|
HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 66
|
Facility
|
IP
|
$6,691.20
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,018.40 |
| Max. Negotiated Rate |
$6,691.20 |
| Rate for Payer: Aetna Commercial |
$6,022.08
|
| Rate for Payer: ASR ASR |
$6,490.46
|
| Rate for Payer: BCBS Trust/PPO |
$5,494.81
|
| Rate for Payer: BCN Commercial |
$5,494.81
|
| Rate for Payer: Cash Price |
$5,352.96
|
| Rate for Payer: Cofinity Commercial |
$6,289.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,352.96
|
| Rate for Payer: Healthscope Commercial |
$6,490.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,691.20
|
| Rate for Payer: Mclaren Commercial |
$6,022.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,687.52
|
| Rate for Payer: Nomi Health Commercial |
$5,486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,018.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,888.26
|
|
|
HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 66
|
Facility
|
OP
|
$6,691.20
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,475.74 |
| Max. Negotiated Rate |
$6,691.20 |
| Rate for Payer: Aetna Commercial |
$6,022.08
|
| Rate for Payer: Aetna Medicare |
$2,475.74
|
| Rate for Payer: ASR ASR |
$6,490.46
|
| Rate for Payer: BCBS Complete |
$2,676.48
|
| Rate for Payer: BCBS Trust/PPO |
$5,516.89
|
| Rate for Payer: BCN Commercial |
$5,516.89
|
| Rate for Payer: Cash Price |
$5,352.96
|
| Rate for Payer: Cofinity Commercial |
$6,289.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,352.96
|
| Rate for Payer: Healthscope Commercial |
$6,490.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,691.20
|
| Rate for Payer: Mclaren Commercial |
$6,022.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,352.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,687.52
|
| Rate for Payer: Nomi Health Commercial |
$5,486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,018.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,862.83
|
| Rate for Payer: Priority Health Narrow Network |
$4,690.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,888.26
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 12
|
Facility
|
IP
|
$1,232.87
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
27200325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$924.65 |
| Max. Negotiated Rate |
$1,232.87 |
| Rate for Payer: Aetna Commercial |
$1,109.58
|
| Rate for Payer: ASR ASR |
$1,195.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.43
|
| Rate for Payer: BCN Commercial |
$1,012.43
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,158.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,195.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.87
|
| Rate for Payer: Mclaren Commercial |
$1,109.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.93
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 12
|
Facility
|
OP
|
$1,232.87
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
27200325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$456.16 |
| Max. Negotiated Rate |
$1,232.87 |
| Rate for Payer: Aetna Commercial |
$1,109.58
|
| Rate for Payer: Aetna Medicare |
$456.16
|
| Rate for Payer: ASR ASR |
$1,195.88
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.50
|
| Rate for Payer: BCN Commercial |
$1,016.50
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,158.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,195.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.87
|
| Rate for Payer: Mclaren Commercial |
$1,109.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$986.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,080.24
|
| Rate for Payer: Priority Health Narrow Network |
$864.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.93
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
IP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,153.47 |
| Max. Negotiated Rate |
$2,871.30 |
| Rate for Payer: Aetna Commercial |
$2,584.17
|
| Rate for Payer: ASR ASR |
$2,785.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,357.91
|
| Rate for Payer: BCN Commercial |
$2,357.91
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Commercial |
$2,699.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Healthscope Commercial |
$2,785.16
|
| Rate for Payer: Healthscope Whirlpool |
$2,871.30
|
| Rate for Payer: Mclaren Commercial |
$2,584.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,526.74
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
OP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,062.38 |
| Max. Negotiated Rate |
$2,871.30 |
| Rate for Payer: Aetna Commercial |
$2,584.17
|
| Rate for Payer: Aetna Medicare |
$1,062.38
|
| Rate for Payer: ASR ASR |
$2,785.16
|
| Rate for Payer: BCBS Complete |
$1,148.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,367.39
|
| Rate for Payer: BCN Commercial |
$2,367.39
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Commercial |
$2,699.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Healthscope Commercial |
$2,785.16
|
| Rate for Payer: Healthscope Whirlpool |
$2,871.30
|
| Rate for Payer: Mclaren Commercial |
$2,584.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,515.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,012.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,526.74
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
IP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,448.00 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,937.60
|
| Rate for Payer: ASR ASR |
$3,166.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,680.40
|
| Rate for Payer: BCN Commercial |
$2,680.40
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Commercial |
$3,068.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Healthscope Commercial |
$3,166.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,264.00
|
| Rate for Payer: Mclaren Commercial |
$2,937.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Nomi Health Commercial |
$2,676.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,448.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,872.32
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
OP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,207.68 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,937.60
