|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$954.60 |
| Rate for Payer: Aetna Commercial |
$859.14
|
| 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 |
$925.96
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$787.07
|
| Rate for Payer: BCN Commercial |
$787.07
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$763.68
|
| 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: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$925.96
|
| Rate for Payer: Healthscope Whirlpool |
$954.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$859.14
|
| 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 |
$811.41
|
| Rate for Payer: Nomi Health Commercial |
$782.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| 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 |
$836.42
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$669.17
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$840.05
|
| 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 EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$17,829.15 |
| Rate for Payer: Aetna Commercial |
$15,406.13
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$16,604.38
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$14,113.73
|
| Rate for Payer: BCN Commercial |
$14,113.73
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Commercial |
$16,090.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$16,604.38
|
| Rate for Payer: Healthscope Whirlpool |
$17,117.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$15,406.13
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Nomi Health Commercial |
$14,036.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,161.68
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$8,929.34
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,063.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,838.44 |
| Max. Negotiated Rate |
$17,117.92 |
| Rate for Payer: Aetna Commercial |
$15,406.13
|
| Rate for Payer: ASR ASR |
$16,604.38
|
| Rate for Payer: BCBS Trust/PPO |
$14,057.24
|
| Rate for Payer: BCN Commercial |
$14,057.24
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Commercial |
$16,090.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Healthscope Commercial |
$16,604.38
|
| Rate for Payer: Healthscope Whirlpool |
$17,117.92
|
| Rate for Payer: Mclaren Commercial |
$15,406.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Nomi Health Commercial |
$14,036.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,063.77
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,754.08
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,065.56 |
| Max. Negotiated Rate |
$18,754.08 |
| Rate for Payer: Aetna Commercial |
$16,878.67
|
| Rate for Payer: ASR ASR |
$18,191.46
|
| Rate for Payer: BCBS Trust/PPO |
$15,400.85
|
| Rate for Payer: BCN Commercial |
$15,400.85
|
| Rate for Payer: Cash Price |
$15,003.26
|
| Rate for Payer: Cofinity Commercial |
$17,628.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,003.26
|
| Rate for Payer: Healthscope Commercial |
$18,191.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,754.08
|
| Rate for Payer: Mclaren Commercial |
$16,878.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,940.97
|
| Rate for Payer: Nomi Health Commercial |
$15,378.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,065.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,503.59
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,754.08
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,929.34 |
| Max. Negotiated Rate |
$28,311.87 |
| Rate for Payer: Aetna Commercial |
$16,878.67
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$18,191.46
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$15,462.74
|
| Rate for Payer: BCN Commercial |
$15,462.74
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$15,003.26
|
| Rate for Payer: Cash Price |
$15,003.26
|
| Rate for Payer: Cofinity Commercial |
$17,628.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,003.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$18,191.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,754.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$16,878.67
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,940.97
|
| Rate for Payer: Nomi Health Commercial |
$15,378.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,065.56
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,161.68
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$8,929.34
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,503.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
IP
|
$7,781.26
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,835.94 |
| Max. Negotiated Rate |
$7,781.26 |
| Rate for Payer: Aetna Commercial |
$7,003.13
|
| Rate for Payer: ASR ASR |
$7,547.82
|
| Rate for Payer: BCBS Trust/PPO |
$6,389.97
|
| Rate for Payer: BCN Commercial |
$6,389.97
|
| Rate for Payer: Cash Price |
$6,225.01
|
| Rate for Payer: Cofinity Commercial |
$7,314.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,225.01
|
| Rate for Payer: Healthscope Commercial |
$7,547.82
|
| Rate for Payer: Healthscope Whirlpool |
$7,781.26
|
| Rate for Payer: Mclaren Commercial |
$7,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,614.07
|
| Rate for Payer: Nomi Health Commercial |
$6,380.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,835.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,847.51
