|
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 |
$801.37 |
| 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: ASR Commercial |
$1,195.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.67
|
| Rate for Payer: BCN Commercial |
$955.84
|
| 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 |
$1,232.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,195.88
|
| 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: Priority Health Cigna Priority Health |
$801.37
|
| 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 |
$1,866.34 |
| 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: ASR Commercial |
$2,785.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,339.82
|
| Rate for Payer: BCN Commercial |
$2,226.12
|
| 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 |
$2,871.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,785.16
|
| Rate for Payer: Mclaren Commercial |
$2,584.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.60
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.34
|
| 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 |
$1,148.52 |
| Max. Negotiated Rate |
$2,871.30 |
| Rate for Payer: Aetna Commercial |
$2,584.17
|
| Rate for Payer: Aetna Medicare |
$1,435.65
|
| Rate for Payer: ASR ASR |
$2,785.16
|
| Rate for Payer: ASR Commercial |
$2,785.16
|
| Rate for Payer: BCBS Complete |
$1,148.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,351.31
|
| Rate for Payer: BCN Commercial |
$2,226.12
|
| 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 |
$2,871.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,785.16
|
| Rate for Payer: Mclaren Commercial |
$2,584.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.60
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.34
|
| Rate for Payer: 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
|
OP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,305.60 |
| Max. Negotiated Rate |
$3,264.00 |
| Rate for Payer: Aetna Commercial |
$2,937.60
|
| Rate for Payer: Aetna Medicare |
$1,632.00
|
| Rate for Payer: ASR ASR |
$3,166.08
|
| Rate for Payer: ASR Commercial |
$3,166.08
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.89
|
| Rate for Payer: BCN Commercial |
$2,530.58
|
| 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 |
$3,264.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,166.08
|
| 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: Priority Health Cigna Priority Health |
$2,121.60
|
| Rate for Payer: 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 32
|
Facility
|
IP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,121.60 |
| 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: ASR Commercial |
$3,166.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,659.83
|
| Rate for Payer: BCN Commercial |
$2,530.58
|
| 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 |
$3,264.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,166.08
|
| 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: Priority Health Cigna Priority Health |
$2,121.60
|
| 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 |
$275.40 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: Aetna Medicare |
$344.25
|
| Rate for Payer: ASR ASR |
$667.84
|
| Rate for Payer: ASR Commercial |
$667.84
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$563.81
|
| Rate for Payer: BCN Commercial |
$533.79
|
| 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 |
$688.50
|
| Rate for Payer: Healthscope Whirlpool |
$667.84
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.22
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: 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 |
$447.52 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: ASR ASR |
$667.84
|
| Rate for Payer: ASR Commercial |
$667.84
|
| Rate for Payer: BCBS Trust/PPO |
$561.06
|
| Rate for Payer: BCN Commercial |
$533.79
|
| 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 |
$688.50
|
| Rate for Payer: Healthscope Whirlpool |
$667.84
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.22
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
OP
|
$4,792.38
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,916.95 |
| Max. Negotiated Rate |
$4,792.38 |
| Rate for Payer: Aetna Commercial |
$4,313.14
|
| Rate for Payer: Aetna Medicare |
$2,396.19
|
| Rate for Payer: ASR ASR |
$4,648.61
|
| Rate for Payer: ASR Commercial |
$4,648.61
|
| Rate for Payer: BCBS Complete |
$1,916.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,924.48
|
| Rate for Payer: BCN Commercial |
$3,715.53
|
| Rate for Payer: Cash Price |
$3,833.90
|
| Rate for Payer: Cofinity Commercial |
$4,504.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,833.90
|
| Rate for Payer: Healthscope Commercial |
$4,792.38
|
| Rate for Payer: Healthscope Whirlpool |
$4,648.61
|
| Rate for Payer: Mclaren Commercial |
$4,313.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,073.52
|
| Rate for Payer: Nomi Health Commercial |
