|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$75.95 |
| Rate for Payer: Aetna Commercial |
$68.36
|
| Rate for Payer: Aetna Medicare |
$36.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: ASR ASR |
$73.67
|
| Rate for Payer: ASR Commercial |
$73.67
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$62.20
|
| Rate for Payer: BCN Commercial |
$58.88
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$71.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$75.95
|
| Rate for Payer: Healthscope Whirlpool |
$73.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.54
|
| Rate for Payer: Mclaren Commercial |
$68.36
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$40.19
|
| Rate for Payer: PHP Medicaid |
$19.59
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$34.03
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$56.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP DNSP |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: VA VA |
$36.54
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$80.15 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| 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 |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.01
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| 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 |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| 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 |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.15
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow Network |
$64.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.76
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$87.82 |
| Rate for Payer: Aetna Commercial |
$79.04
|
| Rate for Payer: ASR ASR |
$85.19
|
| Rate for Payer: ASR Commercial |
$85.19
|
| Rate for Payer: BCBS Trust/PPO |
$71.56
|
| Rate for Payer: BCN Commercial |
$68.09
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$82.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Whirlpool |
$85.19
|
| Rate for Payer: Mclaren Commercial |
$79.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.28
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$87.82 |
| Rate for Payer: Aetna Commercial |
$79.04
|
| 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 |
$85.19
|
| Rate for Payer: ASR Commercial |
$85.19
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$71.92
|
| Rate for Payer: BCN Commercial |
$68.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$82.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Whirlpool |
$85.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.01
|
| Rate for Payer: Mclaren Commercial |
$79.04
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| 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 |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| 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 |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.15
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow Network |
$64.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.76
|
| Rate for Payer: VA VA |
$7.01
|
|
|
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 |
$1,260.00 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$2,835.00
|
| Rate for Payer: Aetna Medicare |
$1,575.00
|
| Rate for Payer: ASR ASR |
$3,055.50
|
| Rate for Payer: ASR Commercial |
$3,055.50
|
| Rate for Payer: BCBS Complete |
$1,260.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,579.54
|
| Rate for Payer: BCN Commercial |
$2,442.20
|
| 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 |
$3,150.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,055.50
|
| 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: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: 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 |
$2,047.50 |
| 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: ASR Commercial |
$3,055.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,566.94
|
| Rate for Payer: BCN Commercial |
$2,442.20
|
| 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 |
$3,150.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,055.50
|
| 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: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,772.00
|
|
|
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 |
$2,592.20 |
| 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: ASR Commercial |
$3,868.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,249.82
|
| Rate for Payer: BCN Commercial |
$3,091.90
|
| 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 |
$3,988.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,868.36
|
| 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: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.44
|
|
|
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 |
$1,595.20 |
| Max. Negotiated Rate |
$3,988.00 |
| Rate for Payer: Aetna Commercial |
$3,589.20
|
| Rate for Payer: Aetna Medicare |
$1,994.00
|
| Rate for Payer: ASR ASR |
$3,868.36
|
| Rate for Payer: ASR Commercial |
$3,868.36
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.77
|
| Rate for Payer: BCN Commercial |
$3,091.90
|
| 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 |
$3,988.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,868.36
|
| 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: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: 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 46
|
Facility
|
IP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,003.00 |
| 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: ASR Commercial |
$4,481.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,764.84
|
| Rate for Payer: BCN Commercial |
$3,581.89
|
| 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 |
$4,620.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,481.40
|
| 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: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,065.60
|
|
|
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 |
$1,848.00 |
| Max. Negotiated Rate |
$4,620.00 |
| Rate for Payer: Aetna Commercial |
$4,158.00
|
| Rate for Payer: Aetna Medicare |
$2,310.00
|
| Rate for Payer: ASR ASR |
$4,481.40
|
| Rate for Payer: ASR Commercial |
$4,481.40
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,783.32
|
| Rate for Payer: BCN Commercial |
$3,581.89
|
| 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 |
$4,620.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,481.40
|
| 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: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: 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 47
|
Facility
|
IP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,112.20 |
| 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: ASR Commercial |
$4,644.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,901.74
|
| Rate for Payer: BCN Commercial |
$3,712.14
|
| 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 |
$4,788.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,644.36
|
| 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: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,213.44
|
|
|
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 |
$1,915.20 |
| Max. Negotiated Rate |
$4,788.00 |
| Rate for Payer: Aetna Commercial |
$4,309.20