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
OP
|
$7,781.26
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,454.66 |
| Max. Negotiated Rate |
$28,311.87 |
| Rate for Payer: Aetna Commercial |
$7,003.13
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$7,547.82
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$6,415.65
|
| Rate for Payer: BCN Commercial |
$6,415.65
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$6,225.01
|
| Rate for Payer: Cash Price |
$6,225.01
|
| Rate for Payer: Cofinity Commercial |
$7,314.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,225.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$7,547.82
|
| Rate for Payer: Healthscope Whirlpool |
$7,781.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$7,003.13
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,614.07
|
| Rate for Payer: Nomi Health Commercial |
$6,380.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,835.94
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,817.94
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$5,454.66
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,847.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$693.47 |
| Max. Negotiated Rate |
$1,874.25 |
| Rate for Payer: Aetna Commercial |
$1,686.83
|
| Rate for Payer: Aetna Medicare |
$693.47
|
| Rate for Payer: ASR ASR |
$1,818.02
|
| Rate for Payer: BCBS Complete |
$749.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,545.32
|
| Rate for Payer: BCN Commercial |
$1,545.32
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,761.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,818.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,874.25
|
| Rate for Payer: Mclaren Commercial |
$1,686.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,499.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,642.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,313.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,649.34
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
IP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,405.69 |
| Max. Negotiated Rate |
$1,874.25 |
| Rate for Payer: Aetna Commercial |
$1,686.83
|
| Rate for Payer: ASR ASR |
$1,818.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,539.13
|
| Rate for Payer: BCN Commercial |
$1,539.13
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,761.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,818.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,874.25
|
| Rate for Payer: Mclaren Commercial |
$1,686.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,649.34
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$144.59
|
| Rate for Payer: Aetna Medicare |
$59.44
|
| Rate for Payer: ASR ASR |
$155.83
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS Trust/PPO |
$132.46
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$151.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$155.83
|
| Rate for Payer: Healthscope Whirlpool |
$160.65
|
| Rate for Payer: Mclaren Commercial |
$144.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$140.76
|
| Rate for Payer: Priority Health Narrow Network |
$112.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.37
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
IP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.49 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$144.59
|
| Rate for Payer: ASR ASR |
$155.83
|
| Rate for Payer: BCBS Trust/PPO |
$131.93
|
| Rate for Payer: BCN Commercial |
$131.93
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$151.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$155.83
|
| Rate for Payer: Healthscope Whirlpool |
$160.65
|
| Rate for Payer: Mclaren Commercial |
$144.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.37
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.32 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.75
|
| Rate for Payer: Aetna Medicare |
$178.32
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: BCBS Complete |
$192.78
|
| Rate for Payer: BCBS Trust/PPO |
$397.37
|
| Rate for Payer: BCN Commercial |
$397.37
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$453.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$467.49
|
| Rate for Payer: Healthscope Whirlpool |
$481.95
|
| Rate for Payer: Mclaren Commercial |
$433.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$422.28
|
| Rate for Payer: Priority Health Narrow Network |
$337.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.12
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$361.46 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.75
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: BCBS Trust/PPO |
$395.78
|
| Rate for Payer: BCN Commercial |
$395.78
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$453.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$467.49
|
| Rate for Payer: Healthscope Whirlpool |
$481.95
|
| Rate for Payer: Mclaren Commercial |
$433.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.12
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$875.76 |
| Max. Negotiated Rate |
$2,366.91 |
| Rate for Payer: Aetna Commercial |
$2,130.22
|
| Rate for Payer: Aetna Medicare |
$875.76
|
| Rate for Payer: ASR ASR |
$2,295.90
|
| Rate for Payer: BCBS Complete |
$946.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.52
|