$3,929.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,199.08
|
| Rate for Payer: Priority Health Narrow Network |
$3,359.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,217.29
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
IP
|
$4,792.38
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,115.05 |
| Max. Negotiated Rate |
$4,792.38 |
| Rate for Payer: Aetna Commercial |
$4,313.14
|
| Rate for Payer: ASR ASR |
$4,648.61
|
| Rate for Payer: ASR Commercial |
$4,648.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,905.31
|
| Rate for Payer: BCN Commercial |
$3,715.53
|
| Rate for Payer: Cash Price |
$3,833.90
|
| Rate for Payer: Cofinity Commercial |
$4,504.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,833.90
|
| Rate for Payer: Healthscope Commercial |
$4,792.38
|
| Rate for Payer: Healthscope Whirlpool |
$4,648.61
|
| Rate for Payer: Mclaren Commercial |
$4,313.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,073.52
|
| Rate for Payer: Nomi Health Commercial |
$3,929.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,217.29
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
OP
|
$266.93
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.77 |
| Max. Negotiated Rate |
$266.93 |
| Rate for Payer: Aetna Commercial |
$240.24
|
| Rate for Payer: Aetna Medicare |
$133.46
|
| Rate for Payer: ASR ASR |
$258.92
|
| Rate for Payer: ASR Commercial |
$258.92
|
| Rate for Payer: BCBS Complete |
$106.77
|
| Rate for Payer: BCBS Trust/PPO |
$218.59
|
| Rate for Payer: BCN Commercial |
$206.95
|
| Rate for Payer: Cash Price |
$213.54
|
| Rate for Payer: Cofinity Commercial |
$250.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.54
|
| Rate for Payer: Healthscope Commercial |
$266.93
|
| Rate for Payer: Healthscope Whirlpool |
$258.92
|
| Rate for Payer: Mclaren Commercial |
$240.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.89
|
| Rate for Payer: Nomi Health Commercial |
$218.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.88
|
| Rate for Payer: Priority Health Narrow Network |
$187.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.90
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
IP
|
$266.93
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.50 |
| Max. Negotiated Rate |
$266.93 |
| Rate for Payer: Aetna Commercial |
$240.24
|
| Rate for Payer: ASR ASR |
$258.92
|
| Rate for Payer: ASR Commercial |
$258.92
|
| Rate for Payer: BCBS Trust/PPO |
$217.52
|
| Rate for Payer: BCN Commercial |
$206.95
|
| Rate for Payer: Cash Price |
$213.54
|
| Rate for Payer: Cofinity Commercial |
$250.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.54
|
| Rate for Payer: Healthscope Commercial |
$266.93
|
| Rate for Payer: Healthscope Whirlpool |
$258.92
|
| Rate for Payer: Mclaren Commercial |
$240.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.89
|
| Rate for Payer: Nomi Health Commercial |
$218.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.90
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
OP
|
$27,014.28
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,984.98 |
| Max. Negotiated Rate |
$27,014.28 |
| Rate for Payer: Aetna Commercial |
$24,312.85
|
| Rate for Payer: Aetna Medicare |
$7,434.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,293.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,293.34
|
| Rate for Payer: ASR ASR |
$26,203.85
|
| Rate for Payer: ASR Commercial |
$26,203.85
|
| Rate for Payer: BCBS Complete |
$4,184.23
|
| Rate for Payer: BCBS MAPPO |
$7,434.67
|
| Rate for Payer: BCBS Trust/PPO |
$22,121.99
|
| Rate for Payer: BCN Commercial |
$20,944.17
|
| Rate for Payer: BCN Medicare Advantage |
$7,434.67
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cofinity Commercial |
$25,393.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,611.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,434.67
|
| Rate for Payer: Healthscope Commercial |
$27,014.28
|
| Rate for Payer: Healthscope Whirlpool |
$26,203.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,434.67
|
| Rate for Payer: Mclaren Commercial |
$24,312.85
|
| Rate for Payer: Mclaren Medicaid |
$3,984.98
|
| Rate for Payer: Mclaren Medicare |
$7,434.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,806.40
|
| Rate for Payer: Meridian Medicaid |
$4,184.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,549.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,962.14
|
| Rate for Payer: Nomi Health Commercial |
$22,151.71
|
| Rate for Payer: PACE Medicare |
$7,062.94
|
| Rate for Payer: PACE SWMI |
$7,434.67
|
| Rate for Payer: PHP Commercial |
$8,178.14
|
| Rate for Payer: PHP Medicaid |
$3,984.98
|
| Rate for Payer: PHP Medicare Advantage |
$7,434.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,984.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,559.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,669.91
|
| Rate for Payer: Priority Health Medicare |
$7,434.67
|
