for Payer: Mclaren Commercial |
$713.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$697.67
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
IP
|
$1,532.09
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$995.86 |
| Max. Negotiated Rate |
$1,532.09 |
| Rate for Payer: Aetna Commercial |
$1,378.88
|
| Rate for Payer: ASR ASR |
$1,486.13
|
| Rate for Payer: ASR Commercial |
$1,486.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.50
|
| Rate for Payer: BCN Commercial |
$1,187.83
|
| Rate for Payer: Cash Price |
$1,225.67
|
| Rate for Payer: Cofinity Commercial |
$1,440.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.67
|
| Rate for Payer: Healthscope Commercial |
$1,532.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,486.13
|
| Rate for Payer: Mclaren Commercial |
$1,378.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.28
|
| Rate for Payer: Nomi Health Commercial |
$1,256.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,348.24
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
OP
|
$1,532.09
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$612.84 |
| Max. Negotiated Rate |
$1,532.09 |
| Rate for Payer: Aetna Commercial |
$1,378.88
|
| Rate for Payer: Aetna Medicare |
$766.04
|
| Rate for Payer: ASR ASR |
$1,486.13
|
| Rate for Payer: ASR Commercial |
$1,486.13
|
| Rate for Payer: BCBS Complete |
$612.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.63
|
| Rate for Payer: BCN Commercial |
$1,187.83
|
| Rate for Payer: Cash Price |
$1,225.67
|
| Rate for Payer: Cofinity Commercial |
$1,440.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.67
|
| Rate for Payer: Healthscope Commercial |
$1,532.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,486.13
|
| Rate for Payer: Mclaren Commercial |
$1,378.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.28
|
| Rate for Payer: Nomi Health Commercial |
$1,256.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,074.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,348.24
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.36
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$24.71
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.09
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Mclaren Medicaid |
$4.87
|
| Rate for Payer: Mclaren Medicare |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Meridian Medicaid |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Medicare |
$8.64
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Commercial |
$10.00
|
| Rate for Payer: PHP Medicaid |
$4.87
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.68
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: Priority Health Narrow Network |
$6.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Exchange |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UHCCP DNSP |
$9.09
|
| Rate for Payer: UHCCP Medicaid |
$4.87
|
| Rate for Payer: VA VA |
$9.09
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: Aetna Medicare |
$33.66
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: ASR Commercial |
$65.30
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS Trust/PPO |
$55.13
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.99
|
| Rate for Payer: Priority Health Narrow Network |
$47.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$43.76 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: ASR Commercial |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$54.86
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.05 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: ASR Commercial |
$346.29
|
| Rate for Payer: BCBS Trust/PPO |
$290.92
|
| Rate for Payer: BCN Commercial |
$276.78
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$357.00
|
| Rate for Payer: Healthscope Whirlpool |
$346.29
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$321.30
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: ASR ASR |
$346.29
|
| Rate for Payer: ASR Commercial |
$346.29
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$292.35
|
| Rate for Payer: BCN Commercial |
$276.78
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$357.00
|
| Rate for Payer: Healthscope Whirlpool |
$346.29
|
| Rate for Payer: Mclaren Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.80
|
| Rate for Payer: Priority Health Narrow Network |
$250.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.16
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
OP
|
$11,857.50
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,743.00 |
| Max. Negotiated Rate |
$11,857.50 |
| Rate for Payer: Aetna Commercial |
$10,671.75
|
| Rate for Payer: Aetna Medicare |
$5,928.75
|