| Rate for Payer: BCN Commercial |
$1,951.52
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,295.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,366.91
|
| Rate for Payer: Mclaren Commercial |
$2,130.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,893.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,775.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,073.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,659.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.88
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,775.18 |
| Max. Negotiated Rate |
$2,366.91 |
| Rate for Payer: Aetna Commercial |
$2,130.22
|
| Rate for Payer: ASR ASR |
$2,295.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.71
|
| Rate for Payer: BCN Commercial |
$1,943.71
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,295.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,366.91
|
| Rate for Payer: Mclaren Commercial |
$2,130.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,775.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.88
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$18,123.76
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,592.82 |
| Max. Negotiated Rate |
$18,123.76 |
| Rate for Payer: Aetna Commercial |
$16,311.38
|
| Rate for Payer: ASR ASR |
$17,580.05
|
| Rate for Payer: BCBS Trust/PPO |
$14,883.23
|
| Rate for Payer: BCN Commercial |
$14,883.23
|
| Rate for Payer: Cash Price |
$14,499.01
|
| Rate for Payer: Cofinity Commercial |
$17,036.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,499.01
|
| Rate for Payer: Healthscope Commercial |
$17,580.05
|
| Rate for Payer: Healthscope Whirlpool |
$18,123.76
|
| Rate for Payer: Mclaren Commercial |
$16,311.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,405.20
|
| Rate for Payer: Nomi Health Commercial |
$14,861.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,592.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,948.91
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$18,123.76
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$18,123.76 |
| Rate for Payer: Aetna Commercial |
$16,311.38
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$17,580.05
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$14,943.04
|
| Rate for Payer: BCN Commercial |
$14,943.04
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$14,499.01
|
| Rate for Payer: Cash Price |
$14,499.01
|
| Rate for Payer: Cofinity Commercial |
$17,036.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,499.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$17,580.05
|
| Rate for Payer: Healthscope Whirlpool |
$18,123.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$16,311.38
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,405.20
|
| Rate for Payer: Nomi Health Commercial |
$14,861.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,592.82
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,161.68
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$8,929.34
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,948.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,359.41
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,019.56 |
| Max. Negotiated Rate |
$5,359.41 |
| Rate for Payer: Aetna Commercial |
$4,823.47
|
| Rate for Payer: ASR ASR |
$5,198.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,401.15
|
| Rate for Payer: BCN Commercial |
$4,401.15
|
| Rate for Payer: Cash Price |
$4,287.53
|
| Rate for Payer: Cofinity Commercial |
$5,037.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,287.53
|
| Rate for Payer: Healthscope Commercial |
$5,198.63
|
| Rate for Payer: Healthscope Whirlpool |
$5,359.41
|
| Rate for Payer: Mclaren Commercial |
$4,823.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,555.50
|
| Rate for Payer: Nomi Health Commercial |
$4,394.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,019.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,716.28
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,359.41
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,756.95 |
| Max. Negotiated Rate |
$17,829.15 |
| Rate for Payer: Aetna Commercial |
$4,823.47
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$5,198.63
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,418.83
|
| Rate for Payer: BCN Commercial |
$4,418.83
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$4,287.53
|
| Rate for Payer: Cash Price |
$4,287.53
|
| Rate for Payer: Cofinity Commercial |
$5,037.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,287.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$5,198.63
|
| Rate for Payer: Healthscope Whirlpool |
$5,359.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$4,823.47
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,555.50
|
| Rate for Payer: Nomi Health Commercial |
$4,394.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,019.56
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,695.92
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$3,756.95
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,716.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$437.34
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.82 |
| Max. Negotiated Rate |
$437.34 |
| Rate for Payer: Aetna Commercial |
$393.61
|
| Rate for Payer: Aetna Medicare |
$161.82
|
| Rate for Payer: ASR ASR |
$424.22
|
| Rate for Payer: BCBS Complete |
