|
HC COPPER URINE
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$72.63 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$53.18
|
| Rate for Payer: BCN Commercial |
$53.18
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: Mclaren Medicaid |
$12.41
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$58.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicaid |
$6.49
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.49
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.38 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Trust/PPO |
$52.97
|
| Rate for Payer: BCN Commercial |
$52.97
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$200.55
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.41 |
| Max. Negotiated Rate |
$200.55 |
| Rate for Payer: Aetna Commercial |
$180.50
|
| Rate for Payer: ASR ASR |
$194.53
|
| Rate for Payer: BCBS Trust/PPO |
$164.69
|
| Rate for Payer: BCN Commercial |
$164.69
|
| Rate for Payer: Cash Price |
$160.44
|
| Rate for Payer: Cofinity Commercial |
$188.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.44
|
| Rate for Payer: Healthscope Commercial |
$194.53
|
| Rate for Payer: Healthscope Whirlpool |
$200.55
|
| Rate for Payer: Mclaren Commercial |
$180.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.47
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.48
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$200.55
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$200.55 |
| Rate for Payer: Aetna Commercial |
$180.50
|
| Rate for Payer: Aetna Medicare |
$74.20
|
| Rate for Payer: ASR ASR |
$194.53
|
| Rate for Payer: BCBS Complete |
$80.22
|
| Rate for Payer: BCBS Trust/PPO |
$165.35
|
| Rate for Payer: BCN Commercial |
$165.35
|
| Rate for Payer: Cash Price |
$160.44
|
| Rate for Payer: Cofinity Commercial |
$188.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.44
|
| Rate for Payer: Healthscope Commercial |
$194.53
|
| Rate for Payer: Healthscope Whirlpool |
$200.55
|
| Rate for Payer: Mclaren Commercial |
$180.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$160.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.47
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$175.72
|
| Rate for Payer: Priority Health Narrow Network |
$140.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.48
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$96.42 |
| Rate for Payer: Aetna Commercial |
$86.78
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$93.53
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.50
|
| Rate for Payer: BCN Commercial |
$79.50
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$90.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$93.53
|
| Rate for Payer: Healthscope Whirlpool |
$96.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$86.78
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| 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 |
$34.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| 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 |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84.48
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$67.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$96.42 |
| Rate for Payer: Aetna Commercial |
$86.78
|
| Rate for Payer: ASR ASR |
$93.53
|
| Rate for Payer: BCBS Trust/PPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$90.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$93.53
|
| Rate for Payer: Healthscope Whirlpool |
$96.42
|
| Rate for Payer: Mclaren Commercial |
$86.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.85
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$17.32
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$38.60
|
| Rate for Payer: BCN Commercial |
$38.60
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.45
|
| Rate for Payer: BCN Commercial |
$38.45
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC CORN POLLEN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC CORN POLLEN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$9,143.70
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,857.77 |
| Max. Negotiated Rate |
$9,143.70 |
| Rate for Payer: Aetna Commercial |
$8,229.33
|
| Rate for Payer: ASR ASR |
$8,869.39
|
| Rate for Payer: BCBS Trust/PPO |
$7,508.81
|
| Rate for Payer: BCN Commercial |
$7,508.81
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cofinity Commercial |
$8,595.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,314.96
|
| Rate for Payer: Healthscope Commercial |
$8,869.39
|
| Rate for Payer: Healthscope Whirlpool |
$9,143.70
|
| Rate for Payer: Mclaren Commercial |
$8,229.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,772.15
|
| Rate for Payer: Nomi Health Commercial |
$7,497.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,857.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,046.46
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
OP
|
$9,143.70
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$9,143.70 |
| Rate for Payer: Aetna Commercial |
$8,229.33
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$8,869.39
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$7,538.98
|
| Rate for Payer: BCN Commercial |
$7,538.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cofinity Commercial |
$8,595.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,314.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$8,869.39
|
| Rate for Payer: Healthscope Whirlpool |
