|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.65
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$88.37 |
| Rate for Payer: Aetna Commercial |
$25.79
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: ASR ASR |
$27.79
|
| Rate for Payer: BCBS Complete |
$3.85
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.62
|
| Rate for Payer: BCN Commercial |
$23.62
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$27.79
|
| Rate for Payer: Healthscope Whirlpool |
$28.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.01
|
| Rate for Payer: Mclaren Commercial |
$25.79
|
| Rate for Payer: Mclaren Medicaid |
$7.01
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$3.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$7.71
|
| Rate for Payer: PHP Medicaid |
$3.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.37
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow Network |
$70.69
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.87
|
| Rate for Payer: UHC Medicaid |
$3.67
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.67
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.65
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$25.79
|
| Rate for Payer: ASR ASR |
$27.79
|
| Rate for Payer: BCBS Trust/PPO |
$23.53
|
| Rate for Payer: BCN Commercial |
$23.53
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$27.79
|
| Rate for Payer: Healthscope Whirlpool |
$28.65
|
| Rate for Payer: Mclaren Commercial |
$25.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.21
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$89.58 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: ASR ASR |
$86.89
|
| Rate for Payer: BCBS Complete |
$3.85
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$73.86
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$86.89
|
| Rate for Payer: Healthscope Whirlpool |
$89.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.01
|
| Rate for Payer: Mclaren Commercial |
$80.62
|
| Rate for Payer: Mclaren Medicaid |
$7.01
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$3.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$7.71
|
| Rate for Payer: PHP Medicaid |
$3.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.37
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow Network |
$70.69
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.87
|
| Rate for Payer: UHC Medicaid |
$3.67
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.67
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.19 |
| Max. Negotiated Rate |
$89.58 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: ASR ASR |
$86.89
|
| Rate for Payer: BCBS Trust/PPO |
$73.56
|
| Rate for Payer: BCN Commercial |
$73.56
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$86.89
|
| Rate for Payer: Healthscope Whirlpool |
$89.58
|
| Rate for Payer: Mclaren Commercial |
$80.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.83
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 100
|
Facility
|
IP
|
$10,050.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,537.50 |
| Max. Negotiated Rate |
$10,050.00 |
| Rate for Payer: Aetna Commercial |
$9,045.00
|
| Rate for Payer: ASR ASR |
$9,748.50
|
| Rate for Payer: BCBS Trust/PPO |
$8,253.06
|
| Rate for Payer: BCN Commercial |
$8,253.06
|
| Rate for Payer: Cash Price |
$8,040.00
|
| Rate for Payer: Cofinity Commercial |
$9,447.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.00
|
| Rate for Payer: Healthscope Commercial |
$9,748.50
|
| Rate for Payer: Healthscope Whirlpool |
$10,050.00
|
| Rate for Payer: Mclaren Commercial |
$9,045.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,542.50
|
| Rate for Payer: Nomi Health Commercial |
$8,241.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,537.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,844.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 100
|
Facility
|
OP
|
$10,050.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,718.50 |
| Max. Negotiated Rate |
$10,050.00 |
| Rate for Payer: Aetna Commercial |
$9,045.00
|
| Rate for Payer: Aetna Medicare |
$3,718.50
|
| Rate for Payer: ASR ASR |
$9,748.50
|
| Rate for Payer: BCBS Complete |
$4,020.00
|
| Rate for Payer: BCBS Trust/PPO |
$8,286.23
|
| Rate for Payer: BCN Commercial |
$8,286.23
|
| Rate for Payer: Cash Price |
$8,040.00
|
| Rate for Payer: Cofinity Commercial |
$9,447.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.00
|
| Rate for Payer: Healthscope Commercial |
$9,748.50
|
| Rate for Payer: Healthscope Whirlpool |
$10,050.00
|
| Rate for Payer: Mclaren Commercial |
$9,045.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,040.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,542.50
|
| Rate for Payer: Nomi Health Commercial |
$8,241.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,537.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,805.81
|
| Rate for Payer: Priority Health Narrow Network |
$7,045.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,844.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
OP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,165.50 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$2,835.00
|
| Rate for Payer: Aetna Medicare |
$1,165.50
|
| Rate for Payer: ASR ASR |
$3,055.50
|
| Rate for Payer: BCBS Complete |
$1,260.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,597.18
|
| Rate for Payer: BCN Commercial |
$2,597.18
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,961.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$3,055.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,150.00
|
| Rate for Payer: Mclaren Commercial |
$2,835.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,520.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,362.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,760.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,208.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,772.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,362.50 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$2,835.00
|
| Rate for Payer: ASR ASR |
$3,055.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,586.78
|
| Rate for Payer: BCN Commercial |
$2,586.78
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,961.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$3,055.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,150.00
|
| Rate for Payer: Mclaren Commercial |