$174.94
|
| Rate for Payer: BCBS Trust/PPO |
$360.59
|
| Rate for Payer: BCN Commercial |
$360.59
|
| Rate for Payer: Cash Price |
$349.87
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.87
|
| Rate for Payer: Healthscope Commercial |
$424.22
|
| Rate for Payer: Healthscope Whirlpool |
$437.34
|
| Rate for Payer: Mclaren Commercial |
$393.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.74
|
| Rate for Payer: Nomi Health Commercial |
$358.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$383.20
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.86
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$437.34
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.00 |
| Max. Negotiated Rate |
$437.34 |
| Rate for Payer: Aetna Commercial |
$393.61
|
| Rate for Payer: ASR ASR |
$424.22
|
| Rate for Payer: BCBS Trust/PPO |
$359.14
|
| Rate for Payer: BCN Commercial |
$359.14
|
| Rate for Payer: Cash Price |
$349.87
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.87
|
| Rate for Payer: Healthscope Commercial |
$424.22
|
| Rate for Payer: Healthscope Whirlpool |
$437.34
|
| Rate for Payer: Mclaren Commercial |
$393.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.74
|
| Rate for Payer: Nomi Health Commercial |
$358.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.86
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$22,634.58
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$22,634.58 |
| Rate for Payer: Aetna Commercial |
$20,371.12
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$21,955.54
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$18,662.21
|
| Rate for Payer: BCN Commercial |
$18,662.21
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$18,107.66
|
| Rate for Payer: Cash Price |
$18,107.66
|
| Rate for Payer: Cofinity Commercial |
$21,276.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,107.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$21,955.54
|
| Rate for Payer: Healthscope Whirlpool |
$22,634.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$20,371.12
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,239.39
|
| Rate for Payer: Nomi Health Commercial |
$18,560.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,975.94
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,161.68
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$8,929.34
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,918.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$22,634.58
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,975.94 |
| Max. Negotiated Rate |
$22,634.58 |
| Rate for Payer: Aetna Commercial |
$20,371.12
|
| Rate for Payer: ASR ASR |
$21,955.54
|
| Rate for Payer: BCBS Trust/PPO |
$18,587.52
|
| Rate for Payer: BCN Commercial |
$18,587.52
|
| Rate for Payer: Cash Price |
$18,107.66
|
| Rate for Payer: Cofinity Commercial |
$21,276.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,107.66
|
| Rate for Payer: Healthscope Commercial |
$21,955.54
|
| Rate for Payer: Healthscope Whirlpool |
$22,634.58
|
| Rate for Payer: Mclaren Commercial |
$20,371.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,239.39
|
| Rate for Payer: Nomi Health Commercial |
$18,560.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,975.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,918.43
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$6,020.46
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,515.35 |
| Max. Negotiated Rate |
$6,020.46 |
| Rate for Payer: Aetna Commercial |
$5,418.41
|
| Rate for Payer: ASR ASR |
$5,839.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,944.00
|
| Rate for Payer: BCN Commercial |
$4,944.00
|
| Rate for Payer: Cash Price |
$4,816.37
|
| Rate for Payer: Cofinity Commercial |
$5,659.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,816.37
|
| Rate for Payer: Healthscope Commercial |
$5,839.85
|
| Rate for Payer: Healthscope Whirlpool |
$6,020.46
|
| Rate for Payer: Mclaren Commercial |
$5,418.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,117.39
|
| Rate for Payer: Nomi Health Commercial |
$4,936.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,515.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,298.00
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$6,020.46
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,227.57 |
| Max. Negotiated Rate |
$6,020.46 |
| Rate for Payer: Aetna Commercial |
$5,418.41
|
| Rate for Payer: Aetna Medicare |
$2,227.57
|
| Rate for Payer: ASR ASR |
$5,839.85
|
| Rate for Payer: BCBS Complete |
$2,408.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,963.87
|
| Rate for Payer: BCN Commercial |
$4,963.87
|
| Rate for Payer: Cash Price |
$4,816.37
|
| Rate for Payer: Cofinity Commercial |
$5,659.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,816.37
|
| Rate for Payer: Healthscope Commercial |
$5,839.85
|
| Rate for Payer: Healthscope Whirlpool |
$6,020.46
|
| Rate for Payer: Mclaren Commercial |
$5,418.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,816.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,117.39
|
| Rate for Payer: Nomi Health Commercial |
$4,936.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,515.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,275.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,220.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,298.00
|
|