$9,143.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$8,229.33
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,772.15
|
| Rate for Payer: Nomi Health Commercial |
$7,497.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,857.77
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,011.71
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$6,409.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,046.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,254.18
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,440.64 |
| Max. Negotiated Rate |
$7,254.18 |
| Rate for Payer: Aetna Commercial |
$6,528.76
|
| Rate for Payer: ASR ASR |
$7,036.55
|
| Rate for Payer: BCBS Trust/PPO |
$5,957.13
|
| Rate for Payer: BCN Commercial |
$5,957.13
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cofinity Commercial |
$6,818.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,803.34
|
| Rate for Payer: Healthscope Commercial |
$7,036.55
|
| Rate for Payer: Healthscope Whirlpool |
$7,254.18
|
| Rate for Payer: Mclaren Commercial |
$6,528.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,166.05
|
| Rate for Payer: Nomi Health Commercial |
$5,948.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,440.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,383.68
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,254.18
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$7,254.18 |
| Rate for Payer: Aetna Commercial |
$6,528.76
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$7,036.55
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,981.07
|
| Rate for Payer: BCN Commercial |
$5,981.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cofinity Commercial |
$6,818.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,803.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$7,036.55
|
| Rate for Payer: Healthscope Whirlpool |
$7,254.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$6,528.76
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,166.05
|
| Rate for Payer: Nomi Health Commercial |
$5,948.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,440.64
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,356.11
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$5,085.18
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,383.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,701.38
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,776.03 |
| Max. Negotiated Rate |
$7,701.38 |
| Rate for Payer: Aetna Commercial |
$6,931.24
|
| Rate for Payer: ASR ASR |
$7,470.34
|
| Rate for Payer: BCBS Trust/PPO |
$6,324.37
|
| Rate for Payer: BCN Commercial |
$6,324.37
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cofinity Commercial |
$7,239.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,161.10
|
| Rate for Payer: Healthscope Commercial |
$7,470.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,701.38
|
| Rate for Payer: Mclaren Commercial |
$6,931.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,546.17
|
| Rate for Payer: Nomi Health Commercial |
$6,315.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,776.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,777.21
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,701.38
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$7,701.38 |
| Rate for Payer: Aetna Commercial |
$6,931.24
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$7,470.34
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,349.79
|
| Rate for Payer: BCN Commercial |
$6,349.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cofinity Commercial |
$7,239.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,161.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$7,470.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,701.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$6,931.24
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,546.17
|
| Rate for Payer: Nomi Health Commercial |
$6,315.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,776.03
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,747.95
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$5,398.67
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,777.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,464.21
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$4,848.16 |
| Max. Negotiated Rate |
$6,464.21 |
| Rate for Payer: Aetna Commercial |
$5,817.79
|
| Rate for Payer: ASR ASR |
$6,270.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,308.41
|
| Rate for Payer: BCN Commercial |
$5,308.41
|
| Rate for Payer: Cash Price |
$5,171.37
|
| Rate for Payer: Cofinity Commercial |
$6,076.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,171.37
|
| Rate for Payer: Healthscope Commercial |
$6,270.28
|
| Rate for Payer: Healthscope Whirlpool |
$6,464.21
|
| Rate for Payer: Mclaren Commercial |
$5,817.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,494.58
|
| Rate for Payer: Nomi Health Commercial |
$5,300.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,848.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,688.50
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,592.74
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$589.31 |
| Max. Negotiated Rate |
$1,592.74 |
| Rate for Payer: Aetna Commercial |
$1,433.47
|
| Rate for Payer: Aetna Medicare |
$589.31
|
| Rate for Payer: ASR ASR |
$1,544.96
|
| Rate for Payer: BCBS Complete |
$637.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.21
|
| Rate for Payer: BCN Commercial |
$1,313.21
