|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,676.41 |
| Max. Negotiated Rate |
$5,656.01 |
| Rate for Payer: Aetna Commercial |
$5,090.41
|
| Rate for Payer: ASR ASR |
$5,486.33
|
| Rate for Payer: ASR Commercial |
$5,486.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,609.08
|
| Rate for Payer: BCN Commercial |
$4,385.10
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$5,316.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Healthscope Commercial |
$5,656.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,486.33
|
| Rate for Payer: Mclaren Commercial |
$5,090.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: Nomi Health Commercial |
$4,637.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,977.29
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,262.40 |
| Max. Negotiated Rate |
$5,656.01 |
| Rate for Payer: Aetna Commercial |
$5,090.41
|
| Rate for Payer: Aetna Medicare |
$2,828.01
|
| Rate for Payer: ASR ASR |
$5,486.33
|
| Rate for Payer: ASR Commercial |
$5,486.33
|
| Rate for Payer: BCBS Complete |
$2,262.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,631.71
|
| Rate for Payer: BCN Commercial |
$4,385.10
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$5,316.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Healthscope Commercial |
$5,656.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,486.33
|
| Rate for Payer: Mclaren Commercial |
$5,090.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: Nomi Health Commercial |
$4,637.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,955.80
|
| Rate for Payer: Priority Health Narrow Network |
$3,964.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,977.29
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$2,046.45 |
| Rate for Payer: Aetna Commercial |
$1,841.81
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,985.06
|
| Rate for Payer: ASR Commercial |
$1,985.06
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,675.84
|
| Rate for Payer: BCN Commercial |
$1,586.61
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,923.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$2,046.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,985.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,841.81
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: Nomi Health Commercial |
$1,678.09
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.10
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,434.56
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,800.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,330.19 |
| Max. Negotiated Rate |
$2,046.45 |
| Rate for Payer: Aetna Commercial |
$1,841.81
|
| Rate for Payer: ASR ASR |
$1,985.06
|
| Rate for Payer: ASR Commercial |
$1,985.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,667.65
|
| Rate for Payer: BCN Commercial |
$1,586.61
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,923.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Healthscope Commercial |
$2,046.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,985.06
|
| Rate for Payer: Mclaren Commercial |
$1,841.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: Nomi Health Commercial |
$1,678.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,800.88
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$517.08 |
| Max. Negotiated Rate |
$795.50 |
| Rate for Payer: Aetna Commercial |
$715.95
|
| Rate for Payer: ASR ASR |
$771.63
|
| Rate for Payer: ASR Commercial |
$771.63
|
| Rate for Payer: BCBS Trust/PPO |
$648.25
|
| Rate for Payer: BCN Commercial |
$616.75
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$747.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Healthscope Commercial |
$795.50
|
| Rate for Payer: Healthscope Whirlpool |
$771.63
|
| Rate for Payer: Mclaren Commercial |
$715.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.17
|
| Rate for Payer: Nomi Health Commercial |
$652.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.04
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$795.50 |
| Rate for Payer: Aetna Commercial |
$715.95
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$771.63
|
| Rate for Payer: ASR Commercial |
$771.63
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$651.43
|
| Rate for Payer: BCN Commercial |
$616.75
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$747.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$795.50
|
| Rate for Payer: Healthscope Whirlpool |
$771.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$715.95
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.17
|
| Rate for Payer: Nomi Health Commercial |
$652.31
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$697.02
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$557.65
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$17,143.36 |
| Rate for Payer: Aetna Commercial |
$15,104.04
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$16,278.80
|
| Rate for Payer: ASR Commercial |
$16,278.80
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$13,743.00
|
| Rate for Payer: BCN Commercial |
$13,011.29
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$15,775.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$16,782.27
|
| Rate for Payer: Healthscope Whirlpool |
$16,278.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$15,104.04
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: Nomi Health Commercial |
$13,761.46
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,704.62
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$11,764.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,768.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,908.48 |
| Max. Negotiated Rate |
$16,782.27 |
| Rate for Payer: Aetna Commercial |
$15,104.04
|
| Rate for Payer: ASR ASR |
$16,278.80
|
| Rate for Payer: ASR Commercial |
$16,278.80
|
| Rate for Payer: BCBS Trust/PPO |
$13,675.87
|
| Rate for Payer: BCN Commercial |
$13,011.29
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$15,775.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Healthscope Commercial |