$2,835.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,362.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,772.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
OP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,475.56 |
| Max. Negotiated Rate |
$3,988.00 |
| Rate for Payer: Aetna Commercial |
$3,589.20
|
| Rate for Payer: Aetna Medicare |
$1,475.56
|
| Rate for Payer: ASR ASR |
$3,868.36
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,288.11
|
| Rate for Payer: BCN Commercial |
$3,288.11
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,748.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,868.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,988.00
|
| Rate for Payer: Mclaren Commercial |
$3,589.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,190.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,991.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,494.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,795.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
IP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,991.00 |
| Max. Negotiated Rate |
$3,988.00 |
| Rate for Payer: Aetna Commercial |
$3,589.20
|
| Rate for Payer: ASR ASR |
$3,868.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,274.95
|
| Rate for Payer: BCN Commercial |
$3,274.95
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,748.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,868.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,988.00
|
| Rate for Payer: Mclaren Commercial |
$3,589.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,991.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
OP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,709.40 |
| Max. Negotiated Rate |
$4,620.00 |
| Rate for Payer: Aetna Commercial |
$4,158.00
|
| Rate for Payer: Aetna Medicare |
$1,709.40
|
| Rate for Payer: ASR ASR |
$4,481.40
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,809.19
|
| Rate for Payer: BCN Commercial |
$3,809.19
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$4,342.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,481.40
|
| Rate for Payer: Healthscope Whirlpool |
$4,620.00
|
| Rate for Payer: Mclaren Commercial |
$4,158.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,696.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,465.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,048.04
|
| Rate for Payer: Priority Health Narrow Network |
$3,238.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,065.60
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
IP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,465.00 |
| Max. Negotiated Rate |
$4,620.00 |
| Rate for Payer: Aetna Commercial |
$4,158.00
|
| Rate for Payer: ASR ASR |
$4,481.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,793.94
|
| Rate for Payer: BCN Commercial |
$3,793.94
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$4,342.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,481.40
|
| Rate for Payer: Healthscope Whirlpool |
$4,620.00
|
| Rate for Payer: Mclaren Commercial |
$4,158.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,465.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,065.60
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
OP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,771.56 |
| Max. Negotiated Rate |
$4,788.00 |
| Rate for Payer: Aetna Commercial |
$4,309.20
|
| Rate for Payer: Aetna Medicare |
$1,771.56
|
| Rate for Payer: ASR ASR |
$4,644.36
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,947.71
|
| Rate for Payer: BCN Commercial |
$3,947.71
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,644.36
|
| Rate for Payer: Healthscope Whirlpool |
$4,788.00
|
| Rate for Payer: Mclaren Commercial |
$4,309.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,830.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,591.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,195.25
|
| Rate for Payer: Priority Health Narrow Network |
$3,356.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,213.44
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
IP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,591.00 |
| Max. Negotiated Rate |
$4,788.00 |
| Rate for Payer: Aetna Commercial |
$4,309.20
|
| Rate for Payer: ASR ASR |
$4,644.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,931.91
|
| Rate for Payer: BCN Commercial |
$3,931.91
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,500.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,644.36
|
| Rate for Payer: Healthscope Whirlpool |
$4,788.00
|
| Rate for Payer: Mclaren Commercial |
$4,309.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,591.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,213.44
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
OP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$414.03 |
| Max. Negotiated Rate |
$1,119.00 |
| Rate for Payer: Aetna Commercial |
$1,007.10
|
| Rate for Payer: Aetna Medicare |
$414.03
|
| Rate for Payer: ASR ASR |
$1,085.43
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS Trust/PPO |
$922.62
|
| Rate for Payer: BCN Commercial |
$922.62
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$1,051.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,085.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,119.00
|
| Rate for Payer: Mclaren Commercial |
$1,007.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$895.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$980.47
|
| Rate for Payer: Priority Health Narrow Network |
$784.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.72
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
IP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$839.25 |
| Max. Negotiated Rate |
$1,119.00 |
| Rate for Payer: Aetna Commercial |
$1,007.10
|
| Rate for Payer: ASR ASR |
$1,085.43
|
| Rate for Payer: BCBS Trust/PPO |
$918.92
|
| Rate for Payer: BCN Commercial |
$918.92
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$1,051.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,085.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,119.00
|
| Rate for Payer: Mclaren Commercial |
$1,007.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.72
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
OP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$496.73 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$1,208.25
|
| Rate for Payer: Aetna Medicare |
$496.73
|
| Rate for Payer: ASR ASR |
$1,302.22
|