|
| Rate for Payer: Cash Price |
$1,274.19
|
| Rate for Payer: Cofinity Commercial |
$1,497.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,274.19
|
| Rate for Payer: Healthscope Commercial |
$1,544.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,592.74
|
| Rate for Payer: Mclaren Commercial |
$1,433.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,274.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.83
|
| Rate for Payer: Nomi Health Commercial |
$1,306.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,395.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,116.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,401.61
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,592.74
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,194.56 |
| Max. Negotiated Rate |
$1,592.74 |
| Rate for Payer: Aetna Commercial |
$1,433.47
|
| Rate for Payer: ASR ASR |
$1,544.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$1,307.96
|
| Rate for Payer: Cash Price |
$1,274.19
|
| Rate for Payer: Cofinity Commercial |
$1,497.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,274.19
|
| Rate for Payer: Healthscope Commercial |
$1,544.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,592.74
|
| Rate for Payer: Mclaren Commercial |
$1,433.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.83
|
| Rate for Payer: Nomi Health Commercial |
$1,306.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,401.61
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$11,340.73
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,196.07 |
| Max. Negotiated Rate |
$11,340.73 |
| Rate for Payer: Aetna Commercial |
$10,206.66
|
| Rate for Payer: Aetna Medicare |
$4,196.07
|
| Rate for Payer: ASR ASR |
$11,000.51
|
| Rate for Payer: BCBS Complete |
$4,536.29
|
| Rate for Payer: BCBS Trust/PPO |
$9,350.43
|
| Rate for Payer: BCN Commercial |
$9,350.43
|
| Rate for Payer: Cash Price |
$9,072.58
|
| Rate for Payer: Cofinity Commercial |
$10,660.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,072.58
|
| Rate for Payer: Healthscope Commercial |
$11,000.51
|
| Rate for Payer: Healthscope Whirlpool |
$11,340.73
|
| Rate for Payer: Mclaren Commercial |
$10,206.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,072.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,639.62
|
| Rate for Payer: Nomi Health Commercial |
$9,299.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,505.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,936.75
|
| Rate for Payer: Priority Health Narrow Network |
$7,949.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,979.84
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$11,340.73
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,505.55 |
| Max. Negotiated Rate |
$11,340.73 |
| Rate for Payer: Aetna Commercial |
$10,206.66
|
| Rate for Payer: ASR ASR |
$11,000.51
|
| Rate for Payer: BCBS Trust/PPO |
$9,313.01
|
| Rate for Payer: BCN Commercial |
$9,313.01
|
| Rate for Payer: Cash Price |
$9,072.58
|
| Rate for Payer: Cofinity Commercial |
$10,660.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,072.58
|
| Rate for Payer: Healthscope Commercial |
$11,000.51
|
| Rate for Payer: Healthscope Whirlpool |
$11,340.73
|
| Rate for Payer: Mclaren Commercial |
$10,206.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,639.62
|
| Rate for Payer: Nomi Health Commercial |
$9,299.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,505.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,979.84
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$4,145.24
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,533.74 |
| Max. Negotiated Rate |
$4,145.24 |
| Rate for Payer: Aetna Commercial |
$3,730.72
|
| Rate for Payer: Aetna Medicare |
$1,533.74
|
| Rate for Payer: ASR ASR |
$4,020.88
|
| Rate for Payer: BCBS Complete |
$1,658.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,417.75
|
| Rate for Payer: BCN Commercial |
$3,417.75
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$3,896.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.19
|
| Rate for Payer: Healthscope Commercial |
$4,020.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,145.24
|
| Rate for Payer: Mclaren Commercial |
$3,730.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,316.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.45
|
| Rate for Payer: Nomi Health Commercial |
$3,399.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,108.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,632.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,905.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,647.81
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$4,145.24
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,108.93 |
| Max. Negotiated Rate |
$4,145.24 |
| Rate for Payer: Aetna Commercial |
$3,730.72
|
| Rate for Payer: ASR ASR |
$4,020.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,404.07
|
| Rate for Payer: BCN Commercial |
$3,404.07
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$3,896.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.19
|
| Rate for Payer: Healthscope Commercial |
$4,020.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,145.24
|
| Rate for Payer: Mclaren Commercial |
$3,730.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.45
|
| Rate for Payer: Nomi Health Commercial |
$3,399.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,108.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,647.81
|
|
