|
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 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 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 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
|
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 |
$11,501.77
|
| Rate for Payer: ASR Commercial |
$11,501.77
|
| 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 |
$11,501.77
|
| 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 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 |
$11,501.77
|
| Rate for Payer: ASR Commercial |
$11,501.77
|
| 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 |
$11,501.77
|
| 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 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 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 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 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 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 |
$3,848.03
|
| 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 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 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
|
|
|
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 CATH LAB STANDBY
|
Facility
|
OP
|
$499.71
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.88 |
| Max. Negotiated Rate |
$499.71 |
| Rate for Payer: Aetna Commercial |
$449.74
|
| Rate for Payer: Aetna Medicare |
$249.85
|
| Rate for Payer: ASR ASR |
$484.72
|
| Rate for Payer: ASR Commercial |
$484.72
|
| Rate for Payer: BCBS Complete |
$199.88
|
| Rate for Payer: BCBS Trust/PPO |
$409.21
|
| Rate for Payer: BCN Commercial |
$387.43
|
| Rate for Payer: Cash Price |
$399.77
|
| Rate for Payer: Cofinity Commercial |
$469.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.77
|
| Rate for Payer: Healthscope Commercial |
$499.71
|
| Rate for Payer: Healthscope Whirlpool |
$484.72
|
| Rate for Payer: Mclaren Commercial |
$449.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.75
|
| Rate for Payer: Nomi Health Commercial |
$409.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.85
|
| Rate for Payer: Priority Health Narrow Network |
$350.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.74
|
|
|
HC CATH LAB STANDBY
|
Facility
|
IP
|
$499.71
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$324.81 |
| Max. Negotiated Rate |
$499.71 |
| Rate for Payer: Aetna Commercial |
$449.74
|
| Rate for Payer: ASR ASR |
$484.72
|
| Rate for Payer: ASR Commercial |
$484.72
|
| Rate for Payer: BCBS Trust/PPO |
$407.21
|
| Rate for Payer: BCN Commercial |
$387.43
|
| Rate for Payer: Cash Price |
$399.77
|
| Rate for Payer: Cofinity Commercial |
$469.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.77
|
| Rate for Payer: Healthscope Commercial |
$499.71
|
| Rate for Payer: Healthscope Whirlpool |
$484.72
|
| Rate for Payer: Mclaren Commercial |
$449.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.75
|
| Rate for Payer: Nomi Health Commercial |
$409.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.74
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
IP
|
$153.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.45 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$124.68
|
| Rate for Payer: BCN Commercial |
$118.62
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Healthscope Whirlpool |
$148.41
|
| Rate for Payer: Mclaren Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
OP
|
$153.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$125.29
|
| Rate for Payer: BCN Commercial |
$118.62
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Healthscope Whirlpool |
$148.41
|
| Rate for Payer: Mclaren Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.06
|
| Rate for Payer: Priority Health Narrow Network |
$107.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
OP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$293.76 |
| Max. Negotiated Rate |
$734.40 |
| Rate for Payer: Aetna Commercial |
$660.96
|
| Rate for Payer: Aetna Medicare |
$367.20
|
| Rate for Payer: ASR ASR |
$712.37
|
| Rate for Payer: ASR Commercial |
$712.37
|
| Rate for Payer: BCBS Complete |
$293.76
|
| Rate for Payer: BCBS Trust/PPO |
$601.40
|
| Rate for Payer: BCN Commercial |
$569.38
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$690.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$734.40
|
| Rate for Payer: Healthscope Whirlpool |
$712.37
|
| Rate for Payer: Mclaren Commercial |
$660.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.48
|
| Rate for Payer: Priority Health Narrow Network |
$514.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.27
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
IP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$477.36 |
| Max. Negotiated Rate |
$734.40 |
| Rate for Payer: Aetna Commercial |
$660.96
|
| Rate for Payer: ASR ASR |
$712.37
|
| Rate for Payer: ASR Commercial |
$712.37
|
| Rate for Payer: BCBS Trust/PPO |
$598.46
|
| Rate for Payer: BCN Commercial |
$569.38
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$690.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$734.40
|
| Rate for Payer: Healthscope Whirlpool |
$712.37
|
| Rate for Payer: Mclaren Commercial |
$660.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.27
|
|
|
HC CAT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
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 CAT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
IP
|
$30.45
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: ASR ASR |
$29.54
|
| Rate for Payer: ASR Commercial |
$29.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.81
|
| Rate for Payer: BCN Commercial |
$23.61
|
| Rate for Payer: Cash Price |
$24.36
|
| Rate for Payer: Cofinity Commercial |
$28.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.36
|
| Rate for Payer: Healthscope Commercial |
$30.45
|
| Rate for Payer: Healthscope Whirlpool |
$29.54
|
| Rate for Payer: Mclaren Commercial |
$27.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.88
|
| Rate for Payer: Nomi Health Commercial |
$24.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.80
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
OP
|
$30.45
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$7.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: ASR ASR |
$29.54
|
| Rate for Payer: ASR Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$4.37
|
| Rate for Payer: BCBS MAPPO |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.61
|
| Rate for Payer: BCN Medicare Advantage |
$7.77
|
| Rate for Payer: Cash Price |
$24.36
|
| Rate for Payer: Cash Price |
$24.36
|
| Rate for Payer: Cofinity Commercial |
$28.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.77
|
| Rate for Payer: Healthscope Commercial |
$30.45
|
| Rate for Payer: Healthscope Whirlpool |
$29.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.77
|
| Rate for Payer: Mclaren Commercial |
$27.41
|
| Rate for Payer: Mclaren Medicaid |
$4.16
|
| Rate for Payer: Mclaren Medicare |
$7.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.16
|
| Rate for Payer: Meridian Medicaid |
$4.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.88
|
| Rate for Payer: Nomi Health Commercial |
$24.97
|
| Rate for Payer: PACE Medicare |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.77
|
| Rate for Payer: PHP Commercial |
$8.55
|
| Rate for Payer: PHP Medicaid |
$4.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.68
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow Network |
$21.35
|
| Rate for Payer: Railroad Medicare Medicare |
$7.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.77
|
| Rate for Payer: UHC Exchange |
$12.04
|
| Rate for Payer: UHC Medicare Advantage |
$7.77
|
| Rate for Payer: UHCCP DNSP |
$7.77
|
| Rate for Payer: UHCCP Medicaid |
$4.16
|
| Rate for Payer: VA VA |
$7.77
|
|