| Rate for Payer: ASR ASR |
$11,501.78
|
| Rate for Payer: ASR Commercial |
$11,501.78
|
| Rate for Payer: BCBS Complete |
$4,743.00
|
| Rate for Payer: BCBS Trust/PPO |
$9,710.11
|
| Rate for Payer: BCN Commercial |
$9,193.12
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$11,146.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Healthscope Commercial |
$11,857.50
|
| Rate for Payer: Healthscope Whirlpool |
$11,501.78
|
| Rate for Payer: Mclaren Commercial |
$10,671.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,389.54
|
| Rate for Payer: Priority Health Narrow Network |
$8,312.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,434.60
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
IP
|
$11,857.50
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,707.38 |
| Max. Negotiated Rate |
$11,857.50 |
| Rate for Payer: Aetna Commercial |
$10,671.75
|
| Rate for Payer: ASR ASR |
$11,501.78
|
| Rate for Payer: ASR Commercial |
$11,501.78
|
| Rate for Payer: BCBS Trust/PPO |
$9,662.68
|
| Rate for Payer: BCN Commercial |
$9,193.12
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$11,146.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Healthscope Commercial |
$11,857.50
|
| Rate for Payer: Healthscope Whirlpool |
$11,501.78
|
| Rate for Payer: Mclaren Commercial |
$10,671.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,434.60
|
|
|
HC CATHETER SINGLE
|
Facility
|
OP
|
$190.56
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.22 |
| Max. Negotiated Rate |
$190.56 |
| Rate for Payer: Aetna Commercial |
$171.50
|
| Rate for Payer: Aetna Medicare |
$95.28
|
| Rate for Payer: ASR ASR |
$184.84
|
| Rate for Payer: ASR Commercial |
$184.84
|
| Rate for Payer: BCBS Complete |
$76.22
|
| Rate for Payer: BCBS Trust/PPO |
$156.05
|
| Rate for Payer: BCN Commercial |
$147.74
|
| Rate for Payer: Cash Price |
$152.45
|
| Rate for Payer: Cofinity Commercial |
$179.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.45
|
| Rate for Payer: Healthscope Commercial |
$190.56
|
| Rate for Payer: Healthscope Whirlpool |
$184.84
|
| Rate for Payer: Mclaren Commercial |
$171.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.98
|
| Rate for Payer: Nomi Health Commercial |
$156.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.97
|
| Rate for Payer: Priority Health Narrow Network |
$133.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.69
|
|
|
HC CATHETER SINGLE
|
Facility
|
IP
|
$190.56
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.86 |
| Max. Negotiated Rate |
$190.56 |
| Rate for Payer: Aetna Commercial |
$171.50
|
| Rate for Payer: ASR ASR |
$184.84
|
| Rate for Payer: ASR Commercial |
$184.84
|
| Rate for Payer: BCBS Trust/PPO |
$155.29
|
| Rate for Payer: BCN Commercial |
$147.74
|
| Rate for Payer: Cash Price |
$152.45
|
| Rate for Payer: Cofinity Commercial |
$179.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.45
|
| Rate for Payer: Healthscope Commercial |
$190.56
|
| Rate for Payer: Healthscope Whirlpool |
$184.84
|
| Rate for Payer: Mclaren Commercial |
$171.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.98
|
| Rate for Payer: Nomi Health Commercial |
$156.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.69
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
OP
|
$1,638.63
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$655.45 |
| Max. Negotiated Rate |
$1,638.63 |
| Rate for Payer: Aetna Commercial |
$1,474.77
|
| Rate for Payer: Aetna Medicare |
$819.32
|
| Rate for Payer: ASR ASR |
$1,589.47
|
| Rate for Payer: ASR Commercial |
$1,589.47
|
| Rate for Payer: BCBS Complete |
$655.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,341.87
|
| Rate for Payer: BCN Commercial |
$1,270.43
|
| Rate for Payer: Cash Price |
$1,310.90
|
| Rate for Payer: Cofinity Commercial |
$1,540.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,310.90
|
| Rate for Payer: Healthscope Commercial |
$1,638.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,589.47
|
| Rate for Payer: Mclaren Commercial |
$1,474.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,392.84
|
| Rate for Payer: Nomi Health Commercial |
$1,343.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,435.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,441.99
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
IP
|
$1,638.63
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,065.11 |
| Max. Negotiated Rate |
$1,638.63 |
| Rate for Payer: Aetna Commercial |
$1,474.77
|
| Rate for Payer: ASR ASR |
$1,589.47
|
| Rate for Payer: ASR Commercial |
$1,589.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.32
|
| Rate for Payer: BCN Commercial |
$1,270.43
|