| Rate for Payer: Priority Health Narrow Network |
$18,937.01
|
| Rate for Payer: Railroad Medicare Medicare |
$7,434.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,772.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,434.67
|
| Rate for Payer: UHC Exchange |
$11,523.74
|
| Rate for Payer: UHC Medicare Advantage |
$7,434.67
|
| Rate for Payer: UHCCP DNSP |
$7,434.67
|
| Rate for Payer: UHCCP Medicaid |
$3,984.98
|
| Rate for Payer: VA VA |
$7,434.67
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
IP
|
$27,014.28
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,559.28 |
| Max. Negotiated Rate |
$27,014.28 |
| Rate for Payer: Aetna Commercial |
$24,312.85
|
| Rate for Payer: ASR ASR |
$26,203.85
|
| Rate for Payer: ASR Commercial |
$26,203.85
|
| Rate for Payer: BCBS Trust/PPO |
$22,013.94
|
| Rate for Payer: BCN Commercial |
$20,944.17
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cofinity Commercial |
$25,393.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,611.42
|
| Rate for Payer: Healthscope Commercial |
$27,014.28
|
| Rate for Payer: Healthscope Whirlpool |
$26,203.85
|
| Rate for Payer: Mclaren Commercial |
$24,312.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,962.14
|
| Rate for Payer: Nomi Health Commercial |
$22,151.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,559.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,772.57
|
|
|
HC ELM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ELM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ELVAREX CHAP STYLE ONE LEG
|
Facility
|
IP
|
$584.55
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000368
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$379.96 |
| Max. Negotiated Rate |
$584.55 |
| Rate for Payer: Aetna Commercial |
$526.10
|
| Rate for Payer: ASR ASR |
$567.01
|
| Rate for Payer: ASR Commercial |
$567.01
|
| Rate for Payer: BCBS Trust/PPO |
$476.35
|
| Rate for Payer: BCN Commercial |
$453.20
|
| Rate for Payer: Cash Price |
$467.64
|
| Rate for Payer: Cofinity Commercial |
$549.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.64
|
| Rate for Payer: Healthscope Commercial |
$584.55
|
| Rate for Payer: Healthscope Whirlpool |
$567.01
|
| Rate for Payer: Mclaren Commercial |
$526.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.87
|
| Rate for Payer: Nomi Health Commercial |
$479.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.40
|
|
|
HC ELVAREX CHAP STYLE ONE LEG
|
Facility
|
OP
|
$584.55
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000368
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$233.82 |
| Max. Negotiated Rate |
$584.55 |
| Rate for Payer: Aetna Commercial |
$526.10
|
| Rate for Payer: Aetna Medicare |
$292.28
|
| Rate for Payer: ASR ASR |
$567.01
|
| Rate for Payer: ASR Commercial |
$567.01
|
| Rate for Payer: BCBS Complete |
$233.82
|
| Rate for Payer: BCBS Trust/PPO |
$478.69
|
| Rate for Payer: BCN Commercial |
$453.20
|
| Rate for Payer: Cash Price |
$467.64
|
| Rate for Payer: Cofinity Commercial |
$549.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.64
|
| Rate for Payer: Healthscope Commercial |
$584.55
|
| Rate for Payer: Healthscope Whirlpool |
$567.01
|
| Rate for Payer: Mclaren Commercial |
$526.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.87
|
| Rate for Payer: Nomi Health Commercial |
$479.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$512.18
|
| Rate for Payer: Priority Health Narrow Network |
$409.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.40
|
|
|
HC ELVAREX CHAP STYLE TWO LEG
|
Facility
|
IP
|
$1,169.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000369
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$759.90 |
| Max. Negotiated Rate |
$1,169.07 |
| Rate for Payer: Aetna Commercial |
$1,052.16
|
| Rate for Payer: ASR ASR |
$1,134.00
|
| Rate for Payer: ASR Commercial |
$1,134.00
|
| Rate for Payer: BCBS Trust/PPO |
$952.68
|
| Rate for Payer: BCN Commercial |
$906.38
|
| Rate for Payer: Cash Price |
$935.26
|
| Rate for Payer: Cofinity Commercial |
$1,098.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.26
|
| Rate for Payer: Healthscope Commercial |
$1,169.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,134.00
|
| Rate for Payer: Mclaren Commercial |
$1,052.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.71
|
| Rate for Payer: Nomi Health Commercial |
$958.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,028.78
|
|
|
HC ELVAREX CHAP STYLE TWO LEG
|
Facility
|
OP
|
$1,169.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000369
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$467.63 |
| Max. Negotiated Rate |
$1,169.07 |
| Rate for Payer: Aetna Commercial |
$1,052.16
|
| Rate for Payer: Aetna Medicare |
$584.54
|
| Rate for Payer: ASR ASR |
$1,134.00
|
| Rate for Payer: ASR Commercial |
$1,134.00
|
| Rate for Payer: BCBS Complete |
$467.63
|
| Rate for Payer: BCBS Trust/PPO |
$957.35
|
| Rate for Payer: BCN Commercial |