$16,782.27
|
| Rate for Payer: Healthscope Whirlpool |
$16,278.80
|
| Rate for Payer: Mclaren Commercial |
$15,104.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: Nomi Health Commercial |
$13,761.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,768.40
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$27,144.89 |
| Rate for Payer: Aetna Commercial |
$16,547.72
|
| Rate for Payer: Aetna Medicare |
$17,512.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: ASR ASR |
$17,834.76
|
| Rate for Payer: ASR Commercial |
$17,834.76
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCBS Trust/PPO |
$15,056.58
|
| Rate for Payer: BCN Commercial |
$14,254.94
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$17,283.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$18,386.35
|
| Rate for Payer: Healthscope Whirlpool |
$17,834.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,512.83
|
| Rate for Payer: Mclaren Commercial |
$16,547.72
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: Nomi Health Commercial |
$15,076.81
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$19,264.11
|
| Rate for Payer: PHP Medicaid |
$9,386.88
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,110.12
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health Narrow Network |
$12,888.83
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,179.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$27,144.89
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP DNSP |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,951.13 |
| Max. Negotiated Rate |
$18,386.35 |
| Rate for Payer: Aetna Commercial |
$16,547.72
|
| Rate for Payer: ASR ASR |
$17,834.76
|
| Rate for Payer: ASR Commercial |
$17,834.76
|
| Rate for Payer: BCBS Trust/PPO |
$14,983.04
|
| Rate for Payer: BCN Commercial |
$14,254.94
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$17,283.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Healthscope Commercial |
$18,386.35
|
| Rate for Payer: Healthscope Whirlpool |
$17,834.76
|
| Rate for Payer: Mclaren Commercial |
$16,547.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: Nomi Health Commercial |
$15,076.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,179.99
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
IP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,958.65 |
| Max. Negotiated Rate |
$7,628.69 |
| Rate for Payer: Aetna Commercial |
$6,865.82
|
| Rate for Payer: ASR ASR |
$7,399.83
|
| Rate for Payer: ASR Commercial |
$7,399.83
|
| Rate for Payer: BCBS Trust/PPO |
$6,216.62
|
| Rate for Payer: BCN Commercial |
$5,914.52
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$7,170.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Healthscope Commercial |
$7,628.69
|
| Rate for Payer: Healthscope Whirlpool |
$7,399.83
|
| Rate for Payer: Mclaren Commercial |
$6,865.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: Nomi Health Commercial |
$6,255.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,713.25
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
OP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,051.48 |
| Max. Negotiated Rate |
$7,628.69 |
| Rate for Payer: Aetna Commercial |
$6,865.82
|
| Rate for Payer: Aetna Medicare |
$3,814.34
|
| Rate for Payer: ASR ASR |
$7,399.83
|
| Rate for Payer: ASR Commercial |
$7,399.83
|
| Rate for Payer: BCBS Complete |
$3,051.48
|
| Rate for Payer: BCBS Trust/PPO |
$6,247.13
|
| Rate for Payer: BCN Commercial |
$5,914.52
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$7,170.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Healthscope Commercial |
$7,628.69
|
| Rate for Payer: Healthscope Whirlpool |
$7,399.83
|
| Rate for Payer: Mclaren Commercial |
$6,865.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: Nomi Health Commercial |
$6,255.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,684.26
|
| Rate for Payer: Priority Health Narrow Network |
$5,347.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,713.25
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$749.70 |
| Max. Negotiated Rate |
$1,874.25 |
| Rate for Payer: Aetna Commercial |
$1,686.83
|
| Rate for Payer: Aetna Medicare |
$937.12
|
| Rate for Payer: ASR ASR |
$1,818.02
|
| Rate for Payer: ASR Commercial |
$1,818.02
|
| Rate for Payer: BCBS Complete |
$749.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,534.82
|
| Rate for Payer: BCN Commercial |
$1,453.11
|
| 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 |
$1,874.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.02
|
| 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: Priority Health Cigna Priority Health |
$1,218.26
|
| Rate for Payer: 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 |
$1,218.26 |
| 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: ASR Commercial |
$1,818.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.33
|
| Rate for Payer: BCN Commercial |
$1,453.11
|
| 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 |
$1,874.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.02
|
| 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: Priority Health Cigna Priority Health |
$1,218.26
|
| 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 |
$64.26 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$144.59
|
| Rate for Payer: Aetna Medicare |
$80.33
|
| Rate for Payer: ASR ASR |
$155.83
|
| Rate for Payer: ASR Commercial |
$155.83
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS Trust/PPO |
$131.56
|
| Rate for Payer: BCN Commercial |
$124.55
|
| 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 |
$160.65
|
| Rate for Payer: Healthscope Whirlpool |
$155.83
|
| 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: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: 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 |
$104.42 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$144.59
|
| Rate for Payer: ASR ASR |
$155.83
|
| Rate for Payer: ASR Commercial |
