|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$53.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.46 |
| Max. Negotiated Rate |
$53.51 |
| Rate for Payer: Aetna Commercial |
$48.16
|
| Rate for Payer: ASR ASR |
$51.90
|
| Rate for Payer: BCBS Trust/PPO |
$41.49
|
| Rate for Payer: BCN Commercial |
$41.49
|
| Rate for Payer: Cash Price |
$42.81
|
| Rate for Payer: Cofinity Commercial |
$50.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
| Rate for Payer: Healthscope Commercial |
$53.51
|
| Rate for Payer: Healthscope Whirlpool |
$51.90
|
| Rate for Payer: Mclaren Commercial |
$48.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.09
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$53.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$53.51 |
| Rate for Payer: Aetna Commercial |
$48.16
|
| Rate for Payer: ASR ASR |
$51.90
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.49
|
| Rate for Payer: BCN Commercial |
$41.49
|
| Rate for Payer: Cash Price |
$42.81
|
| Rate for Payer: Cofinity Commercial |
$50.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
| Rate for Payer: Healthscope Commercial |
$53.51
|
| Rate for Payer: Healthscope Whirlpool |
$51.90
|
| Rate for Payer: Mclaren Commercial |
$48.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.69
|
| Rate for Payer: Priority Health Narrow Network |
$37.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.09
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,314.74
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$8,314.74 |
| Rate for Payer: Aetna Commercial |
$7,483.27
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$8,065.30
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$6,446.42
|
| Rate for Payer: BCN Commercial |
$6,446.42
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cofinity Commercial |
$7,815.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,651.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$8,314.74
|
| Rate for Payer: Healthscope Whirlpool |
$8,065.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$7,483.27
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,067.53
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,820.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,566.41
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$5,903.47
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,316.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,314.74
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,820.32 |
| Max. Negotiated Rate |
$8,314.74 |
| Rate for Payer: Aetna Commercial |
$7,483.27
|
| Rate for Payer: ASR ASR |
$8,065.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,446.42
|
| Rate for Payer: BCN Commercial |
$6,446.42
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cofinity Commercial |
$7,815.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,651.79
|
| Rate for Payer: Healthscope Commercial |
$8,314.74
|
| Rate for Payer: Healthscope Whirlpool |
$8,065.30
|
| Rate for Payer: Mclaren Commercial |
$7,483.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,067.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,820.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,316.97
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$14,804.56
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$14,804.56 |
| Rate for Payer: Aetna Commercial |
$13,324.10
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$14,360.42
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$11,477.98
|
| Rate for Payer: BCN Commercial |
$11,477.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cofinity Commercial |
$13,916.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,843.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$14,804.56
|
| Rate for Payer: Healthscope Whirlpool |
$14,360.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$13,324.10
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,583.88
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,363.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,472.15
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$10,511.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,028.01
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$14,804.56
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,363.19 |
| Max. Negotiated Rate |
$14,804.56 |
| Rate for Payer: Aetna Commercial |
$13,324.10
|
| Rate for Payer: ASR ASR |
$14,360.42
|
| Rate for Payer: BCBS Trust/PPO |
$11,477.98
|
| Rate for Payer: BCN Commercial |
$11,477.98
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cofinity Commercial |
$13,916.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,843.65
|
| Rate for Payer: Healthscope Commercial |
$14,804.56
|
| Rate for Payer: Healthscope Whirlpool |
$14,360.42
|
| Rate for Payer: Mclaren Commercial |
$13,324.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,583.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,363.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,028.01
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$12,514.29
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$12,514.29 |
| Rate for Payer: Aetna Commercial |
$11,262.86
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$12,138.86
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$9,702.33
|
| Rate for Payer: BCN Commercial |
$9,702.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cofinity Commercial |
$11,763.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,011.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$12,514.29
|
| Rate for Payer: Healthscope Whirlpool |
$12,138.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$11,262.86
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,637.15
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,760.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,388.00