$906.38
|
| Rate for Payer: Cash Price |
$935.26
|
| Rate for Payer: Cofinity Commercial |
$1,098.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.26
|
| Rate for Payer: Healthscope Commercial |
$1,169.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,134.00
|
| Rate for Payer: Mclaren Commercial |
$1,052.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.71
|
| Rate for Payer: Nomi Health Commercial |
$958.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,024.34
|
| Rate for Payer: Priority Health Narrow Network |
$819.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,028.78
|
|
|
HC ELVAREX KNEE SLANT OPEN TOE
|
Facility
|
IP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$186.47 |
| Max. Negotiated Rate |
$286.88 |
| Rate for Payer: Aetna Commercial |
$258.19
|
| Rate for Payer: ASR ASR |
$278.27
|
| Rate for Payer: ASR Commercial |
$278.27
|
| Rate for Payer: BCBS Trust/PPO |
$233.78
|
| Rate for Payer: BCN Commercial |
$222.42
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$269.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Healthscope Commercial |
$286.88
|
| Rate for Payer: Healthscope Whirlpool |
$278.27
|
| Rate for Payer: Mclaren Commercial |
$258.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.45
|
|
|
HC ELVAREX KNEE SLANT OPEN TOE
|
Facility
|
OP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.75 |
| Max. Negotiated Rate |
$286.88 |
| Rate for Payer: Aetna Commercial |
$258.19
|
| Rate for Payer: Aetna Medicare |
$143.44
|
| Rate for Payer: ASR ASR |
$278.27
|
| Rate for Payer: ASR Commercial |
$278.27
|
| Rate for Payer: BCBS Complete |
$114.75
|
| Rate for Payer: BCBS Trust/PPO |
$234.93
|
| Rate for Payer: BCN Commercial |
$222.42
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$269.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Healthscope Commercial |
$286.88
|
| Rate for Payer: Healthscope Whirlpool |
$278.27
|
| Rate for Payer: Mclaren Commercial |
$258.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.36
|
| Rate for Payer: Priority Health Narrow Network |
$201.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.45
|
|
|
HC ELVAREX SLEEVE
|
Facility
|
IP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000365
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$165.48 |
| Max. Negotiated Rate |
$254.59 |
| Rate for Payer: Aetna Commercial |
$229.13
|
| Rate for Payer: ASR ASR |
$246.95
|
| Rate for Payer: ASR Commercial |
$246.95
|
| Rate for Payer: BCBS Trust/PPO |
$207.47
|
| Rate for Payer: BCN Commercial |
$197.38
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$254.59
|
| Rate for Payer: Healthscope Whirlpool |
$246.95
|
| Rate for Payer: Mclaren Commercial |
$229.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.04
|
|
|
HC ELVAREX SLEEVE
|
Facility
|
OP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000365
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.84 |
| Max. Negotiated Rate |
$254.59 |
| Rate for Payer: Aetna Commercial |
$229.13
|
| Rate for Payer: Aetna Medicare |
$127.30
|
| Rate for Payer: ASR ASR |
$246.95
|
| Rate for Payer: ASR Commercial |
$246.95
|
| Rate for Payer: BCBS Complete |
$101.84
|
| Rate for Payer: BCBS Trust/PPO |
$208.48
|
| Rate for Payer: BCN Commercial |
$197.38
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$254.59
|
| Rate for Payer: Healthscope Whirlpool |
$246.95
|
| Rate for Payer: Mclaren Commercial |
$229.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.07
|
| Rate for Payer: Priority Health Narrow Network |
$178.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.04
|
|
|
HC ELVAREX SOFT ARMSLEEVE
|
Facility
|
IP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$165.48 |
| Max. Negotiated Rate |
$254.59 |
| Rate for Payer: Aetna Commercial |
$229.13
|
| Rate for Payer: ASR ASR |
$246.95
|
| Rate for Payer: ASR Commercial |
$246.95
|
| Rate for Payer: BCBS Trust/PPO |
$207.47
|
| Rate for Payer: BCN Commercial |
$197.38
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$254.59
|
| Rate for Payer: Healthscope Whirlpool |
$246.95
|
| Rate for Payer: Mclaren Commercial |
$229.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.04
|
|
|
HC ELVAREX SOFT ARMSLEEVE
|
Facility
|
OP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.84 |
| Max. Negotiated Rate |
$254.59 |
| Rate for Payer: Aetna Commercial |
$229.13
|
| Rate for Payer: Aetna Medicare |
$127.30
|
| Rate for Payer: ASR ASR |
$246.95
|
| Rate for Payer: ASR Commercial |
$246.95
|
| Rate for Payer: BCBS Complete |
$101.84
|
| Rate for Payer: BCBS Trust/PPO |
$208.48
|
| Rate for Payer: BCN Commercial |
$197.38
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$254.59
|
| Rate for Payer: Healthscope Whirlpool |
$246.95
|
| Rate for Payer: Mclaren Commercial |
$229.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.07
|
| Rate for Payer: Priority Health Narrow Network |
$178.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.04
|
|