$155.83
|
| Rate for Payer: BCBS Trust/PPO |
$130.91
|
| Rate for Payer: BCN Commercial |
$124.55
|
| 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 |
$160.65
|
| Rate for Payer: Healthscope Whirlpool |
$155.83
|
| 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: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.37
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.27 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.75
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: ASR Commercial |
$467.49
|
| Rate for Payer: BCBS Trust/PPO |
$392.74
|
| Rate for Payer: BCN Commercial |
$373.66
|
| 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 |
$481.95
|
| Rate for Payer: Healthscope Whirlpool |
$467.49
|
| 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: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.12
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.78 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.75
|
| Rate for Payer: Aetna Medicare |
$240.97
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: ASR Commercial |
$467.49
|
| Rate for Payer: BCBS Complete |
$192.78
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$373.66
|
| 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 |
$481.95
|
| Rate for Payer: Healthscope Whirlpool |
$467.49
|
| 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: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: 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 LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,538.49 |
| 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: ASR Commercial |
$2,295.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.79
|
| Rate for Payer: BCN Commercial |
$1,835.07
|
| 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 |
$2,366.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,295.90
|
| 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: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.88
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$946.76 |
| Max. Negotiated Rate |
$2,366.91 |
| Rate for Payer: Aetna Commercial |
$2,130.22
|
| Rate for Payer: Aetna Medicare |
$1,183.45
|
| Rate for Payer: ASR ASR |
$2,295.90
|
| Rate for Payer: ASR Commercial |
$2,295.90
|
| Rate for Payer: BCBS Complete |
$946.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.26
|
| Rate for Payer: BCN Commercial |
$1,835.07
|
| 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 |
$2,366.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,295.90
|
| 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: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: 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 FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$17,260.72 |
| Rate for Payer: Aetna Commercial |
$15,534.65
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$16,742.90
|
| Rate for Payer: ASR Commercial |
$16,742.90
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$14,134.80
|
| Rate for Payer: BCN Commercial |
$13,382.24
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$16,225.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$17,260.72
|
| Rate for Payer: Healthscope Whirlpool |
$16,742.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$15,534.65
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,123.84
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$12,099.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,189.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,219.47 |
| Max. Negotiated Rate |
$17,260.72 |
| Rate for Payer: Aetna Commercial |
$15,534.65
|
| Rate for Payer: ASR ASR |
$16,742.90
|
| Rate for Payer: ASR Commercial |
$16,742.90
|
| Rate for Payer: BCBS Trust/PPO |
$14,065.76
|
| Rate for Payer: BCN Commercial |
$13,382.24
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$16,225.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Healthscope Commercial |
$17,260.72
|
| Rate for Payer: Healthscope Whirlpool |
$16,742.90
|
| Rate for Payer: Mclaren Commercial |
$15,534.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,189.43
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,415.31 |
| Max. Negotiated Rate |
$17,143.36 |
| Rate for Payer: Aetna Commercial |
$4,728.89
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$5,096.69
|
| Rate for Payer: ASR Commercial |
$5,096.69
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,302.76
|
| Rate for Payer: BCN Commercial |
$4,073.67
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,939.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$5,254.32
|
| Rate for Payer: Healthscope Whirlpool |
$5,096.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$4,728.89
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,603.84
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,683.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,415.31 |
| Max. Negotiated Rate |
$5,254.32 |
| Rate for Payer: Aetna Commercial |
$4,728.89
|
| Rate for Payer: ASR ASR |
$5,096.69
|
| Rate for Payer: ASR Commercial |
$5,096.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,281.75
|
| Rate for Payer: BCN Commercial |
$4,073.67
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,939.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Healthscope Commercial |
$5,254.32
|
| Rate for Payer: Healthscope Whirlpool |
$5,096.69
|
| Rate for Payer: Mclaren Commercial |
$4,728.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,623.80
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.69 |
| Max. Negotiated Rate |
$428.76 |
| Rate for Payer: Aetna Commercial |
$385.88
|
| Rate for Payer: ASR ASR |
$415.90
|
| Rate for Payer: ASR Commercial |
$415.90
|
| Rate for Payer: BCBS Trust/PPO |
$349.40
|
| Rate for Payer: BCN Commercial |
$332.42
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$403.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$428.76
|
| Rate for Payer: Healthscope Whirlpool |
$415.90
|
| Rate for Payer: Mclaren Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.31
|
|