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$8,885.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,012.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,514.29
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,760.00 |
| Max. Negotiated Rate |
$12,514.29 |
| Rate for Payer: Aetna Commercial |
$11,262.86
|
| Rate for Payer: ASR ASR |
$12,138.86
|
| Rate for Payer: BCBS Trust/PPO |
$9,702.33
|
| Rate for Payer: BCN Commercial |
$9,702.33
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cofinity Commercial |
$11,763.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,011.43
|
| Rate for Payer: Healthscope Commercial |
$12,514.29
|
| Rate for Payer: Healthscope Whirlpool |
$12,138.86
|
| Rate for Payer: Mclaren Commercial |
$11,262.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,637.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,760.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,012.58
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$8,785.89
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$8,785.89 |
| Rate for Payer: Aetna Commercial |
$7,907.30
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$8,522.31
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$6,811.70
|
| Rate for Payer: BCN Commercial |
$6,811.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cofinity Commercial |
$8,258.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,028.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$8,785.89
|
| Rate for Payer: Healthscope Whirlpool |
$8,522.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$7,907.30
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,468.01
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,150.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,995.16
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$6,237.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,731.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$8,785.89
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,150.12 |
| Max. Negotiated Rate |
$8,785.89 |
| Rate for Payer: Aetna Commercial |
$7,907.30
|
| Rate for Payer: ASR ASR |
$8,522.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,811.70
|
| Rate for Payer: BCN Commercial |
$6,811.70
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cofinity Commercial |
$8,258.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,028.71
|
| Rate for Payer: Healthscope Commercial |
$8,785.89
|
| Rate for Payer: Healthscope Whirlpool |
$8,522.31
|
| Rate for Payer: Mclaren Commercial |
$7,907.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,468.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,150.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,731.58
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$12,598.15
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,818.70 |
| Max. Negotiated Rate |
$12,598.15 |
| Rate for Payer: Aetna Commercial |
$11,338.34
|
| Rate for Payer: ASR ASR |
$12,220.21
|
| Rate for Payer: BCBS Trust/PPO |
$9,767.35
|
| Rate for Payer: BCN Commercial |
$9,767.35
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cofinity Commercial |
$11,842.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,078.52
|
| Rate for Payer: Healthscope Commercial |
$12,598.15
|
| Rate for Payer: Healthscope Whirlpool |
$12,220.21
|
| Rate for Payer: Mclaren Commercial |
$11,338.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,708.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,818.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,086.37
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$12,598.15
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$12,598.15 |
| Rate for Payer: Aetna Commercial |
$11,338.34
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$12,220.21
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$9,767.35
|
| Rate for Payer: BCN Commercial |
$9,767.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cofinity Commercial |
$11,842.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,078.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$12,598.15
|
| Rate for Payer: Healthscope Whirlpool |
$12,220.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$11,338.34
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,708.43
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,818.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,464.32
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$8,944.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,086.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$42.25 |
| Rate for Payer: Aetna Commercial |
$38.02
|
| Rate for Payer: ASR ASR |
$40.98
|
| Rate for Payer: BCBS Complete |
$16.90
|
| Rate for Payer: BCBS Trust/PPO |
$32.76
|
| Rate for Payer: BCN Commercial |
$32.76
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$39.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$42.25
|
| Rate for Payer: Healthscope Whirlpool |
$40.98
|
| Rate for Payer: Mclaren Commercial |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.45
|
| Rate for Payer: Priority Health Narrow Network |
$30.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.18
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$42.25 |
| Rate for Payer: Aetna Commercial |
$38.02
|
| Rate for Payer: ASR ASR |
$40.98
|
| Rate for Payer: BCBS Trust/PPO |
$32.76
|
| Rate for Payer: BCN Commercial |
$32.76
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$39.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$42.25
|
| Rate for Payer: Healthscope Whirlpool |
$40.98
|
| Rate for Payer: Mclaren Commercial |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.18
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$355.75 |
| Max. Negotiated Rate |
$508.22 |
| Rate for Payer: Aetna Commercial |
$457.40
|
| Rate for Payer: ASR ASR |
$492.97
|