| Rate for Payer: Cash Price |
$1,310.90
|
| Rate for Payer: Cofinity Commercial |
$1,540.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,310.90
|
| Rate for Payer: Healthscope Commercial |
$1,638.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,589.47
|
| Rate for Payer: Mclaren Commercial |
$1,474.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,392.84
|
| Rate for Payer: Nomi Health Commercial |
$1,343.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,441.99
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
IP
|
$7,696.07
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,002.45 |
| Max. Negotiated Rate |
$7,696.07 |
| Rate for Payer: Aetna Commercial |
$6,926.46
|
| Rate for Payer: ASR ASR |
$7,465.19
|
| Rate for Payer: ASR Commercial |
$7,465.19
|
| Rate for Payer: BCBS Trust/PPO |
$6,271.53
|
| Rate for Payer: BCN Commercial |
$5,966.76
|
| Rate for Payer: Cash Price |
$6,156.86
|
| Rate for Payer: Cofinity Commercial |
$7,234.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,156.86
|
| Rate for Payer: Healthscope Commercial |
$7,696.07
|
| Rate for Payer: Healthscope Whirlpool |
$7,465.19
|
| Rate for Payer: Mclaren Commercial |
$6,926.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,541.66
|
| Rate for Payer: Nomi Health Commercial |
$6,310.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,002.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,772.54
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
OP
|
$7,696.07
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,078.43 |
| Max. Negotiated Rate |
$7,696.07 |
| Rate for Payer: Aetna Commercial |
$6,926.46
|
| Rate for Payer: Aetna Medicare |
$3,848.04
|
| Rate for Payer: ASR ASR |
$7,465.19
|
| Rate for Payer: ASR Commercial |
$7,465.19
|
| Rate for Payer: BCBS Complete |
$3,078.43
|
| Rate for Payer: BCBS Trust/PPO |
$6,302.31
|
| Rate for Payer: BCN Commercial |
$5,966.76
|
| Rate for Payer: Cash Price |
$6,156.86
|
| Rate for Payer: Cofinity Commercial |
$7,234.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,156.86
|
| Rate for Payer: Healthscope Commercial |
$7,696.07
|
| Rate for Payer: Healthscope Whirlpool |
$7,465.19
|
| Rate for Payer: Mclaren Commercial |
$6,926.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,541.66
|
| Rate for Payer: Nomi Health Commercial |
$6,310.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,002.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,743.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,394.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,772.54
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
IP
|
$9,710.40
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,311.76 |
| Max. Negotiated Rate |
$9,710.40 |
| Rate for Payer: Aetna Commercial |
$8,739.36
|
| Rate for Payer: ASR ASR |
$9,419.09
|
| Rate for Payer: ASR Commercial |
$9,419.09
|
| Rate for Payer: BCBS Trust/PPO |
$7,913.00
|
| Rate for Payer: BCN Commercial |
$7,528.47
|
| Rate for Payer: Cash Price |
$7,768.32
|
| Rate for Payer: Cofinity Commercial |
$9,127.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,768.32
|
| Rate for Payer: Healthscope Commercial |
$9,710.40
|
| Rate for Payer: Healthscope Whirlpool |
$9,419.09
|
| Rate for Payer: Mclaren Commercial |
$8,739.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,253.84
|
| Rate for Payer: Nomi Health Commercial |
$7,962.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,311.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,545.15
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
OP
|
$9,710.40
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,884.16 |
| Max. Negotiated Rate |
$9,710.40 |
| Rate for Payer: Aetna Commercial |
$8,739.36
|
| Rate for Payer: Aetna Medicare |
$4,855.20
|
| Rate for Payer: ASR ASR |
$9,419.09
|
| Rate for Payer: ASR Commercial |
$9,419.09
|
| Rate for Payer: BCBS Complete |
$3,884.16
|
| Rate for Payer: BCBS Trust/PPO |
$7,951.85
|
| Rate for Payer: BCN Commercial |
$7,528.47
|
| Rate for Payer: Cash Price |
$7,768.32
|
| Rate for Payer: Cofinity Commercial |
$9,127.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,768.32
|
| Rate for Payer: Healthscope Commercial |
$9,710.40
|
| Rate for Payer: Healthscope Whirlpool |
$9,419.09
|
| Rate for Payer: Mclaren Commercial |
$8,739.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,253.84
|
| Rate for Payer: Nomi Health Commercial |
$7,962.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,311.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,508.25
|
| Rate for Payer: Priority Health Narrow Network |
$6,806.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,545.15
|
|