|
| Rate for Payer: Aetna Medicare |
$1,207.68
|
| Rate for Payer: ASR ASR |
$3,166.08
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,691.17
|
| Rate for Payer: BCN Commercial |
$2,691.17
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Commercial |
$3,068.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Healthscope Commercial |
$3,166.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,264.00
|
| Rate for Payer: Mclaren Commercial |
$2,937.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,611.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Nomi Health Commercial |
$2,676.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,448.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,859.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,288.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,872.32
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
OP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: Aetna Medicare |
$254.75
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$567.67
|
| Rate for Payer: BCN Commercial |
$567.67
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$667.85
|
| Rate for Payer: Healthscope Whirlpool |
$688.50
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$603.26
|
| Rate for Payer: Priority Health Narrow Network |
$482.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
IP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$516.38 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: BCBS Trust/PPO |
$565.40
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$667.85
|
| Rate for Payer: Healthscope Whirlpool |
$688.50
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
IP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,666.17 |
| Max. Negotiated Rate |
$4,888.23 |
| Rate for Payer: Aetna Commercial |
$4,399.41
|
| Rate for Payer: ASR ASR |
$4,741.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,014.21
|
| Rate for Payer: BCN Commercial |
$4,014.21
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Commercial |
$4,594.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Healthscope Commercial |
$4,741.58
|
| Rate for Payer: Healthscope Whirlpool |
$4,888.23
|
| Rate for Payer: Mclaren Commercial |
$4,399.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Nomi Health Commercial |
$4,008.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,301.64
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
OP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,808.65 |
| Max. Negotiated Rate |
$4,888.23 |
| Rate for Payer: Aetna Commercial |
$4,399.41
|
| Rate for Payer: Aetna Medicare |
$1,808.65
|
| Rate for Payer: ASR ASR |
$4,741.58
|
| Rate for Payer: BCBS Complete |
$1,955.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.35
|
| Rate for Payer: BCN Commercial |
$4,030.35
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Commercial |
$4,594.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Healthscope Commercial |
$4,741.58
|
| Rate for Payer: Healthscope Whirlpool |
$4,888.23
|
| Rate for Payer: Mclaren Commercial |
$4,399.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,910.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Nomi Health Commercial |
$4,008.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,283.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,426.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,301.64
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
IP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$204.20 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$245.04
|
| Rate for Payer: ASR ASR |
$264.10
|
| Rate for Payer: BCBS Trust/PPO |
$223.59
|
| Rate for Payer: BCN Commercial |
$223.59
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Healthscope Commercial |
$264.10
|
| Rate for Payer: Healthscope Whirlpool |
$272.27
|
| Rate for Payer: Mclaren Commercial |
$245.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Nomi Health Commercial |
$223.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.60
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
OP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$100.74 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$245.04
|
| Rate for Payer: Aetna Medicare |
$100.74
|
| Rate for Payer: ASR ASR |
$264.10
|
| Rate for Payer: BCBS Complete |
$108.91
|
| Rate for Payer: BCBS Trust/PPO |
$224.49
|
| Rate for Payer: BCN Commercial |
$224.49
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Healthscope Commercial |
$264.10
|
| Rate for Payer: Healthscope Whirlpool |
$272.27
|
| Rate for Payer: Mclaren Commercial |
$245.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Nomi Health Commercial |
$223.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$238.56
|
| Rate for Payer: Priority Health Narrow Network |
$190.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.60
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
OP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,064.56 |
| Max. Negotiated Rate |
$28,474.35 |
| Rate for Payer: Aetna Commercial |
$25,626.92
|
| Rate for Payer: Aetna Medicare |
$7,771.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: ASR ASR |
$27,620.12
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$23,477.10
|
| Rate for Payer: BCN Commercial |
$23,477.10
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Commercial |
$26,765.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$27,620.12
|
| Rate for Payer: Healthscope Whirlpool |
$28,474.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,771.62
|
| Rate for Payer: Mclaren Commercial |
$25,626.92
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$4,268.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Nomi Health Commercial |
$23,348.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$8,548.78
|
| Rate for Payer: PHP Medicaid |
$4,165.59
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24,949.23
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health Narrow Network |
$19,960.52
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,057.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Exchange |
$12,046.01
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP DNSP |
$7,771.62
