|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,243.12 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Aetna Commercial |
$1,721.25
|
| Rate for Payer: ASR ASR |
$1,855.12
|
| Rate for Payer: ASR Commercial |
$1,855.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.50
|
| Rate for Payer: BCN Commercial |
$1,482.76
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,797.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Commercial |
$1,912.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,855.12
|
| Rate for Payer: Mclaren Commercial |
$1,721.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,683.00
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Aetna Commercial |
$1,721.25
|
| Rate for Payer: Aetna Medicare |
$956.25
|
| Rate for Payer: ASR ASR |
$1,855.12
|
| Rate for Payer: ASR Commercial |
$1,855.12
|
| Rate for Payer: BCBS Complete |
$765.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.15
|
| Rate for Payer: BCN Commercial |
$1,482.76
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,797.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Commercial |
$1,912.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,855.12
|
| Rate for Payer: Mclaren Commercial |
$1,721.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,675.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,683.00
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$36.57
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$65.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| 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 |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$36.75
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| 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 |
$6.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| 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 |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.88
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$52.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.65
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$65.88 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| 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 |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| 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 |
$6.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| 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 |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.88
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$52.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.65
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Aetna Commercial |
$176.96
|
| Rate for Payer: ASR ASR |
$190.72
|
| Rate for Payer: ASR Commercial |
$190.72
|
| Rate for Payer: BCBS Trust/PPO |
$160.23
|
| Rate for Payer: BCN Commercial |
$152.44
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Healthscope Commercial |
$196.62
|
| Rate for Payer: Healthscope Whirlpool |
$190.72
|
| Rate for Payer: Mclaren Commercial |
$176.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.03
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.65 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Aetna Commercial |
$176.96
|
| Rate for Payer: Aetna Medicare |
$98.31
|
| Rate for Payer: ASR ASR |
$190.72
|
| Rate for Payer: ASR Commercial |
$190.72
|
| Rate for Payer: BCBS Complete |
$78.65
|
| Rate for Payer: BCBS Trust/PPO |
$161.01
|
| Rate for Payer: BCN Commercial |
$152.44
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Healthscope Commercial |
$196.62
|
| Rate for Payer: Healthscope Whirlpool |
$190.72
|
| Rate for Payer: Mclaren Commercial |
$176.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.28
|
| Rate for Payer: Priority Health Narrow Network |
$137.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.03
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$96.32 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.83
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.03
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$37.40
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.22
|
| Rate for Payer: Priority Health Narrow Network |
$32.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| 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 CORN POLLEN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORN POLLEN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| 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 CORO ANGIOS W RHC
|
Facility
|
OP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.13 |
| Max. Negotiated Rate |
$8,964.41 |
| Rate for Payer: Aetna Commercial |
$8,067.97
|
| Rate for Payer: Aetna Medicare |
$3,151.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: ASR ASR |
$8,695.48
|
| Rate for Payer: ASR Commercial |
$8,695.48
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$7,340.96
|
| Rate for Payer: BCN Commercial |
$6,950.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$8,426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$8,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$8,695.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,151.37
|
| Rate for Payer: Mclaren Commercial |
$8,067.97
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$3,466.51
|
| Rate for Payer: PHP Medicaid |
$1,689.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,854.62
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$6,284.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,888.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$4,884.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP DNSP |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,826.87 |
| Max. Negotiated Rate |
$8,964.41 |
| Rate for Payer: Aetna Commercial |
$8,067.97
|
| Rate for Payer: ASR ASR |
$8,695.48
|
| Rate for Payer: ASR Commercial |
$8,695.48
|
| Rate for Payer: BCBS Trust/PPO |
$7,305.10
|
| Rate for Payer: BCN Commercial |
$6,950.11
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$8,426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Healthscope Commercial |
$8,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$8,695.48
|
| Rate for Payer: Mclaren Commercial |
$8,067.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,888.68
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,622.76 |
| Max. Negotiated Rate |
$7,111.94 |
| Rate for Payer: Aetna Commercial |
$6,400.75
|
| Rate for Payer: ASR ASR |
$6,898.58
|
| Rate for Payer: ASR Commercial |
$6,898.58
|
| Rate for Payer: BCBS Trust/PPO |
$5,795.52
|
| Rate for Payer: BCN Commercial |
$5,513.89
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,685.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Healthscope Commercial |
$7,111.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,898.58
|
| Rate for Payer: Mclaren Commercial |
$6,400.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,258.51
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.13 |
| Max. Negotiated Rate |
$7,111.94 |
| Rate for Payer: Aetna Commercial |
$6,400.75
|
| Rate for Payer: Aetna Medicare |
$3,151.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: ASR ASR |
$6,898.58
|
| Rate for Payer: ASR Commercial |
$6,898.58
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$5,823.97
|
| Rate for Payer: BCN Commercial |
$5,513.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,685.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$7,111.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,898.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,151.37
|
| Rate for Payer: Mclaren Commercial |
$6,400.75
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$3,466.51
|
| Rate for Payer: PHP Medicaid |
$1,689.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,231.48
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,985.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,258.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$4,884.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP DNSP |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.13 |
| Max. Negotiated Rate |
$7,550.37 |
| Rate for Payer: Aetna Commercial |
$6,795.33
|
| Rate for Payer: Aetna Medicare |
$3,151.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: ASR ASR |
$7,323.86
|
| Rate for Payer: ASR Commercial |
$7,323.86
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$6,183.00
|
| Rate for Payer: BCN Commercial |
$5,853.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$7,097.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$7,550.37
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,151.37
|
| Rate for Payer: Mclaren Commercial |
$6,795.33
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$3,466.51
|
| Rate for Payer: PHP Medicaid |
$1,689.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,615.63
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$5,292.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,644.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$4,884.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP DNSP |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,907.74 |
| Max. Negotiated Rate |
$7,550.37 |
| Rate for Payer: Aetna Commercial |
$6,795.33
|
| Rate for Payer: ASR ASR |
$7,323.86
|
| Rate for Payer: ASR Commercial |
$7,323.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,152.80
|
| Rate for Payer: BCN Commercial |
$5,853.80
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$7,097.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Healthscope Commercial |
$7,550.37
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.86
|
| Rate for Payer: Mclaren Commercial |
$6,795.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,644.33
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$4,119.35 |
| Max. Negotiated Rate |
$6,337.46 |
| Rate for Payer: Aetna Commercial |
$5,703.71
|
| Rate for Payer: ASR ASR |
$6,147.34
|
| Rate for Payer: ASR Commercial |
$6,147.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,164.40
|
| Rate for Payer: BCN Commercial |
$4,913.43
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$5,957.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Healthscope Commercial |
$6,337.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,147.34
|
| Rate for Payer: Mclaren Commercial |
$5,703.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: Nomi Health Commercial |
$5,196.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,576.96
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$624.60 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: Aetna Medicare |
$780.76
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: ASR Commercial |
$1,514.66
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,278.72
|
| Rate for Payer: BCN Commercial |
$1,210.64
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,561.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,514.66
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,368.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,014.98 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: ASR Commercial |
$1,514.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.47
|
| Rate for Payer: BCN Commercial |
$1,210.64
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,561.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,514.66
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