| Rate for Payer: BCBS Trust/PPO |
$394.02
|
| Rate for Payer: BCN Commercial |
$394.02
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$477.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.58
|
| Rate for Payer: Healthscope Commercial |
$508.22
|
| Rate for Payer: Healthscope Whirlpool |
$492.97
|
| Rate for Payer: Mclaren Commercial |
$457.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.23
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.29 |
| Max. Negotiated Rate |
$508.22 |
| Rate for Payer: Aetna Commercial |
$457.40
|
| Rate for Payer: ASR ASR |
$492.97
|
| Rate for Payer: BCBS Complete |
$203.29
|
| Rate for Payer: BCBS Trust/PPO |
$394.02
|
| Rate for Payer: BCN Commercial |
$394.02
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$477.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.58
|
| Rate for Payer: Healthscope Commercial |
$508.22
|
| Rate for Payer: Healthscope Whirlpool |
$492.97
|
| Rate for Payer: Mclaren Commercial |
$457.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.48
|
| Rate for Payer: Priority Health Narrow Network |
$360.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.23
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,555.04 |
| Max. Negotiated Rate |
$9,364.34 |
| Rate for Payer: Aetna Commercial |
$8,427.91
|
| Rate for Payer: ASR ASR |
$9,083.41
|
| Rate for Payer: BCBS Trust/PPO |
$7,260.17
|
| Rate for Payer: BCN Commercial |
$7,260.17
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$8,802.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,491.47
|
| Rate for Payer: Healthscope Commercial |
$9,364.34
|
| Rate for Payer: Healthscope Whirlpool |
$9,083.41
|
| Rate for Payer: Mclaren Commercial |
$8,427.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,240.62
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$9,364.34 |
| Rate for Payer: Aetna Commercial |
$8,427.91
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$9,083.41
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$7,260.17
|
| Rate for Payer: BCN Commercial |
$7,260.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$8,802.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,491.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$9,364.34
|
| Rate for Payer: Healthscope Whirlpool |
$9,083.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$8,427.91
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,521.55
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$6,648.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,240.62
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$32.62 |
| Rate for Payer: Aetna Commercial |
$29.36
|
| Rate for Payer: ASR ASR |
$31.64
|
| Rate for Payer: BCBS Complete |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$25.29
|
| Rate for Payer: BCN Commercial |
$25.29
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$30.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$32.62
|
| Rate for Payer: Healthscope Whirlpool |
$31.64
|
| Rate for Payer: Mclaren Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.68
|
| Rate for Payer: Priority Health Narrow Network |
$23.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.71
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$32.62 |
| Rate for Payer: Aetna Commercial |
$29.36
|
| Rate for Payer: ASR ASR |
$31.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.29
|
| Rate for Payer: BCN Commercial |
$25.29
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$30.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$32.62
|
| Rate for Payer: Healthscope Whirlpool |
$31.64
|
| Rate for Payer: Mclaren Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.71
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$22.58
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$110.83 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: BCBS Complete |
$10.90
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$22.58
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$10.38
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Medicaid |
$10.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$25.08 |
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: Aetna Medicare |
$16.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: ASR ASR |
$24.33
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$19.44
|
| Rate for Payer: BCN Commercial |
$19.44
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$25.08
|
| Rate for Payer: Healthscope Whirlpool |
$24.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.26
|
| Rate for Payer: Mclaren Commercial |
$22.57
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$17.89
|
| Rate for Payer: PHP Medicaid |
$8.89
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.82
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health Narrow Network |
$17.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.75
|
| Rate for Payer: VA VA |
$16.26
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.56 |
| Max. Negotiated Rate |
$25.08 |
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: ASR ASR |
$24.33
|
| Rate for Payer: BCBS Trust/PPO |
$19.44
|
| Rate for Payer: BCN Commercial |
$19.44
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.06
|
| Rate for Payer: Healthscope Commercial |
$25.08
|
| Rate for Payer: Healthscope Whirlpool |
$24.33
|
| Rate for Payer: Mclaren Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.07
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: Aetna Commercial |
$32.66
|
| Rate for Payer: ASR ASR |
$35.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.14
|
| Rate for Payer: BCN Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$34.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$36.29
|
| Rate for Payer: Healthscope Whirlpool |
$35.20
|
| Rate for Payer: Mclaren Commercial |
$32.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.94
|
|