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
IP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$21,355.76 |
| Max. Negotiated Rate |
$28,474.35 |
| Rate for Payer: Aetna Commercial |
$25,626.92
|
| Rate for Payer: ASR ASR |
$27,620.12
|
| Rate for Payer: BCBS Trust/PPO |
$23,383.14
|
| Rate for Payer: BCN Commercial |
$23,383.14
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Commercial |
$26,765.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Healthscope Commercial |
$27,620.12
|
| Rate for Payer: Healthscope Whirlpool |
$28,474.35
|
| Rate for Payer: Mclaren Commercial |
$25,626.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Nomi Health Commercial |
$23,348.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,057.43
|
|
|
HC ELM IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ELM IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
IP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,070.99 |
| Max. Negotiated Rate |
$12,094.65 |
| Rate for Payer: Aetna Commercial |
$10,885.18
|
| Rate for Payer: ASR ASR |
$11,731.81
|
| Rate for Payer: BCBS Trust/PPO |
$9,932.13
|
| Rate for Payer: BCN Commercial |
$9,932.13
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$11,368.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$11,731.81
|
| Rate for Payer: Healthscope Whirlpool |
$12,094.65
|
| Rate for Payer: Mclaren Commercial |
$10,885.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,643.29
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
OP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,475.02 |
| Max. Negotiated Rate |
$12,094.65 |
| Rate for Payer: Aetna Commercial |
$10,885.18
|
| Rate for Payer: Aetna Medicare |
$4,475.02
|
| Rate for Payer: ASR ASR |
$11,731.81
|
| Rate for Payer: BCBS Complete |
$4,837.86
|
| Rate for Payer: BCBS Trust/PPO |
$9,972.04
|
| Rate for Payer: BCN Commercial |
$9,972.04
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$11,368.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$11,731.81
|
| Rate for Payer: Healthscope Whirlpool |
$12,094.65
|
| Rate for Payer: Mclaren Commercial |
$10,885.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,675.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,597.33
|
| Rate for Payer: Priority Health Narrow Network |
$8,478.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,643.29
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,134.58 |
| Max. Negotiated Rate |
$5,769.13 |
| Rate for Payer: Aetna Commercial |
$5,192.22
|
| Rate for Payer: Aetna Medicare |
$2,134.58
|
| Rate for Payer: ASR ASR |
$5,596.06
|
| Rate for Payer: BCBS Complete |
$2,307.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,756.65
|
| Rate for Payer: BCN Commercial |
$4,756.65
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Commercial |
$5,422.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Healthscope Commercial |
$5,596.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,769.13
|
| Rate for Payer: Mclaren Commercial |
$5,192.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,615.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Nomi Health Commercial |
$4,730.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,054.91
|
| Rate for Payer: Priority Health Narrow Network |
$4,044.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,076.83
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,326.85 |
| Max. Negotiated Rate |
$5,769.13 |
| Rate for Payer: Aetna Commercial |
$5,192.22
|
| Rate for Payer: ASR ASR |
$5,596.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,737.61
|
| Rate for Payer: BCN Commercial |
$4,737.61
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Commercial |
$5,422.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Healthscope Commercial |
$5,596.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,769.13
|
| Rate for Payer: Mclaren Commercial |
$5,192.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Nomi Health Commercial |
$4,730.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,076.83
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,565.54 |
| Max. Negotiated Rate |
$2,087.38 |
| Rate for Payer: Aetna Commercial |
$1,878.64
|
| Rate for Payer: ASR ASR |
$2,024.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.16
|
| Rate for Payer: BCN Commercial |
$1,714.16
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Commercial |
$1,962.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Healthscope Commercial |
$2,024.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,087.38
|
| Rate for Payer: Mclaren Commercial |
$1,878.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Nomi Health Commercial |
$1,711.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,836.89
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$2,087.38 |
| Rate for Payer: Aetna Commercial |
$1,878.64
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$2,024.76
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,721.04
|
| Rate for Payer: BCN Commercial |
$1,721.04
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Commercial |
$1,962.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$2,024.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,087.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,878.64
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Nomi Health Commercial |
$1,711.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,828.96
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,463.25
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,836.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$715.95 |
| Max. Negotiated Rate |
$954.60 |
| Rate for Payer: Aetna Commercial |
$859.14
|
| Rate for Payer: ASR ASR |
$925.96
|
| Rate for Payer: BCBS Trust/PPO |
$783.92
|
| Rate for Payer: BCN Commercial |
$783.92
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cofinity Commercial |
$897.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$763.68
|
| Rate for Payer: Healthscope Commercial |
$925.96
|
| Rate for Payer: Healthscope Whirlpool |
$954.60
|
| Rate for Payer: Mclaren Commercial |
$859.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.41
|
| Rate for Payer: Nomi Health Commercial |
$782.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$840.05
|
|