| Rate for Payer: BCBS Complete |
$537.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.89
|
| Rate for Payer: BCN Commercial |
$1,106.89
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,261.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,302.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.50
|
| Rate for Payer: Mclaren Commercial |
$1,208.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,074.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: Nomi Health Commercial |
$1,100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,006.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,176.30
|
| Rate for Payer: Priority Health Narrow Network |
$941.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.40
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
IP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,006.88 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$1,208.25
|
| Rate for Payer: ASR ASR |
$1,302.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.46
|
| Rate for Payer: BCN Commercial |
$1,102.46
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,261.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,302.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.50
|
| Rate for Payer: Mclaren Commercial |
$1,208.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: Nomi Health Commercial |
$1,100.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,006.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.40
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
IP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,153.12 |
| Max. Negotiated Rate |
$1,537.50 |
| Rate for Payer: Aetna Commercial |
$1,383.75
|
| Rate for Payer: ASR ASR |
$1,491.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.60
|
| Rate for Payer: BCN Commercial |
$1,262.60
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,491.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,537.50
|
| Rate for Payer: Mclaren Commercial |
$1,383.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: Nomi Health Commercial |
$1,260.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,153.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,353.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
OP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$568.88 |
| Max. Negotiated Rate |
$1,537.50 |
| Rate for Payer: Aetna Commercial |
$1,383.75
|
| Rate for Payer: Aetna Medicare |
$568.88
|
| Rate for Payer: ASR ASR |
$1,491.38
|
| Rate for Payer: BCBS Complete |
$615.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.67
|
| Rate for Payer: BCN Commercial |
$1,267.67
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,491.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,537.50
|
| Rate for Payer: Mclaren Commercial |
$1,383.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,230.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: Nomi Health Commercial |
$1,260.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,153.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,347.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,353.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,812.50 |
| Max. Negotiated Rate |
$3,750.00 |
| Rate for Payer: Aetna Commercial |
$3,375.00
|
| Rate for Payer: ASR ASR |
$3,637.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.50
|
| Rate for Payer: BCN Commercial |
$3,079.50
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$3,525.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,637.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,750.00
|
| Rate for Payer: Mclaren Commercial |
$3,375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Nomi Health Commercial |
$3,075.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,812.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,300.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,387.50 |
| Max. Negotiated Rate |
$3,750.00 |
| Rate for Payer: Aetna Commercial |
$3,375.00
|
| Rate for Payer: Aetna Medicare |
$1,387.50
|
| Rate for Payer: ASR ASR |
$3,637.50
|
| Rate for Payer: BCBS Complete |
$1,500.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,091.88
|
| Rate for Payer: BCN Commercial |
$3,091.88
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$3,525.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,637.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,750.00
|
| Rate for Payer: Mclaren Commercial |
$3,375.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Nomi Health Commercial |
$3,075.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,812.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,285.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,628.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,300.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.28 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: Aetna Medicare |
$162.28
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: BCBS Complete |
$175.44
|
| Rate for Payer: BCBS Trust/PPO |
$361.63
|
| Rate for Payer: BCN Commercial |
$361.63
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$425.44
|
| Rate for Payer: Healthscope Whirlpool |
$438.60
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$384.30
|
| Rate for Payer: Priority Health Narrow Network |
$307.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$328.95 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: BCBS Trust/PPO |
$360.18
|
| Rate for Payer: BCN Commercial |
$360.18
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$425.44
|
| Rate for Payer: Healthscope Whirlpool |
$438.60
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$925.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$2,250.00
|
| Rate for Payer: Aetna Medicare |
$925.00
|
| Rate for Payer: ASR ASR |
$2,425.00
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,061.25
|
| Rate for Payer: BCN Commercial |
$2,061.25
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,350.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Healthscope Commercial |
$2,425.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,500.00
|
| Rate for Payer: Mclaren Commercial |
$2,250.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: Nomi Health Commercial |
$2,050.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,875.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,190.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,752.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,200.00
|
|