|
| Rate for Payer: Aetna Medicare |
$2,394.00
|
| Rate for Payer: ASR ASR |
$4,644.36
|
| Rate for Payer: ASR Commercial |
$4,644.36
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,920.89
|
| Rate for Payer: BCN Commercial |
$3,712.14
|
| 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 |
$4,788.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,644.36
|
| 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: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: 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 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 |
$447.60 |
| Max. Negotiated Rate |
$1,119.00 |
| Rate for Payer: Aetna Commercial |
$1,007.10
|
| Rate for Payer: Aetna Medicare |
$559.50
|
| Rate for Payer: ASR ASR |
$1,085.43
|
| Rate for Payer: ASR Commercial |
$1,085.43
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS Trust/PPO |
$916.35
|
| Rate for Payer: BCN Commercial |
$867.56
|
| 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 |
$1,119.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.43
|
| 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: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: 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 |
$727.35 |
| 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: ASR Commercial |
$1,085.43
|
| Rate for Payer: BCBS Trust/PPO |
$911.87
|
| Rate for Payer: BCN Commercial |
$867.56
|
| 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 |
$1,119.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.43
|
| 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: Priority Health Cigna Priority Health |
$727.35
|
| 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 |
$537.00 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$1,208.25
|
| Rate for Payer: Aetna Medicare |
$671.25
|
| Rate for Payer: ASR ASR |
$1,302.22
|
| Rate for Payer: ASR Commercial |
$1,302.22
|
| Rate for Payer: BCBS Complete |
$537.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.37
|
| Rate for Payer: BCN Commercial |
$1,040.84
|
| 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 |
$1,342.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.22
|
| 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: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: 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 |
$872.62 |
| 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: ASR Commercial |
$1,302.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.00
|
| Rate for Payer: BCN Commercial |
$1,040.84
|
| 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 |
$1,342.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.22
|
| 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: Priority Health Cigna Priority Health |
$872.62
|
| 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 |
$999.38 |
| 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: ASR Commercial |
$1,491.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.91
|
| Rate for Payer: BCN Commercial |
$1,192.02
|
| 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 |
$1,537.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.38
|
| 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: Priority Health Cigna Priority Health |
$999.38
|
| 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 |
$615.00 |
| Max. Negotiated Rate |
$1,537.50 |
| Rate for Payer: Aetna Commercial |
$1,383.75
|
| Rate for Payer: Aetna Medicare |
$768.75
|
| Rate for Payer: ASR ASR |
$1,491.38
|
| Rate for Payer: ASR Commercial |
$1,491.38
|
| Rate for Payer: BCBS Complete |
$615.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.06
|
| Rate for Payer: BCN Commercial |
$1,192.02
|
| 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 |
$1,537.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.38
|
| 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: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: 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 |
$2,437.50 |
| 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: ASR Commercial |
$3,637.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,055.88
|
| Rate for Payer: BCN Commercial |
$2,907.38
|
| 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 |
$3,750.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,637.50
|
| 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: Priority Health Cigna Priority Health |
$2,437.50
|
| 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 |
$1,500.00 |
| Max. Negotiated Rate |
$3,750.00 |
| Rate for Payer: Aetna Commercial |
$3,375.00
|
| Rate for Payer: Aetna Medicare |
$1,875.00
|
| Rate for Payer: ASR ASR |
$3,637.50
|
| Rate for Payer: ASR Commercial |
$3,637.50
|
| Rate for Payer: BCBS Complete |
$1,500.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,070.88
|
| Rate for Payer: BCN Commercial |
$2,907.38
|
| 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 |
$3,750.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,637.50
|
| 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: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: 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 |
$175.44 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: Aetna Medicare |
$219.30
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Complete |
$175.44
|
| Rate for Payer: BCBS Trust/PPO |
$359.17
|
| Rate for Payer: BCN Commercial |
$340.05
|
| 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 |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| 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: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: 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 |
$285.09 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Trust/PPO |
$357.42
|
| Rate for Payer: BCN Commercial |
$340.05
|
| 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 |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| 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: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,625.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$2,250.00
|
| Rate for Payer: ASR ASR |
$2,425.00
|
| Rate for Payer: ASR Commercial |
$2,425.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.25
|
| Rate for Payer: BCN Commercial |
$1,938.25
|
| 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 |
$2,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,425.00
|
| Rate for Payer: Mclaren Commercial |
$2,250.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: Nomi Health Commercial |
$2,050.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,200.00
|
|
|
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 |
$1,000.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$2,250.00
|
| Rate for Payer: Aetna Medicare |
$1,250.00
|
| Rate for Payer: ASR ASR |
$2,425.00
|
| Rate for Payer: ASR Commercial |
$2,425.00
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.25
|
| Rate for Payer: BCN Commercial |
$1,938.25
|
| 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 |
$2,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,425.00
|
| Rate for Payer: Mclaren Commercial |
$2,250.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: Nomi Health Commercial |
$2,050.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: 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
|
|
